Journal of Research in Interprofessional Practice and Education (JRIPE)
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Harnessing Complexity Science for Interprofessional Education Development: A Case Study
Get PDFBackground: Developing learning activities for interprofessional education (IPE) with a group of stakeholders often involves negotiation, collectivity, creativity, innovation, and unpredictable results. Theoretical approaches that can explain and support such emergent processes are needed. This case study explored the applicability of complexity science to explain the experiences of committee members as they developed learning experiences for an IPE placement in a non-acute care hospital.Methods and Findings: Data from a focus group with project steering committee members were re-analyzed through the lens of complexity science—specifically, three key principles of complex systems and five conditions for nurturing collective learning. Quotes were compared against each of these principles and conditions and, if there was a sufficient match, categorized accordingly into themes. These general themes were then sorted into clusters of sub-themes.Conclusions: Complexity science provides a useful framework for understanding the open-ended, unpredictable, and innovative IPE development process analyzed in this article. It also offers helpful practical guidelines for future learning activity and curriculum development
Using a Complex Systems Perspective to Achieve Sustainable Health Care Practice Change
Get PDFBackground: There has been a surge of interventions at health care settings to achieve practice change, but sustaining these new practices remains challenging. The purpose of the study is to use the Legacy Sustainability Model, a framework grounded in complexity science, to examine the implementation and sustainability of an interprofessional (IP) collaboration intervention in health care. The model considers the six factors communication, connections, coherence, continuous assessment, commitment and constructs essential to building capacity for sustainability.Methods and Findings: Three health care settings in Alberta implemented IP practice interventions over a six-month period. After three and six months, we interviewed participants at each site about the progress of the IP intervention and emerging challenges. We examined the interview data for emergence of the six factors of the Legacy Sustainability Model. Conclusions: Our analysis showed distinct contextual differences between the three sites as represented by the strengths of the six factors at the outset of the IP interventions and the way the factors evolved throughout the project. Using a complex systems lens may be valuable for examining contextual factors that might affect the success of a practice intervention and for monitoring progress towards capacity building for lasting practice change
Making the familiar extraordinary: Using a communication perspective to explore team based simulation as part of interprofessional education
Get PDFThis short report describes the qualitative analysis of a simulation exercise that was part of a larger interprofessional education curriculum designed to promote interprofessional collaboration within an acute care hospital. The purpose of this study was to explore the utility of a communication perspective as an analytic tool to support the intended learning outcomes of the interprofessional education initiative. In particular, the Coordinated Management of Meaning model was used as an exemplar of a pragmatic communication perspective. This study supports the need for scholars, practitioners, and educators to critically reflect on what we are making within our interprofessional education initiatives. The Coordinated Management of Meaning model provides a useful analytic frame to shape that reflection
Differences in Pre-licensure Interprofessional Learning: Classroom Versus Practice Settings
Get PDFAbstractBackground: Health Canada and Cochrane reviews indicate a need for rigorous outcome testing following interprofessional learning, particularly in practice settings. This led to research questioning whether knowledge, attitudes, perceptions, values, and skills regarding collaborative patient care improve after interprofessional learning in classroom and practice settings based on the degree of exposure to interprofessional learning compared to a control group.Methods and Findings: Pre-licensure students from seven health-profession programs were assigned to three groups: Control (no intervention), Education (classroom-based interprofessional learning), and Full-Participant (classroom-based and practice-based interprofessional learning). They were later surveyed to assess outcomes. Immersion at an interprofessional practice setting had a greater impact on scores than classroom-based interprofessional education. Both interventions significantly improved attitudes, perceptions, knowledge, and skills related to interprofessional collaboration. Only immersion improved the perceived importance of sharing leadership. