Interprofessional Practice Competencies Research Articles

Designing Interprofessional Online Learning Experiences for Future Healthcare Professionals

The design case details the collaborative work of a design team—three faculty members, one instructional designer, and one educational resource specialist—to create a simulation-based interprofessional education (IPE) experience for future healthcare professionals. Before the COVID-19 pandemic that caused the shutdown of campuses across the country/world, this simulation-based learning experience was always offered in a face-to-face format. Thus, this case highlights the challenges and opportunities of designing this online learning experience within a limited period of time. Further, this case documents what theories or evidence-based practices were instrumental in designing this learning experience, along with the design team’s narrative regarding key design decisions and moves. It also includes a design narrative focusing on the description of the design process, such as key design judgments, decisions, and concrete examples of the design process outcome. Lastly, the design case highlights unique design features: Scalability of instruction through accessibility and usability, authenticity, interprofessional collaboration, and reflection. The design was guided by the TEACH (Team Education Advancing Collaboration in Health) core curriculum in the state of Indiana that foregrounds interprofessional practice competencies and teamwork in preparing future healthcare professionals.

Interprofessional team-based education: A comparison of in-person and online learner experiences by method of delivery and health profession.

Building capacity for teamwork, communication, role clarification and recognition of shared values is essential for interprofessional healthcare workforce development. Requirements to demonstrate interprofessional practice competencies have coincided with pivots to online delivery. Comparison of in-person and online delivery models for interprofessional education is important for future curriculum design. This article presents an evaluation of in-person and online delivery modes for interprofessional team-based education and compares learner experiences across different health professions. Students from 13 health professions (n=2236) participated between Spring 2020 and Fall 2021. In-person and online delivery models were compared, assessing learner perceptions of efficacy for interprofessional practice, using reflective pre-post responses to the Interprofessional Collaborative Competency Attainment Scale (ICCAS). Mean ICCAS scores improved for in-person and online delivery (0.79 vs 0.66), with strong effect (Cohen's D 2.03 and 1.31 respectively; p<0.001). Statistically significant differences were observed across professions, although all experienced ICCAS score improvements. Logistical benefits were evident for online delivery. In-person and online interprofessional team-based education can provide valuable learner experiences for large student cohorts from multiple professions. ICCAS score differences should be weighed against potential logistical benefits of online delivery. Timing of delivery and determinants of differences in student response across professions warrant evaluation for future curriculum design.

Get Out of Your Silo: A Qualitative Examination of an Interprofessional Undergraduate Course

Purpose: Interprofessional collaboration in schools is fundamental to the success of all students. The purpose of this exploratory study is to examine the impact of an innovative one-credit-hour undergraduate course on students' knowledge of the Interprofessional Education Collaborative's (IPEC) core competencies for interprofessional practice. Method: Nine undergraduate students from communication sciences and disorders, inclusive early childhood education, and elementary education majors participated in two focus groups (one at the beginning and one at the end of the course). The researchers used a directed content analysis approach to analyze the data in terms of frequency and depth of the students' descriptions of the IPEC core competencies. Results: Two main findings emerged: (a) participants discussed the roles and responsibilities for collaborative practice (RR) and interprofessional teamwork and team-based practice (TT) competencies more frequently at the end of the course, and (b) participants discussed the RR, TT, and interprofessional communication practices competencies in a greater level of depth at the end of the course. Conclusions: These results suggest that a one-credit-hour course has the potential to enhance undergraduate students' knowledge of the IPEC core competencies in relation to school-based collaboration. Additional learning experiences for undergraduate students could include observations of co-teaching in schools, practicum experiences in which students have the opportunity to engage in co-teaching, and additional coursework on collaboration and teamwork. Supplemental Material: https://doi.org/10.23641/asha.21313722

Getting outside the box: exploring role fluidity in interprofessional student groups through the lens of activity theory.

