Interprofessional Health Care Research Articles

Using IPEC pedagogy to transform the future rural advanced practice nursing workforce

Objective: The number of primary care providers has not kept pace with the increasing number of underserved rural populations placing unprecedented demands on the healthcare system and the gap is expected to widen with shortages projected to increase across the United States. Given the urgent need to grow and expand the number of trained diverse primary care providers in rural communities, an innovative sustainable program was implemented to recruit and train diverse rural advanced practice nurses. Building on the successful rural medical and rural pharmacy educational programs at the UIC Health Sciences Campus in Rockford, a rural nursing program with interprofessional curriculum was designed and refined to enable nursing students along with two other professions to develop appreciation, insight, and knowledge of rural healthcare and health disparities in a variety of rural settings as part of an interprofessional team.Methods: A mixed-methods program evaluation approach utilized both quantitative and qualitative data to evaluate program satisfaction and inform ongoing program refinement.Results: Students indicated positive responses to this interprofessional course of study. Continued development and refinement of the curriculum is planned to train the future rural healthcare workforce.Conclusions: Students from three health sciences colleges benefitted from the IPEC program with confirmed satisfaction in interprofessional rural education and collaborative practice. The addition of a rural nursing program merits continuation with modification and expansion to prepare the future rural interprofessional healthcare workforce.

Value of Interprofessional Education: The VA Quality Scholars Program.

Interprofessional collaboration (IPC) has been shown to improve healthcare quality and patient safety; however, formal interprofessional education (IPE) training is insufficient. The VA Quality Scholars (VAQS) program exists to develop interprofessional leaders and scholars in healthcare improvement. The purpose of this study was to examine the impact of integrating interprofessional healthcare learners and designing an interprofessional curriculum for the national VAQS program. VAQS alumni (graduates from 2001 to 2017) across eight national sites (n = 102 [53.1%]) completed a web-based survey to assess alumni perceptions of IPC skill development during the program and IPC skill utilization in their careers. Alumni from 2009 and earlier were physicians; alumni after 2009 came from diverse health professional backgrounds. Overall, IPC and teamwork was identified as the most used skill (n = 82, 70%) during their career. When comparing the pre-IPE period and the post-IPE period, post-IPE alumni identified IPC and teamwork as the area of greatest skill development (n = 38). Integrating interprofessional trainees and robust IPE curricula enhanced an established and successful quality improvement (QI) training program. VAQS alumni endorsed the importance of IPC skills during their careers. The VAQS program is an example of how health professionals can successfully learn IPC skills in healthcare QI.

An experiential learning collaborative on quality improvement for interprofessional learners

ABSTRACT Growing evidence supports the need to teach future healthcare practitioners the fundamentals of quality improvement (QI), but curricula rarely include opportunities to apply QI principles or develop relevant teamwork skills. We initiated a program in 2017 called QUEST to engage our learners in interprofessional health care improvement through a 7-month learning collaborative. QUEST pairs learners with mentors in clinical QI teams and provides structured content, tasks, and feedback. The model is intentionally experiential, intended to use existing expertise and opportunities in the clinical learning environment to support QI training. Three cohorts of health professions learners have completed QUEST (n = 45), resulting in 27 unique quality improvement projects and poster presentations. QI knowledge, as measured by the QIKAT-R, increased from 5.48 to 6.34 on a 9-point scale (p = .01). Teamwork readiness also improved: ISVS-9B scores increased from 5.25 to 6.23 on a 7-point scale (p < .01). Feedback has been positive with participants noting the unique learning opportunity, benefit to learner professional development, and enjoyment found in working across professions. QUEST continues to grow each year. Ongoing modifications are addressing mentor development and curricular standardization.

Effects of a Chronic Pain Simulation Empathy Training Kit on the Empathy of Interprofessional Healthcare Students for Chronic Pain Patients

ObjectiveTo evaluate changes in empathy for pharmacy, nursing, and health sciences students after the use of a Chronic Pain Simulation Empathy Training Kit (CPSETKit). MethodsThe apparatuses contained in the CPSETKit simulated chronic pain from several disease states. With kit devices applied, participants completed ten Activities of Daily Living (ADLs). The Jefferson Scale of Empathy-Health Professions Scale (JSE-HPS) and the Kiersma-Chen Empathy Scale (KCES) were used to measure empathy pre-/post-kit use. ResultsScores from the empathy scales indicate the use of this kit significantly increased the empathy (p values <.00001) of the 182 student study participants. ConclusionConclusion: The use of the CPSETKit increased empathy for chronic pain patients in health care students. Further research may determine whether the use of the kit improves patient outcomes.

