Interprofessional education (IPE) has a longstanding presence in the health and social care (HASC) professions, by which its sustainable implementation in HASC professional education has the potential to effectively prepare HASC professional students for interprofessional collaborative practice (IPCP). Implementation of IPE has increased over the last two decades with the emergence of a curriculum guided by constructivist epistemology and learning theories that emphasize demonstrating competence in practice. Nonetheless, since IPE first emerged in the early 1960s, most IPE initiatives have been sporadic and lacked guidance through theoretical underpinnings. This conceptual article first discusses why it is important to have theory drive HASC professional education. Next, it explores what is meant by curriculum, followed by a discussion on the importance of curriculum theory to HASC professional education processes. This article then illustrates the learning theories arising from behaviourist and constructivist epistemologies that inform curriculum theory in the HASC professions, with particular emphasis on how constructivist learning theories inform IPE. Lastly, the article proposes a theoretical framework for productive engaged learning through which IPE opportunities may be grounded, leading to student proficiency in interprofessional professional competencies (knowledge, skills, and dispositions), establishment of professional communities of practice, and eventual improvement of patient/client-oriented outcomes.
Background: Health systems globally need more clinicians to work rurally and in community-based primary care. This study explores factors influencing health graduates’ choice of clinical setting and geographical location during early careers, across a range of disciplines that work together to support the health of people in community-based and rural locations.Methods: Students from eight disciplines (n = 611) were recruited prior to their final year of pre-registration training. Data were collected via three electronic surveys completed at the end of participants’ first, second, and third year of clinical practice. Data were managed and analyzed with Template Analysis.Findings: Similar factors influenced clinical setting and location choice but differed in relative importance for each. The nature of the job itself was the most important factor influencing clinical setting choices. A broader range of influences were important to geographical location choices including personal reasons, the nature of the job, the nature of the location, and job availability and opportunities. Regulatory or training requirements limited choices available to some clinicians, particularly those from medicine.Conclusion: A range of complex and interacting factors influenced health graduates’ career choices. Findings indicate that a broad system-wide approach is needed to address community and rural health workforce needs.
Background: A scoping review was conducted to map the current body of research pertaining to simulation-enhanced interprofessional education (Sim-IPE) as a modality for teaching interprofessional collaboration (IPC) in the emergencydepartment (ED).Methods and Findings: The research team followed the PRISMA Extension for Scoping Reviews framework. Studies were included if they involved two or more healthcare professions, utilized simulation as the learning method for interprofessional education (IPE), involved simulation pertaining to the ED, and identified at least one Canadian Interprofessional Health Collaborative or Interprofessional Education Collaborative IPC competency as a learning outcome. In total, 896 studies were included for title and abstract screening and 806 were deemed irrelevant. Ninety full-text studies were assessed for eligibility and 34 were included in the review.Conclusions: Eighteen studies found Sim-IPE to be an effective method for teaching interprofessional competencies in the ED. Simulation-enhanced interprofessional education appears to be a promising methodology for teaching IPC competencies to ED healthcare professionals. Interprofessional collaboration competency frameworks should be utilized to guide Sim-IPE, and assessment tools specific to interprofessional competencies should be used in the assessment phase of Sim-IPE. Faculty development is a crucial component of Sim-IPE. Further longitudinal and outcome-based research is required.
Background: Despite the growing presence of physiotherapy private practitioners within Australia’s healthcare workforce, little is known about their perspectives of interprofessional collaborative practice (IPCP). This study aims to explore the barriers to IPCP from the perspective of Australian physiotherapy private practitioners. Methods: Semi-structured interviews were conducted with 28 physiotherapists and 64 hours of observation was completed in 10 private practice sites in Queensland, Australia. Interview and observation data were pooled and analyzed using reflexive thematic analysis. Findings: Data analysis produced five themes that characterized physiotherapists’ perspectives of IPCP: a) competition for clientele, b) personal attitudes and beliefs, c) time constraints and work schedules, d) geographic location, and e) rules of funding schemes. Conclusion: The findings from this study suggest that implementing IPCP in the Australian physiotherapy private practice setting presents several challenges. Financial concerns, such as physiotherapy private practitioners’ perceived need to compete for clientele, were significant barriers to IPCP. The introduction of financial incentives and adoption of alternative payment models may be necessary to provide physiotherapy private practitioners with a clear motivation to engage in IPCP. The need for more formal opportunities to bring health practitioners from diverse professional backgrounds together to gain new insights and knowledge of other professions’ expertise and challenge their own assumptions was also highlighted.