Health professionals' roles and scopes often overlap, creating a need for role clarity in interprofessional teamwork. Yet, such clarity does not mean roles are fixed within teams and some literature suggests role flexibility can enhance team functioning. Interprofessional practice competencies and learning activities often emphasize knowledge and definition of roles, but rarely attend to the dynamic nature of roles and influential contextual factors. This study explores role fluidity in interprofessional student groups using an activity theory framework. Using a collective instrumental case study approach, the authors examine the fluidity of one physical therapy (PT) student's role within 3 different interprofessional (medical, pharmacy, PT) student groups completing nursing home patient care plans. Field notes, group debriefing interviews, and care plans were collected and coded from all care planning sessions. Codes mapped to group-specific activity systems that compared role-influencing interactions and tensions. The PT student's role fluidity varied in each group's activity system, influenced primarily by system tensions from implicit rules (e.g., encouraging questions), division of labor (e.g., rigid profession-based task assignment), and tool use (e.g., computers). Attention to modifiable system elements, such as tool use and explicit rules of inclusivity, could foster role fluidity and improve interprofessional teamwork and learning environments.

Original Interprofessional Simulations to Train Students in CSD and Related Health Professions in Team-Based Health Care

Students in health professions receive extensive training across the scope of practice within their profession; however, most lack experience in performing clinical functions as a member of a coordinated health care team. We describe outcomes of a quasi-experimental study that used simulations to target interprofessional practice competencies. Simulations incorporated clinical knowledge from five professions, and used standardized patients to provide students with a low-stakes opportunity to apply knowledge and skills. Students observed one simulation and participated in another. Post-simulation quantitative and qualitative data were collected by having students, faculty, and standardized patients rate collaboration and decision-making skills for each interprofessional team. Results indicate differences in ratings based on simulation round and rater group. Findings highlight the need for focused training in the use of clear and empathic communication by interprofessional teams. Results also demonstrate the value of feedback from standardized patients who can provide important perspectives regarding the quality of clinical interactions.

Experiences with and attitudes toward interprofessional health care teams among American clinical, counseling, and school psychology doctoral students: a mixed methods study

ABSTRACT Attitudes toward interprofessional collaboration influence interprofessional health care team (IPHCT) functioning and quality of patient care. Yet, research has not examined the attitudes and experiences of psychology doctoral students on IPHCTs. Utilizing a volunteer sample of 214 clinical, counseling, and school psychology doctoral students from at least 47 doctoral programs in the United States, this study aimed to clarify psychology doctoral students’ experiences on IPHCTs and explore predictors of their attitudes toward IPHCTs. Discovery-oriented analysis and hierarchical multiple regression were used to identify themes of students’ self-reported interprofessional experiences and significant predictors of positive attitudes obtained via online survey questionnaires. Students who had worked on IPHCTs commonly reported taking roles of mental health therapeutic service provision and consultation and reported difficulty with team dynamics and navigating hierarchical structures. Students perceived the psychologist role primarily as clinical expert and team leader. Students reported making positive contributions, increased competency in interprofessional practice, and improvement in patient care as the most common benefits of IPHCTs. Each additional year spent on an IPHCT was related to more positive perceptions of the quality of care delivered by IPHCTs as well as greater endorsement of positive interprofessional socialization practices.

Validity evidence and use of the IPEC Competency Self-Assessment, Version 3

ABSTRACT To guide interprofessional education (IPE), a variety of frameworks have been suggested for defining competency in interprofessional practice, but competency-based assessment remains challenging. One self-report measure developed to facilitate competency-based assessment in IPE is the IPEC Competency Self-Assessment. It was originally described as a 42-item measure constructed on the four domains defined by the Interprofessional Education Collaborative (IPEC) Expert Panel. Response data, however, identified only two factors labeled Interprofessional Interaction and Interprofessional Values. In this study, we tested a revised 19-item, two-factor scale based on these prior findings with a new sample (n = 608) and found good model fit with three items not loading on either factor. This led to a 16-item instrument, which was then tested with an additional sample (n = 676). Internal consistency was high, and scores for both subscales showed variance based on prior healthcare experience. The interprofessional interaction subscale was primarily comprised of items from the Teams and Teamwork domain, with one item each based on competencies from the Interprofessional Communication and Values/Ethics domains; and scores varied by year of enrollment. The interprofessional values subscale was comprised solely of items from the Values/Ethics domain. Scores for both subscales were strongly correlated with scores from the Interprofessional Socialization and Valuing Scale. This study further establishes the validity, reliability, and usability of an assessment tool based on interprofessional competency. The findings also suggest the constructs underlying the subscales may be affected differently by experience and training. Additional study using longitudinal data is needed to test this hypothesis.

Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners.

