Interprofessional Student Groups Research Articles

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

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

Incorporating grand rounds into an existing pharmacy ethics course: An interprofessional education opportunity

Abstract A meaningful, interprofessional education experience was developed by incorporating an existing social work grand rounds into a pharmacy ethics course. Participants included third-year student pharmacists, master's social work students, and licensed master's social workers. Each grand rounds session focused on a different issue regarding social justice and access to care. Grand rounds consisted of a 30-min presentation followed by a 40-min interprofessional panel discussion on issues relevant to the topic. At the conclusion of grand rounds, small interprofessional student groups discussed how interprofessional collaboration could improve the patient experience. This collaborative grand rounds, which has been offered for three consecutive years (2016–2018), has collectively had 450 attendees: 240 student pharmacists, 94 social work students, and 116 licensed master's social work professionals. A post-session survey allowed students to rate how well the session met the learning objectives and the perceived value of the interdisciplinary experience. Students indicated a high level of agreement that each offering achieved the learning objectives, and felt the interprofessional design enhanced their learning and provided them with a greater appreciation for the importance of interprofessional practice. Incorporating an existing grand rounds into a pharmacy ethics course was a successful approach for providing a meaningful interprofessional education experience in a real-world setting, and is a model that can easily be adopted by others for a wide range of health professions student learners.

Students’ perceptions of interprofessional education and collaborative practice: analysis of freehand drawings

ABSTRACT There is a global shortage of healthcare professionals, but in the social economic environment of Africa workforce numbers are lower than the global average per head of population. It is argued that interprofessional and collaborative care may offer a solution to this problem, and therefore interprofessional education has become a requirement for accreditation. This paper reports on an innovative initiative of a South African university, which implemented four two-hour education sessions of which the two middle sessions were simulated with standardised patients. The 28 interprofessional student groups each created a freehand drawing of their perception of collaborative practice during the fourth and final session. Four out of the 28 images were randomly selected and analysed according to specified steps by three researchers using qualitative methods. Seven themes emerged, which identify the characteristics and principles of collaborative practice and suggest that culture plays an important role. The findings also reveal the tensions arising from the difficult and uphill battle to attain collaborative practice due to silo based training models, multidisciplinary care, and fragmented healthcare services. Educational planners may need to consider the challenges of implementation of the theory of IPE into the real world of practice as well as how to overcome the hidden cultural issues that may impede success.

Understanding Pain and Pain Management in Elderly Nursing Home Patients Applying an Interprofessional Learning Activity in Health Care Students: A Norwegian Pilot Study

Background: Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. Aims: This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. Design: We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans. Methods: We collected data through video recordings during teamwork before and after examining the patients and field notes during the patient examination. We analysed the video-recordings applying the seven-step model including 1) viewing the video data, 2) describing the video data, 3) identifying critical events, 4) transcribing, 5) coding, 6) constructing storyline and 7) composing a narrative. Field notes supplied the transcripts. Results: Both teams succeeded in making a pain management plan for their patient. The common examination of the patient was crucial for the students’ approaches to pain management and changed their pre-assumptions about the patients’ pain. By sharing knowledge and reflecting together, the students reached a common consensus on suggestions for management of the patients’ problems. Interprofessional collaboration fostered enthusiasm and a more holistic pain management approach. However, students’ lack of knowledge limited their understanding of pain. Conclusion: Knowledge of pain management in nursing home patients and the practice of interprofessional cooperation should be included in pain curricula for health care professionals.

Interprofessional education for teaching Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use

Abstract The rate of substance use disorders (SUD) within the U.S. is alarmingly high. According to the National Institute on Drug Abuse (NIDA), an estimated 23.9 million Americans ages 12 or older use an illicit drug or misuse a psychotherapeutic medication each month. 1 Patients presenting for anesthesia care are not exempt, and neither are our colleagues. While education and training about SUDs does happen in health professional programs at both the undergraduate and graduate levels, it is often difficult to describe practical solutions to this issue. The Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Interprofessional Groups of Anesthesia Students (InGAS) Project seeks to rectify this situation through didactic and simulation-based interprofessional education. Participants report gaining skills in substance use screening and are more comfortable using SBIRT techniques. Future efforts will be focused on refining the training process by expanding the scope of the simulation scenarios and thus, the opportunity for effective interventions.