Background: In health and social care (HASC) professional education, interprofessional competencies are optimally developed by engaging in interprofessional education (IPE) activities that are delivered sustainably along a continuum. Ultimately, active engagement in IPE is meant to prepare future practitioners for interprofessional collaborative practice (IPCP), which leads to improved patient/client and community-oriented outcomes. Methods and Findings: This qualitative case study explores how four Canadian post-secondary institutions deliver IPE within their HASC professional education programmatic structures. Data were collected from institutional websites, publicly available IPE relevant records and documents, and interviews with coordinators and faculty/facilitators of IPE curriculum. Data were inductively analyzed to generate relevant themes, followed by a deductive analysis guided by the five accreditation standards domains identified in the Accreditation of Interprofessional Health Education (AIPHE) projects. Analyses of the data resulted in five attributes: 1) central administrative unit, 2) longitudinal and integrative program, 3) theoretically informed curriculum design, 4) student-centred pedagogy, and 5) patient/client-oriented approach. Conclusions: Using these attributes and guided by AIPHE’s accreditation standards domains, an organizational-curricular model for sustainable IPE is proposed, through which we assert that IPE reinforced through these organizational and curricular supports reflects successful programming, leading to patient/client-oriented outcomes.
Background: An introductory, longitudinal, authentic experiential IPE opportunity named LIFE was delivered. The objectives were to 1) compare attitudes, including cultural attitudes and beliefs, and team behaviours of learners over time, and 2) assess association between participation in LIFE and changes in team attitudes and performance. Methods: Students (n = 48) from eight schools worked in eight teams. Each team was assigned to a patient/family, who was asked about health and healthcare experiences. Students completed Students’ Perceptions of Interprofessional Clinical Education–Revision 2 (SPICE-R2), Cultural Attitude and Belief Scale (CABS), and Interprofessional Collaborator Assessment Rubric (ICAR). Analyses focused on differences over time for all participants and by team. Findings: Knowledge of roles improved for four teams, and five teams showed improvements in “techniques” to interact with diverse patients. Notably, “communication,” “collaborative working,” and “roles” changed across three teams for ICAR. One team showed improvements in all three assessments and two teams showed little to no changes. Conclusion: LIFE was associated with improvements in “roles” and “techniques” to help teams interact with diverse patients.
Background: Peer-to-peer (P2P) learning occurs when individuals from similar social groups or professions help each other to learn new knowledge skills or problem solving. Peer-to-peer learning is used across many disciplines but has not been widely studied in primary care or chronic disease management. This study explored the use of an interprofessional P2P approach to support the implementation of a chronic disease management program in primary care for patients with chronic obstructive pulmonary disease (COPD), known as Best Care COPD (BCC). Methods and findings: A single descriptive case study design was used to explore P2P learning implementation approach. Focus groups and key informant interviews were held with providers involved in implementation (n = 26). Three key components of the P2P approach were identified: 1) an interprofessional team, 2) iterative peer-led training, and 3) continuous peer connection. Three recommendations are provided to support future P2P efforts: 1) enlist a champion in each profession, 2) build a P2P community, and 3) implement succession planning. Conclusion: This article provides an empirical example of the use of a P2P approach in primary care program implementation. The results will inform the future implementation of programs for chronic disease management as well as the continued sustainability of the BCC program.
Background: Global culture influences health behaviors and attitudes and the way we communicate and solve problems; it can also significantly affect the efficiency of the multicultural and interprofessional healthcare team. This scoping review aims to understand and identify global cultural considerations that exist in interprofessional education (IPE) and that influence the development, implementation, and effectiveness of IPE. Methods and Findings: The search included peer-reviewed articles focused on both IPE and global culture, also referred to as national, ethnic, or racial culture. There was no limitation placed on levels of learners nor specific health professions. Articles were excluded if they did not explicitly discuss global cultural considerations in IPE. The authors screened 1094 records, and 155 full-text articleswere assessed for eligibility. No eligible papers were found for inclusion yielding an empty review. The most common reasons for exclusion were failure to address global culture and a focus on provider-patient cultural competency as opposed to cultural aspects of IPE. Conclusions: Despite the recognition of the importance of global culture in all interactions, it is not explicitly addressed within the interprofessional healthcare team or the development and implementation of IPE. Studies addressing culturally congruent teamwork and IPE, and the relationship to culturally inclusive patient care, are needed.
Background: Understanding how patients perceive their role in the healthcare team can improve overall satisfaction of care and health outcomes. However, it has been challenging to capture the diversity of patient experiences using traditional research approaches. The goal of this study was to explore the perspectives of patients involved in an interprofessional team-based chronic disease management program for chronic obstructive pulmonary disease using visual research techniques. Methods: Our visual approach began with patients autonomously drawing (or mapping) experiences with their healthcare team. The maps were explored with the patients through focus group discussions. Maps were inductively coded to identify similarities and differences between participants’ perceptions. Focus group transcripts were first analyzed independently, then compared to and integrated into the map analysis. Findings: Overall, participants (n = 13) were satisfied as patients of team-based care. Participants drew multiple healthcare providers, sources of information, and themselves to represent their teams. Relationships and significance were represented using arrows, the size of each team member, facial expressions, and symbols. Four key elements of effective team-based models of care emerged: 1) effective information sharing, 2) diversity of providers’ roles, 3) empowerment through self-management, and 4) enhanced access to care. Conclusion: This study used visualization methodology to obtain patient feedback on the program’s performance, elicit patients’ experiences, and attempt to mitigate some of the limitations of isolated survey and focus group methodology, subsequently obtaining rich data on team-based care. Our research also informs ongoing quality improvement of the team nbased model for chronic disease management.