Transgender patients frequently experience discrimination within health care settings due to provider lack of knowledge and bias resulting in poor service delivery. Team-based interprofessional collaboration is becoming a best practice for health professionals to improve patient-centered care and address these health disparities. A team-based interprofessional education simulation activity was developed as a teaching activity at a university for graduate health care learners in medicine, nursing, occupational therapy, physical therapy, physician assistant, social work, and health care administration programs over 2 years (N = 494). The simulation focused on a transgender patient brought to the emergency department (ED) after a workplace assault. Students were placed in interprofessional teams and asked to critique the initial ED interaction with the patient and then complete a team huddle and discharge planning meeting with a standardized patient. Student preparedness to engage in the Interprofessional Education Collaborative (IPEC) competencies was assessed through a posttest measure. Student learners reacted overwhelmingly positively to the activities of the workshop. The averaging of 2 years of data yielded students responses of strongly agree and agree at 90% or higher for all IPEC core competencies, as well as for educational objectives of the workshop. Reducing the structural, interpersonal, and individual stigma experienced by transgender patients requires institutions to offer experiential learning opportunities for future health care providers. This interprofessional education simulation experience focusing on transgender patients calls attention to the negative impact of stigma while also promoting competency in interprofessional practice.

Development and implementation of an interprofessional education certificate program in a community-based osteopathic medical school

Abstract Community-based medical schools face unique barriers in developing meaningful interprofessional education (IPE) opportunities for their students. Here we describe the development, implementation, and preliminary evaluation of an IPE Certificate Program at a community-based osteopathic medical school. The IPE Certificate Program was developed by incorporating new curricular components with pre-existing requirements to minimize the burden on students, administrators, and faculty. The IPE program is delivered longitudinally to medical students, in collaboration with pharmacy and nursing students, over three years using interactive, volunteer, clinical, and reflective experiences. The primary aims of the IPE Certificate Program are to promote interprofessionalism based on the Core Competencies for Interprofessional Practice and provide additional acknowledgment for the students that participate in the program. Student assessments are based on both participation and the use of standardized grading rubrics based on the various activities' learning objectives. The students' knowledge and attitudes regarding interprofessionalism is also assessed using an adapted survey, while the overall program is evaluated with an end-of-year program evaluation. Preliminary results of the attitudes survey display favorable changes towards interprofessionalism. Due to the overwhelming acceptance by students and the administration, the curriculum has transitioned to a for-credit elective course that will appear on the participants’ academic transcripts. The following resources are included: a course syllabus, the course requirements, a grading rubric, the attitudes towards interprofessionalism survey, and a course evaluation. We propose our model can be used to implement IPE at other community-based institutions.

Does Including Public Health Students on Interprofessional Teams Increase Attainment of Interprofessional Practice Competencies?

Interprofessional education (IPE) creates dynamic experiential learning that can address social determinants of health that influence health outcomes. To examine the effects of including public health students on IPE teams on the interprofessional practice domain constructs (values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork). This single-case, mixed-methods study was performed using a grounded theory approach. Students from 8 graduate health sciences programs participated in an asynchronous, 6-week, online IPE learning activity. Three of the 4 interprofessional practice domain constructs were examined as outcome variables: participants' biomedical vs biopsychosocial patient approach (values/ethics); reported change in attitudes, beliefs, or values about other health professions (roles/responsibilities); and anticipated changes in future professional behaviors/interactions/approaches (teams and teamwork). Predictor variables were having an MPH participant on the IPE team, participants' enrollment in a clinical or nonclinical program, and student perception of the online format (interprofessional communication). Three hundred nineteen students were included, 261 from clinical and 58 from nonclinical programs. A significant association was found between having an MPH participant on the IPE teams and participants' awareness of the influence of social determinants of health (OR, 2.04; 95% CI, 1.13-3.66; P<.05). Program type was also significantly associated with awareness of the influence of social determinants of health, such that participants in nonclinical programs were significantly more likely to report the importance of social determinants of health in the care plan (OR, 3.68; 95% CI, 1.38-9.84; P<.01). Participants were significantly less likely to report future behavior change if they were in clinical programs (OR, 0.44; 95% CI, 0.23-0.86; P<.05) or if they disliked the online format (OR, 0.25; 95% CI, 0.14-0.42; P<.01). The model fit the data well (χ23=30.80; P<.001). Inclusion of MPH students on IPE teams has the potential to increase clinical participants' awareness of the influence of social determinants of health and interest in incorporating a biopsychosocial approach to health care.