The Interprofessional Diabetes and Education Awareness (IDEA) community program

This report describes the Interprofessional Diabetes and Education Awareness (IDEA) program that was developed in partnership with the Broward County American Diabetes Association and Nova Southeastern University Health Profession's Division. The intent of the program is to increase engagement and collaboration of students and faculty from multiple professions in providing free community education related to diabetes prevention and management. The education is provided to individuals who are interested in knowing about diabetes, or who actually have a diagnosis. The presentations are done through lecture, active learning, table top displays and discussions, in a variety of community venues throughout an academic year, with the goal of increasing community awareness and appropriate management of diabetes. The variety of presentation methods are available to address different health literacy and age levels. Interprofessional health care groups of faculty and students meet the goals of increasing team functioning awareness and collaboration, as well as increased knowledge of diabetes in the community, as indicated by student focus group results at the end of the academic year. Participant surveys also overwhelmingly reveal satisfaction with the community presentations. Information regarding program replication is available through our Train the Trainer Coordinator – Alison Herman [email protected].

Using operative models (ICF and CBR) within an interprofessional context to address community needs

Background. The use of conceptual frameworks has been advocated when implementing interprofessional initiatives. Objective. To present the use of the International Classification of Functioning Disability and Health (ICF) and the community-based rehabilitation (CBR) matrix for identifying and addressing the health needs of the community. Methods. The ICF care plan and the CBR matrix were used to conduct a retrospective document analysis. The documents were completed by interprofessional groups of students who were involved in an interprofessional community-based intervention. Data were captured on a sheet and analysed descriptively using the domains of the ICF and the CBR matrix. Ethical clearance was obtained from the University of the Western Cape, Cape Town, South Africa. Results. A total of 30 senior nursing, physiotherapy and biokinetics students were divided into groups and interacted with five community-based groups. Each group of students completed one ICF care plan and one CBR matrix. The needs documented in the ICF care plans included impairments, activity limitations, participation restrictions and environmental challenges. Impairments included sensory, motor and psychological impairments, while activity limitations included limitations in activities of daily living and mobility. Limited social interaction and physical environment were identified as experienced environmental challenges. The interventions documented to address these needs included health promotion, prevention, medical care, skills development and facilitation of access to justice. Conclusion. The ICF and CBR matrix can be used to facilitate students’ identification of the needs of communities and the implementation of interventions to address these needs in an interprofessional manner.

Developing an appreciation of patient safety: analysis of interprofessional student experiences with health mentors.

IntroductionA critical task for health profession educators is to foster student appreciation of patient quality and safety issues. Although instructional methods vary, few focus on the direct communication of the patient experience to students. This qualitative study explores the experiences and learning of health profession students participating in a Safety Module in the Health Mentor Programme.MethodsSmall interprofessional groups of students were paired with a health mentor, an individual experiencing chronic health challenges. Students followed a 90-minute, semi-structured interview format exploring issues regarding quality care and safety. Following the interviews, students participated in a facilitated asynchronous online discussion and completed a reflective practice paper. An inductive thematic analysis of both of these text-based datasets revealed emerging themes.ResultsThemes identified in the data included: Patient partnerships as critical to optimal care; consideration of a variety of safety issues; importance of advocacy in promoting safety; improvement of future practice enabled through patient perspectives on clinical error; and embracing of interprofessional communication and collaboration.ConclusionsThe findings suggest that engagement with the health mentor narratives facilitated students’ appreciation of quality and safety issues related to patient care.

