Interprofessional Research Articles

Social Work Students’ Attitudes and Skills Self-Efficacy Toward Collaborative Practice Improve After Interprofessional Opioid Use Disorder Case Discussion

Few studies have examined social work student outcomes after engagement in interprofessional (IP) learning experiences. We examined self-reported attitudes and skills self-efficacy among social work students before and after their engagement in IP Forums. The data comes from social work students who participated in 2016-2018 Fall IP Forums focusing on opioid use disorder. Using the Interprofessional Attitudes Scale (IPAS) and the Interprofessional Collaborative Competency Attainment Scale, revised (ICCAS), we assessed students’ self-reported attitudes (IPAS) and skills self-efficacy (ICCAS) before and after the Fall IP Forums. Paired t-tests identified significant changes in IPAS and ICCAS scores. Students reported increases in their IP attitudes and skills self-efficacy following participation in the IP Forum as measured by pre-IPAS score (n=236, M=4.56, SD=0.29) to post-IPAS score (M=4.68, SD=0.27; t(156)=-5.31, p<.001). Post-ICCAS score also increased (n=48, M=4.26, SD=0.69; t(33)= -5.75, p<.001) from the pre-ICCAS score (M=3.55, SD=0.92). The 2015 Council on Social Work Education Accreditation Standards require that social work students learn how to value and engage in interprofessional teams. Given the self-reported increases in IP attitudes and skills self-efficacy seen in this study, IP Forum participation will help foster greater engagement and contribution to overall IP experiences for social work students.

Improving the Interprofessional Practice, Knowledge, and Skills of Health Professions Students through an Interactive Course in Gerontology

Interprofessional, collaborative health care is the ideal standard in geriatrics. Students’ interprofessional practice skills are limited in typical siloed education. An experiential, team-based geriatrics course was designed to improve health professions (HP) students’ knowledge, skills, and attitudes about interprofessional practice. Students (n=209) from dentistry, medicine, nursing, nutrition, occupational therapy, pharmacy, physician assistant, social work, and speech-language pathology were assigned to interprofessional (IP) and medical-student only teams. The Interprofessional Collaborative Competency Attainment Survey-Revised (ICCAS-R) was administered pre- and post-course, along with program evaluations. Seventy percent of students completed both pre- and post-surveys. ICCAS-R scores were analyzed comparing the impact of training for medical students (n=78) on IP teams and remaining HP students (n=58). Students rated themselves as improved on all six ICCAS-R subscales (paired t-tests, p < 0.05). Sixty-nine percent rated themselves as better able to collaborate interprofessionally. A competitive team-based learning exercise using gamification was rated as the most authentic skill-building interprofessional activity. Experiential learning where students worked with the same team helped to build interprofessional and teamwork skills. Findings will be used to improve authenticity of the clinical and teamwork content, increase the use of gamification as a teaching technique, and refine students’ practice of IP teamwork competencies.

Promoting Quality Improvement in Primary Care Through a Longitudinal, Project-Based, Interprofessional Curriculum.

IntroductionHealth professionals must demonstrate competencies in quality improvement (QI) and interprofessional (IP) practice. Yet few curricula are designed to address these competencies in an integrated, longitudinal way. Our experiential IP QI curriculum addresses this gap.MethodsThe IP QI curriculum was part of a San Francisco VA Health Care System training program for second-year internal medicine residents and adult gerontology primary care nurse practitioner students, pharmacy residents, and postdoctoral psychology fellows. Trainees worked in mentored IP teams to select, design, implement, evaluate, and present a project as part of a 9-month curriculum. Teaching methodologies included didactics and project-based skills application. Curriculum evaluation included trainees' QI knowledge and skills self-assessments, trainee satisfaction, mentor appraisals, and project results and impact assessments.ResultsFrom 2011–2012 to 2017–2018, 242 trainees completed the curriculum and 41 QI projects. Trainees reported high satisfaction with the introductory sessions (M = 4.4, SD = 0.7). They also reported improvement in comfort with QI knowledge and skills by the curriculum's completion. QI mentors (n = 23) observed growth in trainees' QI knowledge and skills, felt confident in trainees' ability to orchestrate a QI initiative, and believed their mentored QI projects added value to the organization. Thirty-eight projects resulted in system modifications.DiscussionThis IP QI curriculum offers team-based, workplace experiences for trainees to learn and apply QI knowledge and skills. Leading factors for successful implementation included attention to team-building and faculty development. Challenges included reliably collecting evaluation data, accurately measuring ongoing systems changes, and variable trainee engagement.

