Interprofessional Learning Outcomes Research Articles

Interprofessional simulation of acute care for nursing and medical students: interprofessional competencies and transfer to the workplace

BackgroundTeamwork and communication are essential tools for doctors, nurses and other team members in the management of critically ill patients. Early interprofessional education during study, using acute care simulation, may improve teamwork and communication between interprofessional team members on the long run.MethodsA comparative sequential quantitative–qualitative study was used to understand interprofessional learning outcomes in nursing and medical students after simulation of acute care. Students were assigned to a uni- or interprofessional training. Questionnaires were used to measure short and long term differences in interprofessional collaboration and communication between the intervention and control group for nursing and medical students respectively. Semi-structured focus groups were conducted to gain a better understanding of IPE in acute simulation.ResultsOne hundred and ninety-one students participated in this study (131 medical, 60 nursing students). No differences were found between the intervention and control group in overall ICCAS scores for both medical and nursing students (p = 0.181 and p = 0.441). There were no differences in ICS scores between the intervention and control group. Focus groups revealed growing competence in interprofessional communication and collaboration for both medical and nursing students.ConclusionsInterprofessional simulation training did show measurable growth of interprofessional competencies, but so did uniprofessional training. Both medical and nursing students reported increased awareness of perspective and expertise of own and other profession. Furthermore, they reported growing competence in interprofessional communication and collaboration in transfer to their workplace.

“Digital interprofessional learning (IPL) for health and social care students in a rural area. Teachers' and students' experiences with digital IPL”

There was a need to implement full-scale interprofessional learning (IPL) across health and social educational programmes in a rural area. We wanted to explore how digital tools could be a means to allow student coalitions to collaborate interprofessionally across campuses. A qualitative method with a phenomenological hermeneutical approach was used. The study shows that thorough planning is important for implementing sustainable IPL in the programmes. The facilitators' role ought to be clear. When IPL can be carried out digitally, opportunities are more accessible, and students' interprofessional collaborative competences can be improved. Digital IPL was successful in rural areas. Digital IPL was less time consuming than physical meetings and provided the opportunity to include students from other campuses. The planning and organization of digital IPL and facilitators' roles influence students' IPL outcomes. A stable facilitator group is preferred.

31 Debriefing strategies for inter-professional simulation

Inter-professional education is becoming more common worldwide and simulation is one way in which this can effectively take place A literature search (see Figure 1) was performed to prompt discussion around debriefing after inter-professional simulation (IPS) and identify the challenges that this IPS debriefing poses and some potential strategies to overcome these. Gaps in the research were also identified. The papers included were analysed by the authors and key themes were identified.The results of the literature search included 20 papers from 2013 to 2019. Four themes relevant to inter-professional debriefing identified during analysis were: ‘The Debriefer’, ‘Method of Debriefing’, ‘The Learner’ and ‘Psychological Safety’. Several challenges around debriefing after IPS have been identified in the literature, including larger groups of debriefers; inter-professional and larger learner groups; multiple debrief tools and psychological safety including hierarchy issues. Potential strategies to overcome them include an inter-professional debriefing team; a lead debriefer; and learner-centred debriefs with a clear structure. Gaps in the research include challenges around having more than one debriefer including around the psychological safety of participants; whether we should be using the same debriefing tools/practices in IPS as well as other forms of simulation; ensuring a balance between inter-professional learning outcomes and individual learner needs; and the effect of hierarchy in debriefing after IPS.Multiple gaps in the research were identified and there is a need for further research in this area to improve our understanding. Identifying firm answers or rules to follow for every debrief is unlikely to be useful, but a framework to consider the challenges and strategies to overcome them may benefit educators in this area.

Comparing evaluation responses of an interprofessional education initiative with students in undergraduate nursing and medical programmes

BackgroundInterprofessional education initiatives can be used as effective means to influence students' perceptions of their own and others' roles and interactions as health professionals. There is a need to better understand how interprofessional education learning outcomes are appreciated by students. AimThe aims of this study were to describe and compare evaluation feedback from students in undergraduate nursing and medicine programmes about the learning outcomes of an interprofessional education initiative. MethodsA mixed methods pre-post-study design was used to collect data using evaluation questions about the initiative and two interprofessional learning outcomes: communication and teamwork. Ratings were analysed with a two-way repeated measures analysis of variance or a t-test. Written responses were analysed using a general inductive approach. ResultsData from 30 nursing students and 12 medical students were analysed. A noteworthy finding was a significantly higher average rating for nursing students than medicine students before and after the session for the statement about valuing interprofessional learning. Three themes represented comments from both groups: positive experiences, relevance to practice, and learning design issues. DiscussionFindings were interpreted to indicate that students from both programmes valued the learning outcomes session and was greater at the end of the session. Notably, the perceived value of interprofessional learning was higher for nursing students than medical students before and after the session. This finding may be related to the familiarity nursing students may have with the teaching methods used in the initiative. Further exploration of this finding is needed so educators can better understand how they can provide optimal learning experiences for all students who participate in interprofessional education. ConclusionNursing and medicine students appear to value the interprofessional learning outcomes in an undergraduate health professional initiative. However, differences between these two groups of students are an area for further exploration.

Does collective efficacy drive readiness for interprofessional learning? Evidence from a large-scale interprofessional education program in Hong Kong

ABSTRACT Interprofessional education has been widely integrated into health education curricula to enable students to work comfortably as members of a healthcare team. However, not much is known about the psychosocial mechanism that defines students’ readiness for interprofessional learning. Drawing from social cognitive theory, we examined the pathway where collective efficacy was construed to influence subsequent students’ satisfaction with team experiences, readiness for interprofessional learning, and attainment of interprofessional learning outcomes. Through path analysis, we examined data from 1,005 health and social care students who participated in a large-scale interprofessional education in Hong Kong. Results indicated that collective efficacy directly and indirectly predicted students’ readiness for interprofessional learning and perception of attainment of IPE learning outcomes. Theoretical and practical implications of findings in the management of interprofessional education are discussed.

Development of Interprofessional Learning Outcomes for Health Professions at Charité - Universitätsmedizin Berlin - A Delphi-Study

The impact of interprofessional (IP) collaboration on patient-centered care is constantly increasing. Health professional students need to be prepared for interprofessional collaboration in the workplace. The Charité - Universitätsmedizin Berlin aims to establish a common understanding of interprofessionalism in order to further develop interprofessional education. The aim of this study was to develop a framework with IP learning outcomes for the local context. IP training goals were developed and validated in a systematic, 2-step process. First, a working group (n=12) developed a draft of IP outcomes using the nominal group technique. This draft was validated with a Delphi study in 2 rounds with IP faculty members and students (n=17). A framework of IP learning outcomes was developed and validated. It included an introductory text and 4 competency domains. Each domain defined a title, a description and operationalized learning outcomes for the areas of knowledge, skills and attitude. The framework resulting from the development and validation of IP learning outcomes at the Charité - Universitätsmedizin Berlin can be used as a basis for the coordinated implementation of IPE at the faculty. This framework may serve other faculties as a basis for their own development of interprofessional education.

WHIRL Study: Workplace Health Interprofessional Learning in the Construction Industry.

Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL (Workplace Health InteRprofessional Learning) was an innovative IPL intervention that engaged volunteer healthcare trainees (n = 20) in multi-professional teams to deliver health checks (n = 464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette-Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees’ interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in the attainment of health check competencies and bridged the gap between research, education and clinical practice.

Development of a scale for measuring physician attitudes toward interprofessional education and collaboration

ABSTRACT Interest has been increasing in interprofessional education and collaboration (IPEC) within health professional schools over the last two decades. Although a growing body of literature addresses the effects of IPEC on healthcare outcomes, psychometrically sound attitudinal instruments that measure concepts surrounding IPEC are still needed. The primary objective of this study was to develop a scale to measure the attitudes of attending physicians and residents toward IPEC. Based on a literature review, a set of questionnaire items was drafted to address all six domains outlined in a World Health Organization report for interprofessional learning outcomes. These domains are teamwork and collaboration, roles and responsibilities, communication, reflection and learning, the patient, and ethics and attitudes. A total of 379 physicians and trainees completed the questionnaire. A principal axis factoring with orthogonal varimax rotation of 20 items produced a 5-factor solution explaining 60% of the variance. Examination of the items in each factor led to the following labels: ‘teamwork and communication,’ ‘ethics and attitudes,’ ‘roles and responsibilities,’ ‘reflective practice,’ and ‘patient-centered care.’ A Generalized Linear Model provided initial evidence that the new scale might detect shifts in attitudes related to some of the emergent factors.

'Bumping along': a qualitative metasynthesis of challenges to interprofessional placements.

Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage-process-product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice-ready workforce. This in turn will enhance service user outcomes and safety.

A review of interprofessional training wards: Enhancing student learning and patient outcomes

Background: In an interprofessional training ward (ITW), students from different health professions collaboratively perform patient care with the goal of improving patient care. In the past two decades, ITWs have been established world-wide and studies have investigated their benefits. We aimed to compare ITWs with respect to their logistics, interprofessional learning outcomes and patient outcomes.Methods: We explored PubMed, CINAHL, Web of Science and EMBASE (1990–June 2017) and included articles focusing on interprofessional, in-patient training wards with student teams of medical and other health professions students. Two independent reviewers screened studies for eligibility and extracted data.Results: Thirty-seven articles from twelve different institutions with ITWs were included. ITWs world-wide are organized similarly with groups of 2–12 students (i.e. medical, nursing, physiotherapy, occupational therapy, and pharmacy) being involved in patient care, usually for a period of two weeks. However, the type of clinical ward and the way supervisors are trained differ.Conclusions: ITWs show promising results in short-term student learning outcomes and patient satisfaction rates. Future ITW studies should measure students’ long-term interprofessional competencies using standardized tools. Furthermore, a research focus on the impact of ITWs on patient satisfaction and relevant patient care outcomes is important.

Impact of an interprofessional population health course and clinical immersion experience: Students and practice outcomes

Abstract The purpose of this paper is to describe the impact of an interprofessional (IP) population health course and accompanying clinical immersion experience. Outcomes related to IP learning, team-based communication, and clinical practice outcomes are discussed. Graduate students in medicine, nursing, pharmacy, public health and social work participated in a blended learning didactic course followed by a clinical immersion experience in primacy care. Students worked in interprofessional teams to complete a needs assessment, and design and implement quality improvement projects with primary care partners. Student assessment included evaluation of teamwork and collaboration and reflective practice. Overall impact of the course was measured by course outcomes, the impact of the quality improvement project at the practice site, and clinical satisfaction working with the student teams. This model demonstrates a clear need to continue to develop educational curricula aimed at building collaborations between health professionals and communities to provide care to populations that is cost effective and quality and outcomes based.

Defining a set of common interprofessional learning competencies for health profession students

Introduction: Increasingly recognized as a core component of contemporary health profession education, interprofessional learning outcomes remain difficult to define and assess across disciplines. The aim of this study was to identify a single set of interprofessional learning competency statements with relevance to all health professions.Methods and results: Six national and international interprofessional competency frameworks were reviewed and combined to give a total of 165 competency statements. Following a process of mapping and grouping these statements into common content areas, duplicate content was removed. In addition, content deemed as a core competency for one or more individual health professions was removed. A round table of experts reviewed the remaining statements and agreed a final set of eight. Each statement was expressed as a specific learning outcome that could be assessed and which described behaviors and practices that students could routinely expect to engage with, and participate in, during the course of their study.Conclusion: Identifying specific interprofessional competencies that students of all health professions require will enable more effective implementation of interprofessional learning activities and assessment within the core curriculum.

International consensus statement on the assessment of interprofessional learning outcomes

Regulatory frameworks around the world mandate that health and social care professional education programs graduate practitioners who have the competence and capability to practice effectively in interprofessional collaborative teams. Academic institutions are responding by offering interprofessional education (IPE); however, there is as yet no consensus regarding optimal strategies for the assessment of interprofessional learning (IPL). The Program Committee for the 17th Ottawa Conference in Perth, Australia in March, 2016, invited IPE champions to debate and discuss the current status of the assessment of IPL. A draft statement from this workshop was further discussed at the global All Together Better Health VIII conference in Oxford, UK in September, 2016. The outcomes of these deliberations and a final round of electronic consultation informed the work of a core group of international IPE leaders to develop this document. The consensus statement we present here is the result of the synthesized views of experts and global colleagues. It outlines the challenges and difficulties but endorses a set of desired learning outcome categories and methods of assessment that can be adapted to individual contexts and resources. The points of consensus focus on pre-qualification (pre-licensure) health professional students but may be transferable into post-qualification arenas.