Interprofessional Learning Experiences as a Component of Fulltime Clinical Practicums for Occupational and Physical Therapy Students

Background: Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. Aims: This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. Design: We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans. Methods: We collected data through video recordings during teamwork before and after examining the patients and field notes during the patient examination. We analysed the video-recordings applying the seven-step model including 1) viewing the video data, 2) describing the video data, 3) identifying critical events, 4) transcribing, 5) coding, 6) constructing storyline and 7) composing a narrative. Field notes supplied the transcripts. Results: Both teams succeeded in making a pain management plan for their patient. The common examination of the patient was crucial for the students’ approaches to pain management and changed their pre-assumptions about the patients’ pain. By sharing knowledge and reflecting together, the students reached a common consensus on suggestions for management of the patients’ problems. Interprofessional collaboration fostered enthusiasm and a more holistic pain management approach. However, students’ lack of knowledge limited their understanding of pain. Conclusion: Knowledge of pain management in nursing home patients and the practice of interprofessional cooperation should be included in pain curricula for health care professionals.

Virtual Patient Stories as a Facilitator of IPE: A Pilot Study

Learning Together With Cases (LTWC) was a pilot project designed to create a series of stand-alone, media rich online modules. We describe how interprofessional groups of pre-licensure students from medicine, nursing and occupational therapy used one case, including the social networking capabilities, to achieve a rich interprofessional community of learning.

Exploring the nature of facilitating interprofessional learning: findings from an exploratory study

With the growing complexity in managing multiple disease and illness-related problems, increased attention is being paid to the importance of interprofessional education (IPE) in preparing students for working collaboratively with different professionals. Educational activities for mixed groups of health professional students are increasing, and facilitation of learning in interprofessional student groups is now acknowledged as an essential part of successful interprofessional learning activities. However, little is known about the strategies used by facilitators with students from different professions, and how they promote learning. Using data obtained through an analysis of videos taken as part of a large study of IPE and interprofessional practice, this study aimed to identify the pedagogical strategies and behaviours of facilitators participating in seven different learning activities with health care students from five different professions. The data captured student reactions and behaviours and provided insight into the dynamics of the interprofessional encounters. The findings showed that facilitating groups involved a complex interchange of three types of interaction between facilitators and students: facilitator-controlled interaction, facilitator-driven interaction and student-driven interactions. The findings also suggest that faculty development programs should assist facilitators to re-examine teaching approaches and encourage students to assume the responsibility for discussing issues and collaborating with others in all their interprofessional contacts. Continuity and stability in faculty development activities will better prepare clinical educators and young professionals to become interprofessional champions.

Investigating a multidisciplinary and patient-centred approach to obesity

Obesity is set to become one of the biggest health problems facing governments in Europe. With a significant sequela of associated chronic conditions, treatment and prevention must become priorities in healthcare provision and policy. The cause and treatment of obesity is complex. However, evidence supports the patient-centred approach, which was the focus of discussion at a multidisciplinary educational event for healthcare students and patients held at the University of Southampton. The aim was to increase existing knowledge, promote shared learning and facilitate a better understanding of strategies needed to address the growing prevalence of obesity. The necessity for improved research strategies and a more integrated, multidisciplinary approach to treatment were echoed by the panel of expert researchers and practitioners who spoke. There was also a consensus that obesity needs to be seen as a chronic health concern by governments and health practitioners. In addition, the event provided a locus for inter-professional student groups to work collaboratively with obese (or formerly obese) patients to explore the patients’ perspective regarding obstacles to health improvement and possible solutions. Feedback indicated that both students and patients found this experience valuable and rewarding. Some patients were motivated to join other community health initiatives as a result, whilst students indicated that their understanding, future practice and research would be enhanced. Therefore it seems that this experiential approach to collaborative learning may provide a model for further educational events with a focus on patient-centred treatment of similar long term chronic health problems.

Learning to listen: Improving students' communication with disabled people

Background: This report outlines the action research used to develop a workshop for interprofessional student groups to enhance listening skills.Aim: The project aimed to enable students to reflect interprofessionally on the human factors central to effective communication using the power of storytelling by disabled people and their carers.Methods: Qualitative data from students and participating service users were collected using focus groups and one-to-one interviews over three pilot cycles.Results: The results from each pilot informed the cyclical development of the project so that each stage of data collection informed the next stage. During the pilots, 20 interviews with service users were completed and a total of 109 students participated. Transcribed data were analysed using principles from grounded theory. Quantitative scored questions on students’ learning were analysed using statistical package for the social sciences.Conclusions: Both students (health and social care) and users benefitted from the education process which delivered highly relevant explicit learning opportunities, with analysis of how to improve communication for safe practice. Students benefitted from meaningful interactions with service users who shared their experiences and gave feedback on students’ communication skills. The final workshop design resulted in a learning model which reflects the human side of healthcare delivery.