Preparing advanced learners for geriatric team care: A short-term curricular model that works

ABSTRACT Health outcomes for complex older adults are enhanced by interprofessional collaboration. Funded by a Geriatrics Workforce Enhancement Program (GWEP), an interprofessional team of educators developed a short-term geriatrics experience, including four hours of pre-clinical education and 12–20 hours of immersion in team-based care for advanced learners in nursing (n = 70 APN), social work (n = 48 MSW), and medicine (n = 122 medical students). Content focused on five areas: medication management, dementia, depression, falls, and myths about aging. Learners completed pre/post surveys measuring knowledge of geriatrics, attitudes toward geriatric patients and team care, and post-surveys regarding perceptions of the overall clinical experience. Results showed significant improvement in knowledge and attitudes toward older adults and interprofessional (IP) team practice. Qualitative comments reflected increased empathy toward and enthusiasm for working with older adults, valuing IP teams, and a desire for geriatrics content earlier in their respective curricula.

Interprofessional education: a unique approach to addressing the challenges of student assessment

ABSTRACT There is emerging evidence on the value of interprofessional education (IPE) for health professional students; however, there is less focus on assessing students on IPE experiences in clinical placement contexts. Researchers have focused on student attitudes to, or readiness for, IPE. Multiple other elements need to be assessed, including formative student assessment, profession-specific competency standards, and students’ interprofessional (IP) capabilities. Effective and authentic IP-assessment models are needed that can both demonstrate student learning, and facilitate successful sharing of assessment amongst professionals. Supervisor’s perspectives on successful sharing of assessment amongst professions have not been addressed to date in the literature. This article describes one approach for IP-Assessment, using a complex theory framework and based on an iterative cycle of developing, implementing, and evaluating a student assessment tool within an international IP placement, which could be utilized in a range of settings. A qualitative research approach explores the strengths, challenges, and outcomes of IP-Assessment from the perspective of the supervisors. Three overarching themes were identified: acknowledging the student journey, interprofessional authenticity, and collective and collaborative learning. The process of developing and implementing IP-Assessment enabled the articulation of placement and assessment priorities and provided learning opportunities for both supervisors and students.

Development of a Certificate in Healthcare Improvement for Inter-Professional Teams

Introduction To address gaps in care team improvement-science education and connect geographically dispersed learners, we created a healthcare improvement certificate program, now completing the third program year, for inter-professional (IP) healthcare teams, including third year medical students. Methods This hybrid learning program consists of five modules: Learning Healthcare Systems, Improvement Science, Patient Safety and Diagnostic Error, Population Health and Health Equity and Leading Change. The curricular materials are comprised of focused readings, concise videos, faculty-moderated discussion boards, weekly synchronous calls of participants with faculty, and a longitudinal improvement project. The faculty are content experts, and worked with a curricular designer to define learning objectives and develop content. Results We have completed three years of this six-month program, training 61 participants (17 of whom were medical students) at 14 sites. In the third year, several medical students participated without an IP team. Development of the materials has been iterative, with feedback from learners and faculty used to shape the materials. Discussion We demonstrate the development and rollout of a hybrid-learning program for diverse and geographically dispersed IP teams, including medical students. Time restrictions limited the depth of topics, and scheduling overlap caused some participants to miss the interactive calls. We plan to evaluate the utility of the program for participants over time, using qualitative methods. Conclusion This educational model is feasible for IP teams studying improvement science and implementing change projects, and can be adopted to dispersed geographic settings.