Faculty development in interprofessional education (IPE): Reflections from an IPE coordinator

Abstract Objectives Faculty development in interprofessional education (IPE) and interprofessional collaboration (IPC) is an important component enabling the cultural shift towards this new mode of education and practice. Most published studies describing interprofessional faculty development focus on facilitating interprofessional groups of learners without consideration of the much larger role that faculty can play as interprofessional ambassadors. This paper aims to describe strategies that fostered interprofessional faculty development within the University of Manitoba IPE Initiative (the Initiative) between 2008 and 2015, highlight exemplars that were implemented and evaluated, and offer reflections from the IPE coordinator. Methods Three overarching strategies fostered interprofessional faculty development within the Initiative: developing interprofessional ambassadors through leadership training; using an adoption model framework that explicitly identified interprofessional faculty development as one key micro-component; and actualizing partnerships within and between academia, practitioners and the government. Results Interprofessional faculty development opportunities for non-practice- and practice-based faculty are described, and evaluation results are presented. The strategies were aligned with most, if not all, of the seven previously published recommended approaches to interprofessional faculty development. Based on the number of participants and evaluation results, the interprofessional faculty development opportunities offered through the Initiative were effective in raising faculty awareness of IPE and IPC and improving perceived interprofessional facilitation skills. Conclusion Upon reflection, the Initiative's interprofessional faculty development undertakings were reactive as opposed to strategic. Future recommendations include reaching consensus on a broad definition of faculty development, adopting a theoretical framework to guide the stated learning outcomes, and developing observation-based assessment strategies to measure the achievement of interprofessional learning outcomes.

Twelve tips for structuring student placements to achieve interprofessional learning outcomes

This article was migrated. The article was marked as recommended. Background: Increasingly, universities are being asked to provide evidence of interprofessional learning within their health and human services programs. Given the authentic nature of the placement setting, this component of curricula is well suited to provide students with these interprofessional learning experiences. Aims: To describe twelve tips for structuring student placements to achieve interprofessional learning outcomes. Methods: Development of these 12 tips was based on knowledge and experience drawn from the literature, focus groups and workshop with experts within the field, together with the authors' own experiences over many years of teaching in multidisciplinary and interprofessional contexts. Results and conclusions: The tips provide direction and clarity for universities and placement sites to facilitate authentic learning in practice based settings. In particular, they describe the ways in which placements can be structured to maximise opportunities for students to achieve specific interprofessional competencies. They are underpinned by the principle that interprofessional learning should be a core component of all healthcare placements and that student learning occurs through participation in routine work activity in addition to structured learning activities.

Using complexity theory to develop a student-directed interprofessional learning activity for 1220 healthcare students.

BackgroundMore and better interprofessional practice is predicated to be necessary to deliver good care to the patients of the future. However, universities struggle to create authentic learning activities that enable students to experience the dynamic interprofessional interactions common in healthcare and that can accommodate large interprofessional student cohorts. We investigated a large-scale mandatory interprofessional learning (IPL) activity for health professional students designed to promote social learning.MethodsA mixed methods research approach determined feasibility, acceptability and the extent to which student IPL outcomes were met. We developed an IPL activity founded in complexity theory to prepare students for future practice by engaging them in a self-directed (self-organised) learning activity with a diverse team, whose assessable products would be emergent creations. Complicated but authentic clinical cases (n = 12) were developed to challenge student teams (n = 5 or 6). Assessment consisted of a written management plan (academically marked) and a five-minute video (peer marked) designed to assess creative collaboration as well as provide evidence of integrated collective knowledge; the cohesive patient-centred management plan.ResultsAll students (including the disciplines of diagnostic radiology, exercise physiology, medicine, nursing, occupational therapy, pharmacy, physiotherapy and speech pathology), completed all tasks successfully. Of the 26 % of students who completed the evaluation survey, 70 % agreed or strongly agreed that the IPL activity was worthwhile, and 87 % agreed or strongly agreed that their case study was relevant. Thematic analysis found overarching themes of engagement and collaboration-in-action suggesting that the IPL activity enabled students to achieve the intended learning objectives. Students recognised the contribution of others and described negotiation, collaboration and creation of new collective knowledge after working together on the complicated patient case studies. The novel video assessment was challenging to many students and contextual issues limited engagement for some disciplines.ConclusionsWe demonstrated the feasibility and acceptability of a large scale IPL activity where design of cases, format and assessment tasks was founded in complexity theory. This theoretically based design enabled students to achieve complex IPL outcomes relevant to future practice. Future research could establish the psychometric properties of assessments of student performance in large-scale IPL events.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0717-y) contains supplementary material, which is available to authorized users.