Interprofessional educator ambassadors: An empirical study of motivation and added value

Background: Interprofessional education (IPE) is being led by a driving force of teaches who advocate for the importance of this learning within health and social care professional curriculum. Many of these leaders have additional uni professional teaching responsibilities.Aims: This study aimed to explore the impact of leading an IPE curriculum on teachers, who were at the forefront of establishing a new IPE curriculum in the east midlands, UK.Methods: The prospective study used the principles of grounded theory to analyse the educator's experiences. The study included teachers who work from academic university posts and those who teach from within practice. These IPE leaders were identified through their involvement in the design and delivery of the local IPE initiatives. They were invited to share their experiences at either a mixed-discipline focus group, a one-to-one interview or by completing a postal/e questionnaire. During analysis the views from each data set were triangulated.Results: A total of 58 educators shared their experiences. All benefitted from being part of the planning and teaching teams. They were driven by a strong belief that IPE had the potential to improve patient care and that future healthcare practice would remain team based. Engagement had brought additional benefits to their teaching and career development in particular through forming new relationships with colleagues from other caring professions. They were concerned about educators teaching interprofessional student groups with little prior experience of IPE.Conclusion: The data suggest educators who take on a leading developmental role in designing and delivering an interprofessional curriculum benefit personally and professionally through working relationships with colleagues in other professions and through teaching wider networks of students. These new insights strengthen personal practice and research and in turn have the potential to influence and improve the quality of faculty teaching.

Preparation of educators involved in interprofessional education

To achieve effective interprofessional learning there must be effective teaching. In this study we analyse the impact of a Masters level two day course designed to prepare teachers for their role(s) in the design development and facilitation of interprofessional student groups. Since its inception the course has run periodically each year attracting over 70 health and social care teachers from academic and practice settings. The evaluation has confirmed the original hypothesis of the course design, that in order to properly facilitate interprofessional education, teachers need tailored professional developmental opportunities. They need to consider both the underpinnings and implications of interprofessionality and the ways in which appropriate pedagogical practice can illuminate and embed truly interprofessional learning.

An Interfaculty Pain Curriculum: Lessons learned from six years experience

Minimal pain content has been documented in pre-licensure curricula and students lack important pain knowledge at graduation. To address this problem, we have implemented and evaluated a mandatory Interfaculty Pain Curriculum (IPC) yearly since 2002 for students ( N = 817 in 2007) from six Health Science Faculties/Departments. The 20-h pain curriculum continues to involve students from Dentistry, Medicine, Nursing, Pharmacy, Physical Therapy, and Occupational Therapy as part of their 2nd or 3rd year program. Evaluation methods based on Kirkpatrick’s model now include evaluation of a Comprehensive Pain Management Plan along with the previously used Pain Knowledge and Beliefs Questionnaire (PKPQ) and Daily Content and Process Questionnaires (DCPQ). Important lessons have been learned and subsequent changes made in this iterative curriculum design based on extensive evaluation over the 6-year period. Modifications have included case development more relevant to the diverse student groups, learning contexts that are uni-, inter-, and multi-professional, and facilitator development in working with interprofessional student groups. PKBQ scores have improved in all years with a statistically significant average change on correct responses from 14% to 17%. The DCPQ responses have also indicated consistently that most students (85–95%) rated highly the patient panel, expert-lead clinically focused sessions, and small interprofessional groups. Relevancy and organization of the information presented have been generally rated highly from 80.3% to 91.2%. This curriculum continues to be a unique and valuable learning opportunity as we utilize lessons learned from extensive evaluation to move the pain agenda forward with pre-licensure health science students.