The relationship between interprofessional education experience and perceptions, values, and attitudes towards interprofessional collaboration in dietetics practice

Abstract Interprofessional education (IPE) is associated with improved perceptions, values, and attitudes towards interprofessional (IP) collaboration, and therefore benefits patients, practitioners, and the health care system. However, little is known about how IPE translates into practice once students graduate and begin working in the field. This study examined if previous IPE experience impacts practicing Registered Dietitian Nutritionists' confidence to identify IP competencies, value of IP collaboration, attitudes towards teamwork, IP communication, and role clarity. Data were collected via electronic survey and consisted of questions about demographics, workplace characteristics, the impact of IPE, and IP collaboration concepts. The study sample consisted of graduates of a combined dietetic internship and Master's program, half of which participated in IP team seminars (IPTS) at the university. Means among the group without IPTS experience were higher for confidence to identify IPE competencies, value of IP collaboration, IP communication, and role clarity sections. The group with previous undergraduate IPE had higher means for all IP sections, with significantly higher means in the confidence to identify IPE competencies section (p-value = 0.09). A positive significant relationship was found between a physical space for IP collaboration and positive attitudes towards teamwork (p-value = 0.048). Overall, this study found participation in IPTS did not significantly improve perceptions, values, and attitudes towards IP collaboration among practicing dietitians.

Interprofessional Collaboration: An Evaluation of Social Work Students’ Skills and Experiences in Integrated Health Care

ABSTRACT Evidence shows that when an interprofessional (IP) approach is effectively implemented, it can counteract some of our most pressing health care problems. One such challenge is the lack of training in IP teamwork health care professionals receive during their education. Using a quasi-experimental matched comparison group design, this study assessed pre- and posttest changes in IP knowledge, attitudes, and skills of MSW students (N = 52) from 2015–2017, who received a specialized curriculum, and clinical internships working in IP teams, compared to an internal control group involving clinical IP teams alone. Two validated measures assessed changes in students’ IP knowledge, values, and skills. Quantitative findings and qualitative responses to open-ended questions elucidate barriers and facilitative factors in IP teams.

An interprofessional education workshop focusing on pain management and prescription opioid abuse

Abstract Interprofessional education (IPE) provides an opportunity to explore health professionals' contributions to pain management and to develop students' competencies in interprofessional (IP) collaborative practice. The purpose of this IPE workshop was to measure students' knowledge gains and changes in perceptions of core competencies for IP collaborative practice. The objectives for the workshop were that students would be able to: 1) Identify roles of healthcare team members in pain management, 2) Describe means of effective communication with the pain management healthcare team members, 3) Describe two pharmacological and two non-pharmacological interventions for pain management to decrease the use of opioids and 4) Reflect on the core competencies for IP collaborative practice. This IPE workshop on pain management and opioid abuse included a keynote speaker, an interprofessional panel and a patient case study. This format provided a comprehensive learning experience in a reasonable amount of time and was logistically feasible for health care professional students at one university.Demographic questions and the Interprofessional Attitudes Scale (IPAS) post-workshop surveys. The IPAS was modified to decrease response bias by removing the five subscale headings and reordering the questions. The post-survey also had three questions to measure achievement of workshop objectives. Scores for the core competencies of Teamwork, Roles and Responsibilities and Community- Centeredness demonstrated statistically significant increases. Post-survey analysis revealed a statistically significant difference by gender (females higher than males) on Teamwork, Roles and Responsibilities. Following the workshop students and faculty participants were emailed an online evaluation. The participants were asked to rate the effectiveness of the workshop: 1) components (keynote speaker, panel discussion and case study), 2) in helping participants to develop competence in IPE, and 3) as a learning experience. The effectiveness of the workshop in all three of these areas was rated as good to excellent by a majority of respondents. This IPE workshop format was effective and could be replicated to develop healthcare professional students’ knowledge of interprofessional pain management and to develop the core competencies of collaborative practice.