Background: The capability of an interprofessional healthcare team to reach a shared understanding through group reasoning is critical to good healthcare delivery. Models for clinical reasoning have proved useful but remain focused on individual cognitive processes. Whilst interprofessional education has steadily gained real-world traction, it is unclear how interprofessional student groups practice group reasoning when performing online tasks.Method: We analyzed the group reasoning processes with two teams of health professional students in an online interprofessional education task (n = 13). Two simulated interprofessional team meetings about a palliative case were audio recorded, transcribed, and deductively analyzed to determine the mechanisms of team deliberation using a previously published study of group reasoning.Results: The reasoning mechanisms outlined in a previous study (informationaccumulating, sense-making, and decision-making) were evident in an analysis of student group reasoning. In particular, students focused on sharing and agreeing on information, and to a lesser extent, recording information.Conclusion: Attention to the mechanisms of action may be useful to facilitate teaching interprofessional reasoning. Group reasoning may benefit from focusing student attention on these stages: 1) prioritizing and sequencing of options, methods for exposing agreement about shared information, shared understanding of the situation, and options; 2) techniques for critically evaluating information so that opportunities arise to identify when information may disrupt existing understandings; and 3) development of documentation tools to assist recording of the process.
Surveys are widely used in interprofessional education (IPE) research and these often collect free-text data. The potential contribution of free-text data to analysis and interpretation is often missed through separate reporting of qualitative and quantitative results, or free-text analyses being superficial or limited to subsets of data. There is little published guidance on how to maximize the use and integration of free-text comments with quantitative responses in large datasets collected over multiple years. Analysis of all qualitative comments, within the context of their related quantitative answers, enables exploration of changes in participants’ construction of meaning over time. This article describes how we used template analysis to analyze 3,626 free-text responses, collected as part of a five-year survey exploring the impact of an IPE program on health professionals’ attitudes to teamwork and early careers. We outline the main procedural steps undertaken by a team of researchers and we share our insights into the methodological challenges encountered. This article aims to inspire other researchers at the planning stage of research proposals, and assist them with practical ideas during data extraction, management, analysis, and reporting of large free-text datasets. We conclude that template analysis has methodologically sound, pragmatic utility in IPE longitudinal survey research
Background: The Trainee Participant Survey was developed for the evaluation of the Department of Veterans Affairs, Centers of Excellence in Primary Care Education (VA CoEPCE), which developed and delivered an interprofessional education (IPE) postgraduate curriculum to learners of multiple professions at seven geographically diverse VA facilities across the United States.Methods and findings: Perceptions of the curriculum by learners across professions were assessed to identify differences in curricular perceptions and unmet needs to inform programmatic changes. The comparison of responses by profession revealed no statistically significant differences across the core domains; precepting, supervising, mentoring; or program practices. Trainee professions differed significantly on satisfaction and system impacts.Conclusion: The Trainee Participant Survey has excellent psychometric properties and can serve as a model for evaluating future IPE programs.
Background: To facilitate a stronger recognition of the importance of the healthcare educator role and clearer communication regarding IPE, consensus is needed regardingn the values and areas of activity that all healthcare educators share, regardless of professional group. Methods and findings: A five-phase consensus process was used, consisting of a survey and search to identify guidance documents, a literature review and text analysis, a face-to-face consensus meeting, a novel workshop to develop organizing principles, and a two-stage Delphi consultation. This consensus process resulted in a nine-item list of shared values and 25 activities sorted into four domains. Conclusion: This article reports the development of a rigorous and collective consensus statement on the core values and activities shared by all healthcare educators. This is a necessary preliminary to establishing the groundwork on which interprofessional educational initiatives can be built.
Background: Interprofessional learning (IPL) research is mainly restricted to health students. The purpose of this study was to assess the IPL preparedness of students from health, social care, and teacher education programs.Methods and findings: This project comprised an exploratory cross-sectionalstudy and online questionnaire. Of the 221 students included, the majority hadlearned about their own future role. In contrast, less than 20 percent had learnedabout other roles.Conclusions: This study suggests that teacher education and health and social carestudents were not equally prepared for IPL. Future research should explore howeducators may balance an unequal understanding of roles among students.