A five-session interprofessional team immersion program for health professions students

Abstract The interprofessional team immersion (IPTI) is a developmental, longitudinal, and sustainable curricular resource that was designed in response to student requests for small, interactive, cross-professional learning experiences. Learning objectives are aligned with behaviors as identified in the Core Competencies for Interprofessional Practice and aim to increase students' understanding of each other's roles and responsibilities, to apply teamwork principles, to refine communication skills for contextualized person-centered practice, and to utilize knowledge in the presentation of a collective project. Instructional formats include a team-building exercise, case-based learning, and simulation. Pre- and post-session evaluation measured students' attitudinal and behavioral changes. Rapid cycle program evaluation used student feedback to continuously improve the quality of the learning experience. Overall students found IPTI to increase their knowledge of other professions, build confidence in their team skills, and provide a basis for working collaboratively in their future workplace settings. Program evaluation feedback reinforced the efficacy of small group, interactive learning and full faculty engagement in IPE learning activities. Both a successful and sustainable shared learning activity, IPTI offers generalizable content, instructional approaches, and assessment strategies for other institutions seeking transformative team-based learning experiences.

Interprofessional Interactions and Competencies on Clinical Rotations: Preceptors' Perspectives of Student Experiences.

This study describes (1) preceptors' perceptions of interprofessional encounters that PA students had at clinical sites and (2) ways that the preceptors report evaluating the PA students' interprofessional practice skills. This study disseminated a single electronic survey of clinical preceptors who were affiliated with an accredited PA program. Descriptive statistics were used to analyze the results. Of 195 preceptors, 66 completed the survey. Practice specialties of respondents and nonrespondents were similar. Preceptors indicated that PA students had frequent interactions with a wide variety of health professionals and students. These interactions occurred with greater frequency in specialty settings and academic medical centers than in other settings. Preceptors reported that they assess interprofessional practice competencies, although many were not familiar with the definitions that the health care profession has endorsed. Findings suggest that educators may identify specific clinical sites or settings that are more optimal for interprofessional education interventions and that focused preceptor development may encourage deliberate assessment of students' interprofessional practice competencies.

How Do Interprofessional Practice Teams Work Together to Identify and Provide for Gifted Students with Multiple Exceptionalities?

&#x0D; &#x0D; &#x0D; Priority learners in New Zealand include thosewho have special educational needs, yet gifted learners with multiple exceptionalities arevariably identified, understood or provided forin our schools. International research advocatesthe use of interprofessional practice (IPP) teams,with competency across shared values, roles and responsibilities, communication, and teamwork, to support gifted learners with multiple exceptionalities. This study explored the experiences and understandings of IPP teams supporting students with multiple exceptionalities in New Zealand. The study found that IPP team identity is still in its infancy and core competencies are still evolving. Shared values towards inclusive practices were hampered by limited knowledge and expertise across the IPP team. Limited understandings of teamwork processes and limited recognition of the importance of communication within the IPP team were also common themes. Parents and students were typically not recognised&#x0D; as part of the IPP team identity and processes. The article concludes that gifted learners with multiple exceptionalities may not have adequate support at a systems level, and development of interprofessional practice competencies may be one way to ensure their full inclusion in our education system. Implications for policy and practice are described.&#x0D; &#x0D; &#x0D;

Interprofessional care of elders

Interprofessional education (IPE) is essential for preparing nurse practitioner (NP) students to provide care in a collaborative team environment. The combination of a virtual clinic and video conferencing designed for NP students to practice interprofessional collaboration has not been studied. This study examined students' perceptions of the virtual learning environment which was developed to improve interprofessional competencies. A survey instrument developed to evaluate interprofessional practice competencies was administered to student participants from eight disciplines (n = 71) following eight video conference discussions of an elderly patient presentation in a virtual clinic. The distribution of responses was significantly associated with interprofessional competency domain (p = .002). The distribution of responses was also significantly associated with discipline (p < .001). Participants rated the value of this activity positively. A virtual clinic and video conferencing was an acceptable learning platform for students, which can be used to simplify IPE logistics. The roles and responsibility competency domain is perhaps the hardest for novices to grasp. Teaching meeting facilitation is a necessary part of IPE for NP students to be able to use these skills in the future.