Interprofessional Healthcare Students' Attitudes, Skills, and Knowledge After Comprehensive Pain Assessment Training in Verbal and Nonverbal Patients.

A comprehensive pain assessment is the first step in safe, effective pain management. Few studies have explored variations of strategies and measures for multidimensional pain assessment education in both verbal and nonverbal patients. In this retrospective cohort study, interprofessional health care students enrolled in a palliative care curriculum completed a pain assessment training, which taught the PQRSTA ("palliating factors, precipitating factors, previous treatments, quality, region, radiation, severity, temporal factors and associated symptoms") mnemonic as a strategy for assessing pain in verbal patients and the Pain Assessment in Advance Dementia and Checklist of Nonverbal Pain Indicators measures for nonverbal patients. The purpose of this study was to compare the change in attitudes, self-perceived skills, and knowledge regarding pain assessment before and after the training. Attitudes and self-perceived skills were assessed in the pretraining and posttraining survey, which was analyzed using χ2 test or Fisher exact test. Students' knowledge responses were analyzed using Wilcoxon signed rank test to assess accuracy of responses compared with the expert defined score. One hundred eighty-two students were included. Results showed a statistically significant improvement in attitudes related to applicability of pain measures and self-perceived skills. Overall, data did not support an increase in knowledge using the PQRSTA mnemonic, or Pain Assessment in Advance Dementia and Checklist of Nonverbal Pain Indicators measures. Future pain trainings should consider training on only 1 nonverbal pain measure, incorporating bedside assessments, and integrating real-time feedback.

Using the AHEC Scholars Program to Enhance Health Professions Learners' Self-Efficacy for Practice Transformation.

The Indiana Area Health Education Centers Scholars program is a 2-year leadership program designed to supplement health professions students' academic training and enhance practice readiness around 6 core topic areas including practice transformation. The study was a retrospective cohort study assessing learners' reported level of self-efficacy on a set of 6 competencies around practice transformation and quality improvement. A total of 68 students graduating in the first cohort responded to the competency questions. Area Health Education Center Scholars reported a significant increase in self-efficacy on the competencies Identify issues emerging in health care delivery such as accountable care organizations, medical homes, and health insurance exchanges; understand how to practice effectively within the organization and culture of the interprofessional team, practice setting, and local health care system, and use an electronic health record to retrieve relevant information and to document care. This study found that learners reported a significant increase in self-efficacy related to implementing practiced transformation.

Interprofessional Healthcare Student Perceptions of Clinical vs. Simulation Learning Through Participation in Underserved Health Clinics.

PurposeThe purpose of this research project is to determine how well three health profession student discipline’s learning needs are met through a real clinical interprofessional environment compared to previous simulation experience by assessing student perceptions following participation in a student-run underserved healthcare setting.MethodsVarious student-run health clinics were initiated throughout Southwest Ohio in underserved settings precepted by healthcare profession faculty. Physician assistant, pharmacy, and medical student learning needs and interprofessional perceptions were assessed following clinic participation utilizing the Clinical Learning Environment Comparison Survey (CLECS) and qualitative comment to allow objectification of students’ perceptions to different clinical learning environments and the interprofessional setting.ResultsThe survey had responses from medical, pharmacy, and physician assistant students (n = 60). Overall, students preferred traditional learning environments compared to previous simulated clinical experiences (p < .01). Significance for communication, holism, and the teaching-learning dyad was demonstrated comparing the traditional clinical experience to the simulated experience (p < .05). Pharmacy students felt their critical thinking skills were more significantly improved after the simulated environment (p < .05). Males more significantly favored teaching-learning dyad simulation vs. the traditional environment (F = 5.86, p < .05). Qualitative comments regarding the interprofessional experience included themes of teamwork, patient communication, and clinical skills.ConclusionWhen comparing a traditional clinical experience in an interprofessional student-run clinic vs. previous simulated learning clinical environment, physician assistant, pharmacy, and medical students qualitatively and quantitatively perceive their learning needs are greater met in the volunteer student-run clinic for communication, holism, and the teaching-learning dyad. There were variations in preferences based on sex and discipline of the student.

Peer support by interprofessional health care providers in aftermath of patient safety incidents: A cross-sectional study.

To investigate the health care professionals' preferences pertaining to support in the aftermath of patient safety incidents and potential variation thereof depending on the degree of harm. Peer support systems are available to support health care professionals in the aftermath of patient safety incidents. It is unclear which type of support is best offered by whom. A cross-sectional study in 32 Dutch hospitals. In total, 2,362 nurses and 1,404 doctors indicated they were involved in patient safety incidents at any time during their career (86%). Less than 10% of health care providers had spoken with professional support, and less than 20% admitted a need to do so. They used different support. A higher degree of harm related to higher odds of desiring support. Respondents mainly wanted to understand what happened and how it can be prevented. The desired support of health care professionals in the aftermath of patient safety incidents depends on the level of harm. Health care professionals seem to mostly rely on persons they are close with, and they mainly desire information related to the aftermath of patient safety incidents. This should be taken into account when support programmes are set up.

Professional Development of Interprofessional Evidence-Based Practice Education.

Health care professionals must be adept at conducting and using evidence-based practice (EBP). No best method to teach EBP to health care providers exists. This article outlines the steps and key points found to be important when developing and teaching EBP to interprofessional executive health care teams. [J Contin Educ Nurs. 2021;52(5):214-216.].

Development of a community outreach project: An interprofessional partnership for thalassemia families guided by nursing students

Children with chronic illnesses have improved physiological and psychosocial outcomes when they are able to identify and converse with others who experience the same challenges. Support groups are one way to enhance this interaction. To facilitate this process, student nurses worked with an interprofessional healthcare team, thalassemia patients, and their families to determine their support needs. The purpose of this article is to describe the innovative development and outcomes of the Thalassemia Patient Support Project, a community engagement partnership. This partnership provided a unique educational clinical experience for nursing students where they had an opportunity to help develop a support group and a pediatric to adult transitional care program. The outcomes could be used as a guide for community nursing education, in US and international settings.

Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway

BackgroundHealthcare providers need training to implement shared decision making (SDM). In Norway, we developed “Ready for SDM”, a comprehensive SDM curriculum tailored to various healthcare providers, settings, and competence levels, including a course targeting interprofessional healthcare teams. The overall aim was to evaluate a train-the-trainer (TTT) program for healthcare providers wanting to offer this course within their hospital trust.MethodsOur observational descriptive design was informed by Kirkpatrick´s Model of Educational Outcomes. The South-Eastern Regional Health Authority invited healthcare providers from all health trusts in its jurisdiction to attend. The TTT consisted of a one-day basic course with lectures on SDM, exercises and group reflections followed by a two-day advanced course including an SDM observer training. Immediately after each of the two courses, reaction and learning (Kirkpatrick levels 1 and 2) were assessed using a self-administered questionnaire. After the advanced course, observer skills were operationalized as accuracy of the participants’ assessment of a consultation compared to an expert assessment. Within three months post-training, we measured number of trainings conducted and number of healthcare providers trained (Kirkpatrick level 3) using an online survey. Qualitative and quantitative descriptive analysis were performed.ResultsTwenty-one out of 24 (basic) and 19 out of 22 (advanced) healthcare providers in 9 health trusts consented to participate. The basic course was evaluated as highly acceptable, the advanced course as complex and challenging. Participants identified a need for more training in pedagogical skills and support for planning implementation of SDM-training. Participants achieved high knowledge scores and were positive about being an SDM trainer. Observer skills regarding patient involvement in decision-making were excellent (mean of weighted t = .80). After three months, 67% of TTT participants had conducted more than two trainings each and trained a total of 458 healthcare providers.ConclusionFindings suggest that the TTT is a feasible approach for supporting large-scale training in SDM. Our study informed us about how to improve the advanced course. Further research shall investigate the efficacy of the training in the context of a comprehensive multifaceted strategy for implementing SDM in clinical practice.Trial registration: Retrospectively registered at ISRCTN (99432465) March 25, 2020.

Interprofessional dynamics that promote client empowerment in mental health practice: A social work perspective

Summary Interprofessional practice has been broadly endorsed as a strategy which supports the delivery of high-quality health services. Few studies have addressed the dynamics inherent to interprofessional mental health practice in an era in which client empowerment is prioritised and valued. Social work perspectives are also underexplored in the studies which have been published on interprofessional health care, despite the increasingly important role of this discipline in community mental health contexts. Through a thematic analysis of 26 semi-structured interviews, this study explored the perspectives of mental health social workers located in two geographically and culturally distinctive sites (Hong Kong and Sydney), and identified a strong theme encompassing their concerns about the facilitation of client empowerment in interprofessional settings. Findings Participant accounts direct attention to the strategies required to co-constitute the shared territories of the different mental health professions. Findings also highlight the frustration with recent mental health reforms which aim to challenge power differentials in interprofessional decision-making. Strategies were proposed for supporting the construction of shared language among different professions, revealing the creativity and insight of practitioners in managing the conflicts arising from interactions between different professional knowledge systems. The comparison of Hong Kong and Sydney accounts highlights the importance of structural, political and cultural influences in supporting not only interprofessional collaboration but also the independence and effectiveness of distinct professional roles. Application This article provides unique insights which aim to strengthen the contribution of social work to interprofessional practice in the promotion of empowerment-oriented interprofessional practice and education.

Assessing oral health literacy of university nursing students: A cross-sectional exploratory study

AimResearch has proven a link between oral health and numerous chronic systemic diseases. To achieve better health outcomes, there is a need to involve interprofessional primary health care providers, such as nurses to raise awareness and promote oral health. Nurses have regular contact with patients which provides a unique opportunity to impart disease-specific information and technical skills for patients to self-manage their oral health conditions. However, the baseline oral health literacy of undergraduate nursing students at the University of Sydney is not known. Before creating a targeted curriculum to improve oral health literacy amongst nursing students, it is essential to assess the baseline oral health knowledge of these students. This study aimed to assess the oral health literacy level among undergraduate nursing students of the University of Sydney, Australia. DesignAn exploratory research approach was used. MethodsA cross-sectional survey study was conducted using the validated Comprehensive Measure of Oral Health Knowledge (CMOHK) instrument. A univariate general linear model was used to explore the association of CMOHK total score with demographic and educational variables. ResultsA total number of 197 nursing students participated in the survey, with a mean CMOHK score of 15.48, SD 3.27. 72% were categorized as having good, 16% fair and 12% poor oral health knowledge. The analysis from the six individual knowledge domains of the CMOHK revealed lower percentages of correct responses in the periodontal disease and oral cancer knowledge domains. Students with English as their second language, on average, scored 2 fewer correct responses (p <.001) than students whose first language was English. Low socioeconomic status was not associated with a low level of oral health literacy. ConclusionThe baseline results show a good level of general oral health knowledge as measured by the CMOHK. However, periodontal disease and oral cancer were identified as the particular domains where a knowledge gap exists. These findings may help to map and design an oral health education intervention to improve oral health literacy amongst nursing students. Culturally responsive pedagogy may need to be considered for students with English as their second language. This baseline survey data may potentially facilitate integrating oral health in nursing education and practice.

Nursing in Albania: A Catalytic Force in Transforming Health Professionals and Health Care.

Transitions in nursing education and professionalism that align with global nursing standards are elucidated as critical success factors in transforming health professionals and health care in Albania. Progressive educational and regulatory pathways throughout the 2000s (1999-2020) are emphasized for their impact on the Albanian health system, including the achievement of universal healthcare coverage. Data collected by the Ministry of Health and Sport and the Regulatory Authority for nursing and other healthcare professions in Albania were analyzed and outcomes explicated with regard to Albania's major health challenges. Three milestones affirmed nursing as a driving force in the Albanian healthcare system: (a) nurses constitute the largest health professional workforce via a nurse-patient ratio of 1:400 in contrast to a physician-patient ratio of 1:2,500; (b) nurses are frontline care providers via clinical leadership in the management of primary healthcare centers, which ensure universal healthcare coverage; and (c) nurses are first responders via their presence and compassionate caring in the primary healthcare centers, including making critical shifts in converting primary healthcare centers to urgent care centers as needed. Nursing advancements have implicated quality care and professionalism in Albania across the health professions via three critical pathways: (a) health professional education at a university degree level for entry into practice (since 1999), which was prompted by and driven by nursing's quest to be a self-regulated profession (achieved in 2007); (b) healthcare global standards sparked by nursing's mandate toward professional autonomy, as achieved via regulatory procedures and policies; and (c) interprofessional healthcare initiatives that serve as collaborative platforms for innovative educational, clinical, and research projects.

Interprofessional education and collaborative practice in Kuwait: attitudes and perceptions of health sciences students

ABSTRACT Interprofessional education (IPE) prepares health students to become collaboration-ready healthcare professionals. Assessing students’ baseline attitudes toward IPE and collaborative practice is essential to inform development of IPE curricula. Kuwait University Health Sciences Center (HSC) is early in its IPE journey but is planning to join the broader global movement toward IPE. A cross-sectional survey was conducted to explore the attitudes of HSC students from Faculties of Medicine, Dentistry, Pharmacy, and Allied Health Sciences toward collaborative practice and IPE at early and late stages of study. A total of 770 students completed the survey (81.1% response rate). Students expressed positive attitudes toward interprofessional healthcare teams and IPE (median [IQR] overall attitudes were rated 4.0 [1.0] and 4.0 [2.0], respectively, on a scale of 5). Overall attitudes toward both scales were significantly more positive among pharmacy students than students from other faculties (p < .001). Final-year students reported more positive attitudes toward healthcare teams than early- and middle-year students, while early- and final-year students expressed more positive attitudes toward IPE than middle-year students (p < .001). There were no significant differences in overall attitudes between female and male students toward the two scales (p > .05). These findings have implications for engaging students from different professions in IPE initiatives.

Advancing team cohesion: Using an escape room as a novel approach

Objective An escape room was used to study teamwork and its determinants, which have been found to relate to the quality and safety of patient care delivery. This pilot study aimed to explore the value of an escape room as a mechanism for improving cohesion among interdisciplinary healthcare teams. Methods This research was conducted at a nonprofit medical center in Southern California. All participants who work on a team were invited to participate. Authors employed an interrupted within-subjects design, with two pre- and post-escape room questionnaires related to two facets of group cohesion: (belonging – (PGC-B) and morale (PGC-M)). Participants rated their perceptions of group cohesion before, after, and one-month after the escape room. The main outcome measures included PGC-B/M. Results Sixty-two teams participated (n = 280 participants) of which 31 teams (50%) successfully “escaped” in the allotted 45 minutes. There was a statistically significant difference in PGC between the three time periods, F(4, 254) = 24.10, p &lt; .001; Wilks’ Λ = .725; partial η2 = .275. Results indicated significantly higher scores for PGC immediately after the escape room and at the one-month follow-up compared to baseline. Conclusions This work offers insights into the utility of using an escape room as a team building intervention in interprofessional healthcare teams. Considering the modifiability of escape rooms, they may function as valuable team building mechanisms in healthcare. More work is needed to determine how escape rooms compare to more traditional team building curriculums.

The wolf you feed: Challenging intraprofessional workplace-based education norms.

ContextThe trajectory towards becoming a medical professional is strongly situated within the clinical workplace. Through participatory engagement, medical trainees learn to address complex health care issues through collaboration with the interprofessional health care team. To help explain learning and teaching dynamics within the clinical workplace, many scholars have relied on socio‐cultural learning theories. In the field of medical education, this research has largely adopted a limited interpretation of a crucial dimension within socio‐cultural learning theory: the expert who guides the trainee into the community is almost exclusively from the same profession. We contend that this narrow interpretation is not necessary. This limited focus is one we choose to maintain—be that choice intentional or implicit. In this cross‐cutting edge paper, we argue that choosing an interprofessional orientation towards workplace learning and guidance may better prepare medical trainees for their future role in health care practice.MethodsBy applying Communities of Practice and Landscapes of Practice , and supported by empirical examples, we demonstrate how medical trainees are not solely on a trajectory towards the Community of Physician Practice (CoPP) but also on a trajectory towards various Landscapes of Healthcare Practice (LoHCP). We discuss some of the barriers present within health care organisations and professions that have likely inhibited adoption of the broader LoHCP perspective. We suggest three perspectives that might help to deliberately and meaningfully incorporate the interprofessional learning and teaching dynamic within the medical education continuum.ConclusionSystematically incorporating Landscapes of Competence, Assessment, and Guidance in workplace‐based education—in addition to our current intraprofessional approach—can better prepare medical trainees for their roles within the LoHCP. By advocating and researching this interprofessional perspective, we can embark on a journey towards fully harnessing and empowering the health care team within workplace‐based education.

The strategic development and strengthening of the profession of biokinetics

Continuous planning for the future of any profession is wise. The profession of biokinetics has made remarkable advances since the 1980s. However, new opportunities for development need to be embarked on. This short commentary explores three such areas: training and education; entry into the South African public healthcare system; and interprofessional healthcare collaboration. The intention is to encourage the Biokinetics Association of South Africa and biokineticists to work together to attain these goals, thereby strengthening the profession.

Validity of Chinese Version of Attitudes Toward Interprofessional Health Care Teams Scale.

ObjectiveEffective teamwork can provide safe and effective care in various medical systems. Thus, there is increasing recognition of the value of interprofessional collaborative practice. The Attitudes Toward Interprofessional Health Care Teams Scale (ATIHCTS) has been applied to a wide variety of health professions for evaluating attitudes toward health care teams. The ATIHCTS has been widely used internationally, but no Chinese version has been developed. The aim of this study was to adapt a Chinese version of the ATIHCTS among Chinese health care professionals and to test its validity.MethodsThe English version of the ATIHCTS was translated into Chinese, back-translated, and modified for cultural adaptation according to Brislin’s guideline. A total of 306 health professionals in a Shanghai tertiary hospital were investigated using the Chinese version of the ATIHCTS to test its validity.ResultsThe Chinese version of the ATIHCTS was adjusted based on expert review and pilot testing. According to expert opinions, the text that did not conform to the Chinese language habits and the Chinese medical environment was adjusted. A total of five adjustments were made. After the pilot testing, minor corrections were made to improve the sentence structure of the scale instructions to make it easier to understand. Factor analysis was subsequently conducted with 306 respondents. The Chinese version of the ATIHCTS had 14 items. Exploratory factor analysis extracted two common factors, quality of care and time constraints, with the cumulative variance contribution rate reaching 70.011% and the load value of each entry on its common factor > 0.4. In addition, for scale confirmatory factor analysis (CFA), the chi-square/degrees of freedom ratio (X2/df) was 1.46, the normed fit index (NFI) was 0.97, the Tucker-Lewis index (TLI) was 0.99, the incremental fit index (IFI) was 0.99, the comparative fit index (CFI) was 0.99, and the root mean square error of approximation (RMSEA) was 0.04. The fitting values all met the judgment criteria, and the scale had good structural validity. Cronbach’s α of the Chinese version of the ATIHCTS was 0.861, and the Cronbach’s α values of each factor were 0.949 and 0.838, respectively. The split-half reliability was 0.644, and the Guttman split-half coefficients of each factor were 0.904 and 0.779, respectively.ConclusionThe Chinese version of the ATIHCTS has good validity. It is a valuable tool for evaluating attitudes toward interprofessional health care teams among the health care professionals in China.

Interprofessional Education on Pain and Opioid Use Meets Team-based Learning Needs

An urgent need exists to improve care for patients who seek opioids for pain relief. Targeting education towards a diverse interprofessional health care team is one approach to ensure all team members communicate effectively and understand evidence-based opioid prescribing practices and policies. The purpose of this session is to (1) share outcomes from an interprofessional education (IPE) program developed for health science students and rural clinics to address stigmatization and gaps in pain and opioid use education; and (2) demonstrate how nurses can lead an interactive IPE program for all members of the health care team.