Evaluating interprofessional socialization: Matched student self-assessments surrounding underserved clinic participation

IntroductionTo determine if an existing tool, the Interprofessional Socialization and Valuing Scale (ISVS), can be used to measure student perceptions of interprofessional (IP) socialization and teamwork in a cohort of pharmacy, medicine, physical therapy, and social work students volunteering in a student-run free clinic (SRFC). MethodsThe ISVS was distributed to these health professions students before and after participation at the SRFC. After a one-month pilot, the plan was to collect data for 12 months. A power analysis determined a minimum sample size was 15 students (power = 0.8). Student surveys were matched utilizing unique alphanumeric identifiers. Results of IP socialization were analyzed by total group and health profession. ResultsA mean value for each ISVS domain was compared before and after the IP SRFC experience over 11 months; the pilot was not included in the final data set. Significant improvement in interprofessional socialization was observed across all ISVS factors including Self-Perceived Ability to Work with Others (p < 0.001), Value in Working with Others (p = 0.002), and Comfort in Working with Others (p < 0.001). Pharmacy and social work disciplines met the threshold for statistical significance for at least one factor. ConclusionsUtilizing the ISVS in an IP SRFC setting can detect changes in professional development that is influenced by beliefs, behaviors, and attitudes as self-assessed in our student population. Engaging students in such a clinic demonstrates educational value and potentially leads to significant improvement in their interprofessional socialization and teamwork skills.

A model for accelerating educational and clinical transformation in primary care by building interprofessional faculty teams: Findings from PACER

To accelerate change in primary care training by undertaking a national effort to build interprofessional (IP) faculty teams. This quasi-experimental mixed method study, conducted between 2015 and 2018, included >100 faculty and staff from medicine, nursing, pharmacy, physician assistant, and behavioral health from 9 institutions. Participants completed surveys at baseline, one year after training, and at program's completion to measure perceived changes in skills, clinics and training programs. Qualitative methods involved analyses of training and site visit observations and telephone interviews with team members. Self-assessment of competency in IP care and education, patient centered care, and leadership improved significantly for 15/15 (100%) skills assessed before and after program completion (p < 0.005). Medical home features improved significantly in all clinics (Leadership and Staff Engagement: 59.3% to 70.5%; Patient Self Management Support: 49.1% to 60.4%; and Team-Based Care: 44.2% to 56.9%, p < 0.05 for all comparisons). Joint educational activities across medical residencies and professions increased significantly (43.4% to 53.6% and 47.3% to 57.6% moderately or fully developed, respectively; p < 0.05 for all comparisons). At program completion, 75% of participants reported the program moderately or fully helped the team accomplish more than they would have working independently. Qualitative analysis identified that providing structure to bring together faculty from different professions, meeting regularly as a team, sharing best practices, and building trusting relationships made the greatest impact on transformation efforts. Creating and supporting IP primary care teams of faculty and staff within institutions appears to accelerate clinical learning environment transformation. Further study should determine if this model can sustain IP collaborative practice and education in other settings.

Attitude adjustments after global health inter-professional student team experiences.

How medical inter-professional (IP) education should be introduced to students is still a matter of research. We evaluated IP student attitudes before and after a busy “hands-on” clinical experience.During 3 separate trips, first/second year medical and physician assistant students and third/fourth year nursing students traveled to Central America to work together for 1 week in an underserved clinical setting. Student opinions on inter-professional education were obtained before and after Brigade-1 using the Readiness for Inter-professional Learning Scale validated questionnaire. From these results, a modified version of the survey was developed that included quantitative and qualitative responses. For brigades-2 and -3, students received this modified version of the survey pre and post brigade. Quantitative data was analyzed via paired student t test, and qualitative data was analyzed to identify emerging themes using constant comparative methodology by three separate investigators.No significant quantitative differences between IP student groups were observed in their evaluation of the importance of inter-professional education either before or after the brigades. Qualitative data noted pre-brigade expectations of positive IP, experiential and patient-centered cultural learning. Pre- and post-brigade student perspectives maintained a strong belief that high functioning IP care benefited the patient. Post-brigade perspectives revealed a shift in attitude from purely positive expectations to more practical aspects of teamwork, respect, and interpersonal relationships.Students believe that patient care benefits from IP collaboration. After a busy clinical experience requiring collaboration, students realized that functional teams require appropriate skills, roles, and respectful interpersonal relationships.