Training and Assessing Interprofessional Virtual Teams Using a Web-Based Case System.

Today, clinical care is often provided by interprofessional virtual teams-groups of practitioners who work asynchronously and use technology to communicate. Members of such teams must be competent in interprofessional practice and the use of information technology, two targets for health professions education reform. The authors created a Web-based case system to teach and assess these competencies in health professions students. They created a four-module, six-week geriatric learning experience using a Web-based case system. Health professions students were divided into interprofessional virtual teams. Team members received profession-specific information, entered a summary of this information into the case system's electronic health record, answered knowledge questions about the case individually, then collaborated asynchronously to answer the same questions as a team. Individual and team knowledge scores and case activity measures--number of logins, message board posts/replies, views of message board posts--were tracked. During academic year 2012-2013, 80 teams composed of 522 students from medicine, nursing, pharmacy, and social work participated. Knowledge scores varied by profession and within professions. Team scores were higher than individual scores (P < .001). Students and teams with higher knowledge scores had higher case activity measures. Team score was most highly correlated with number of message board posts/replies and was not correlated with number of views of message board posts. This Web-based case system provided a novel approach to teach and assess the competencies needed for virtual teams. This approach may be a valuable new tool for measuring competency in interprofessional practice.

Informal Learning Opportunities Matter: The Interprofessional Learning Experiences of Undergraduate Speech Pathology Students

Despite increasing recognition of the importance of interprofessional learning (IPL) for interprofessional practice, it is unclear how and where speech pathology students are developing their interprofessional competencies within the university curriculum. This study aimed to clarify how interprofessional competencies develop in students by using a qualitative approach to explore speech pathology students’ perceptions of their university interprofessional learning experiences. Nine individual semi-structured interviews were conducted. Thematic analysis was used to analyse the data. Two major themes emerged: (i) occurrence of informal interprofessional learning (including informal IPL opportunities/context and its contribution to interprofessional learning experiences), and (ii) factors influencing interprofessional learning (role of placement, clinical educators and student’s motivation to engage in IPL activities). Participants reported valuing their interprofessional learning experiences, which were mainly informal interactions with professionals that occurred during clinical placements. The findings suggest that informal interprofessional learning experiences are a valuable source of interprofessional learning which can assist students to develop competencies for interprofessional practice. Recommendations for universities to more effectively support students’ interprofessional learning are provided.

Screening for diabetic kidney disease in primary care for the underinsured: A quality improvement initiative

PurposeScreening rates for DKD in primary care are low, even though diabetes accounts for 44% of all new kidney disease cases. The purpose of this project was to determine if a primary care team for the underinsured improved screening and diagnosis of diabetic kidney disease (DKD) after initiating a quality improvement (QI) process. MethodsA chart audit with feedback, provider education of clinical practice guidelines, and strategies from TeamSTEPPS™ were implemented with the inter-professional primary care team. ResultsPre/post-intervention chart audit analysis showed the frequency of ordering microalbumin increased from 50.3% (n=148) to 75% (n=148), and diagnosing DKD rose from 3.3% (n=10) to 10.7% (n=21) over three months (P=.000). ConclusionImplementing a QI process in underinsured primary care centers improved the compliance of proper screening and diagnosing DKD AND introduced inter-professional practice competencies and teamwork strategies not previously recognized at the centers.

Occupational Therapy Contributions in Early Intervention

Occupational therapy provides a unique contribution in early intervention programs for families and their children from birth to 3 years old who are at risk for, or who have, identified disabilities. This article describes occupational therapy's distinct value and presents the profession's perspective on services to enhance families' caregiving capacity and increase their young children's participation in home and community settings where all children typically grow, learn, and develop. Preservice education preparation that equips graduates to contribute as members of the collaborative team in infant and toddler programs addresses discipline-specific competencies, together with competencies that are shared among early intervention professionals. Interprofessional practice competencies that can inform thinking about these distinct and overlapping competencies among early intervention professions are discussed. Implications for entry-level education and continuing professional and interprofessional development are highlighted to suggest recommendations for competent occupational therapy practitioners who provide services in Part C early intervention programs. Additional research is needed to examine family and child outcomes associated with various team practices and service delivery models.