The Use of a Modified Delphi Technique to Inform the Development of Best Practice in Interprofessional Training for Collaborative Primary Healthcare

Background: Primary healthcare (PHC) education and training is directed to a diverse range of health professionals at undergraduate, postgraduate, and professional levels. Increasing emphasis is being placed on PHC professionals working together in delivering better care and improving patient outcomes. This article reports on using a modified Delphi technique to determine the level of consensus on a series of statements across four domains of interprofessional education (IPE) for collaborative practice: big picture, organization, capabilities, teaching, and learning. Methods and Findings: The modified Delphi technique used three Delphi rounds: the first round comprising workshops, interviews, or online survey; the remaining rounds used online surveys. A panel of 56 PHC medical, nursing, allied health, and workforce experts participated. There was consensus on a set of capabilities for interprofessional learning outcomes and on a range of teaching and learning strategies. Areas for further consideration included identifying interprofessional training opportunities through continuing professional development, and tailoring team-based approaches to diverse PHC settings. Conclusion: The modified Delphi technique used in this project demonstrated a successful engagement of a heterogeneous panel of PHC experts. The principles of IPE for collaborative practice and strategies for delivering interprofessional training could apply across various PHC settings.

Using the Freeth/Kirkpatrick model to evaluate interprofessional learning outcomes in a rural setting

Background: Considerable claims have been made for the benefits of interprofessional learning (IPL) despite limited evidence of its long-term effectiveness. A collaboration between the Australian National University and the University of South Australia offered opportunities for senior health professional students to undertake IPL teamwork placements in rural NSW— the Health “Hubs and Spokes” Project . The aim of this study was to evaluate, using mixed methods, the outcomes of an IPL project on all four levels of the Freeth/Kirkpatrick evaluation model. Methods: Students completed a debriefing questionnaire, the Interprofessional Education Perception Scale (IEPS) and the Team Performance Scale (TPS) at the time they undertook IPL placements. A follow-up study measured anticipated professional networks and extent of their interprofessional experience. IPL facilitators, clinical supervisors and local health service representatives were asked to provide their views of perceived project outcomes. Results: Initial evaluation demonstrated positive student reaction (Level 1), attitude change and collaborative skills (Level 2). While the follow-up study failed to show significant changes in the size of expected professional networks, qualitative exploration of transfer of learning to professional practice (Level 3) and impact of IPL placements in rural locations (Level 4) suggest a positive impact on participants and on healthcare delivery. Conclusion: The project generated student satisfaction, changes in attitude and skills, and longer-term positive impacts on the community and possibly on the students’ professional practice. This evaluation model can be used effectively to evaluate outcomes of IPL teamwork placements in rural settings and potentially in other locations.

Student perceptions towards interprofessional education: Findings from a longitudinal study based in a Middle Eastern university

ABSTRACTThe Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students’ perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students’ perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.

Interprofessional education and the basic sciences: Rationale and outcomes.

Interprofessional education (IPE) aims to improve patient outcomes and the quality of care. Interprofessional learning outcomes and interprofessional competencies are now included in many countries' health and social care professions' accreditation standards. While IPE may take place at any time in health professions curricula it tends to focus on professionalism and clinical topics rather than basic science activities. However generic interprofessional competencies could be included in basic science courses that are offered to at least two different professional groups. In developing interprofessional activities at the preclinical level, it is important to define explicit interprofessional learning outcomes plus the content and process of the learning. Interprofessional education must involve interactive learning processes and integration of theory and practice. This paper provides examples of IPE in anatomy and makes recommendations for course development and evaluation.