Assessing Self-Perceived Interprofessional Collaborative Competency on Advanced Pharmacy Practice Experiences Through Interprofessional Simulations

Objective. To implement and assess the impact of Doctor of Pharmacy (PharmD) students participating in a required interprofessional (IP) simulation during an advanced pharmacy practice experience (APPE). Methods. Fourth-year PharmD students completing APPEs were required to participate in one of three IP simulations during the 2016-2017 academic year to improve their interprofessional teamwork and collaboration skills. Pharmacy student self-perception of IP competence was measured by the Interprofessional Collaborative Competency Attainment Survey (ICCAS), administered in a retrospective pre-/post-test design. Responses were analyzed using descriptive statistics to obtain an overview of the data. Paired t tests were used to compare the pre- and post-test results. Results. During the 2016-2017 academic year, 157 PharmD students were assigned to complete an IP simulation. Student scores on the six subscales of the ICCAS (communication, collaboration, roles and responsibility, collaborative patient-centered approach, conflict management, and team functioning) were compared. Scores in all categories significantly increased after completion of the simulation. Conclusion. Following participation in an IP simulation, PharmD students felt competent to engage in IP collaboration, and this, along with their performance on APPEs, determined their practice-readiness for IP teamwork upon graduation.

Health Student Readiness Following Inter Professional Education based on Tri Kaya Parisudha

Health Student Readiness Following Inter Professional Education based on Tri Kaya Parisudha

Providing Remote Students with Access to a Video-enabled Standardized Patient Simulation on Interprofessional Competencies and Late-life Depression Screening

Background Standardized patient (SP) simulation is used to teach geropsychiatry. This project tested feasibility and effectiveness of video-enabled SP simulation to teach interprofessional (IP) late-life depression screening.Methods and findings Nurse practitioner, pharmacy, and medical students (N=177) participated in remote (n = 27) and on-site (n = 150) SP simulation. Linear mixed-effect model determined the effects of time and setting on pretest and posttest Interprofessional Education Collaborative Competencies Attainment Survey (ICCAS) data. Overall, no significant difference was observed in degree of change on ICCAS domains, indicating both modalities produced equally beneficial outcomes. Small sample size and focus on late-life depression screening limits generalizing results.Conclusions Video-enabled SP simulations can be incorporated to prepare students with IP competencies for late-life depression screening.

Increasing healthcare access for at-risk youth: How interprofessional collaboration works in population health

Abstract A school-based health center (SBHC) in Minneapolis demonstrates how interprofessional (IP) collaboration between the school nurse, public health professionals, high school faculty and staff can result in improved health access outcomes for underserved youth. Students enrolled in the host high school, a diverse (72% non-white) population, navigate many determinants of health including poor living conditions, food insecurity, increased stress, language barriers, and limited access to health care. This IP collaboration was designed to respond to the needs of this population by creating an overarching program to encourage student usage of the SBHC while building resiliency and capacity for delivering relevant health information. This program was associated with a dramatic (over 300%) increase in usage of the SBHC including a notable increase in male usage. The project demonstrated the potential of an education effort by creating and implementing an effective program to improve healthcare access and to normalize health promotion to an otherwise overlooked population.

Building Pre-Professional Students' Interprofessional Skills and Confidence: A Population Health Approach

Many graduates of health science programs lack the skills and confidence to incorporate multiple providers' perspectives when designing coordinated care outcomes. This longitudinal cross-sectional study used the Interprofessional Attitude Scale (IPAS) to study prelicensure nursing students' perceptions of interprofessional (IP) work. Between 2015 and 2018, IPAS scores and anecdotal data were collected for four consecutive semesters. Data suggest students' (n = 162) attitudes changed significantly toward teamwork, community centeredness, and biases with medium to large effect sizes (r = .33 to .51). Anecdotal findings echoed these shifts in student attitudes. There is no one ideal approach to build IP practice into curricula that is content saturated. With the shared commitment of IP faculty and the use of creative educational approaches, weaving IP processes into population health curricula encourages students to engage in IP work and develop the skills and confidence needed for IP practice. [J Nurs Educ. 2020;59(3):169-172.].