Background: The purpose of this study was to assess learning outcomes and student satisfaction after participating in a large-scale interprofessional (IPL) blended learning course.Methods and findings: In this cross-sectional study, students from health, social care, and teacher education programs completed two questionnaires. The majority were satisfied with the blended learning approach. The IPL group discussions resulted in learning outcomes that were two times higher than those from traditional instruction, including lectures and assignments. Health and social care students reported lower learning outcomes and satisfaction than teacher education and child welfare students (p < 0.05).Conclusions: The study demonstrated the feasibility of the blended learningapproach. However, IPL activities that are explicitly inclusive for all studentsshould be created for future courses.
Background: Interprofessional emergency department (ED) models of care, including physiotherapists, have emerged to answer growing demands for ED care. The purpose of this study was to assess the perceptions of ED physicians regarding ED physiotherapy.Methods and findings: Ninety-five ED physicians, members of one of two ED physicians’ associations in the province of Québec, completed a survey (response rate = 14.7%). Most had a positive perception of physiotherapists’ competencies (96.8%) and were confident that ED physiotherapy care is safe and efficient (96.8%).Conclusions: Based on responses from this limited sample, ED physicians have a positive perception of ED physiotherapy models of care.Keywords: Emergency department; Physiotherapy; Advanced practice physiotherapy;Acceptability; Models of care
Objectives: To describe the development and evaluation of a university-wide competency and evaluation framework for intra- and interprofessional education (IPE) teamwork.Methods: Development of the framework was based on existing literature and specific contexts of the schools within our university. Evaluation and program alignment regarding use of the framework were achieved through qualitative interviews with deans of the Schools of Medicine, Nursing, and Pharmacy, and focused on how they evaluated student progression towards the university-wide teamwork competency. Interview data were analyzed using classical content analysis.Results: Despite efforts to carefully design the framework, interviews revealed that significant variation exists regarding when and how both IPE and team-based care are taught and evaluated across schools. Common barriers to interprofessional education included variations in teamwork practices across disciplines, scheduling challenges, and lack of resources for implementation. Recommendations for how to align teaching and evaluation activities with the framework are posed.Conclusions: Longitudinally tracking the development of interprofessional competencies within/across health professions schools requires careful planning and collaboration among institutional leaders, interprofessional educators, program evaluators, and students. The information gained from this process provides insights toward implementing future high-quality IPE in teamwork and other inter- and intraprofessional competencies, which may be helpful to others.
Background: Interprofessional collaboration in practice (IPCP) between professionals from the medical and social domain within primary care is desirable; however, it is also challenging due to fragmented healthcare. Little is known about the development of IPCP in primary care to fit the implementation context. This article describes the methodological development and the final content of an IPCP program.Methods and findings: The development process started with the identification of IPCP competencies in a literature review and a qualitative needs analysis with semi-structured interviews among eight elders and four health care professionals. The results were discussed during a first consultation with an expert team, which consisted of ten health care professionals. Consensus was reached on the themes role identity, communication, and shared vision development to form the basis of the program. A second consultation with the experts discussed the first version of the program. Then, consensus was reached on the final version of the program, which included a blended learning approach consisting of two face-to-face meetings, online learning, and on-the-job learning with a sixteen-hour time investment over a six-week period.Conclusions: The IPCP program was developed based on educational strategies and evidence, and with the support and knowledge of practice experts to fit the implementation context.
Background: Interprofessional experience is vitally important for nutrition students, as nutritionists often find themselves working independently in a team with other professionals. Few studies have explored qualitatively how nutrition students perceive learning activities in an interprofessional setting.Methods and Findings: Third-year bachelor’s degree nutrition students participated in a focus group interview after interprofessional learning in a nursing home. A qualitative study with a phenomenological-hermeneutical approach was conducted to investigate lived experiences. One theme emerged from the data analysis: A professional understanding of oneself and others. Being acknowledged as a professional, being an active participant, and collaborating to enhance resident care were revealed as sub-themes.Conclusions: A short period of interprofessional learning in an authentic setting may expand students’ experiences and enhance professional confidence.
Background: Research recognizes that collaborative working between academic organizations and clinical institutions may help realize the effective delivery of patient care. Yet, few studies report on the processes required to effect the necessary changes. Ths article reports on a research process that was delivered by a team of academics and clinicians that aimed to illuminate processes of interprofessional collaboration.Methods and findings: Semi-structured interviews were conducted with eight participants selected from both a university and a foundation trust. Data were analyzed using thematic analysis.Conclusions: The fruits of interprofessional practice and collaboration have beneficialeffects, especially for the patient. These are realized through the collegialefforts of stakeholders from each organization, where consistent effort, cooperativeand inclusive actions facilitate participative agency, resulting in rich relationships.