Implementing Interprofessional Collaboration to Improve Patient Outcomes: A Caring and Social Approach to Integrated Nurse-Led Community Based-Care

Nurses have a history of providing compassionate care while caring for patients living with co-occurring medical and mental conditions. Therefore, it is reasonable to develop and implement nurse-led interprofessional (IP) models of care to address chronic illness. A nurse-led IP model of care was evaluated utilizing three selected patient outcomes. Results revealed an increase in mental health stability and access to care and successful completion of a treatment plan. Integrating caring theory and practice with social determinants of health and nurse-led IP models of care is a valuable approach to improving patient outcomes and addressing health disparity.

The Benefits and Challenges of Interprofessional Training Programs Implemented to Increase Access to Primary Care for Medicaid Enrollees

Background: Interprofessional (IP) care teams that bring together health care providers from multiple disciplines can provide a broader scope of services and enhance efficiency so as to increase availability of providers. The use of IP teams may be of particular benefit for Medicaid enrollees who experience difficulty accessing care given socioeconomic barriers and limited provider availability. However, IP training is critical to ensure that health and social service providers understand their roles on these teams. Our study sought to understand the benefits and challenges of IP training programs, including how such programs could help improve access to health care for underserved populations. Methods: We conducted a qualitative study across 10 health care organizations where IP training programs had been implemented. Learners, preceptors, and program staff were interviewed and asked about the structure of the programs, individual roles within the programs, and satisfaction with the programs. Interviews were transcribed and analyzed using rigorous qualitative methods. Results: Two types of IP training programs were identified: those offering a specific program that integrated behavioral health and primary care, and those offering a general program that included multiple types of providers. Benefits of IP training included expanded access to primary care providers, increased ability to deliver ‘whole person care’ that addressed social determinants of health, and improved support across disciplines. Challenges included navigating logistics of integrating IP trainees into a program, changing expectations about approaches to IP care delivery, technology issues, and funding. Conclusions: IP training programs can increase access to care for Medicaid enrollees and improve primary care delivery by increasing the number of trained providers and improving the capacity of organizations to deliver care that addresses social determinants of health. Addressing challenges around logistics, technology, and funding can help IP training programs succeed and sustain their efforts to improve care for Medicaid enrollees.

Impact of the introduction of interprofessional education to first-year university students of health sciences

Background: There is a lack of coordination among various healthcare workers in a hospital which leads to an increase incidence of medical errors and patient sufferings. The various professionals in a hospital are not able to communicate effectively and neither they can understand each other’s roles and responsibilities. This is because they have not studied or learned together. For this reason, the concept of interprofessional (IP) education (IPE) is picking up which is when students from two or more professions learn together for better patient care. Aim and Objectives: The aim of the study was to find out the acceptance among 1st-year university students of IPE being introduced to them. Materials and Methods: Two hundred fifty 1st-year university students, belonging to various courses such as MBBS, BPT, B.Sc., and Diploma allied health sciences such as operation theatre, radiology, laboratory, biochemistry, and microbiology were brought together for a common lecture where they were explained the concepts of IPE and practice. They were divided into mix IP groups of five each and WhatsApp groups were formed and they were given assignments on the topic which they had to prepare online and present on the next date after 10 days in the class. The author joined as a facilitator in each group. Even a voluntary poster competition among these groups was held after 10 days. Results: The students were really enthusiastic and out of 50 groups formed, good interaction was visible in 45 of the groups. Twenty groups presented very highly made posters. More than 90% students gave positive feedback for this method of interactive learning and found themselves more comfortable in dealing with other course students. Conclusion: IPE is an innovative method of learning and if introduced early in the curriculum, can be highly accepted.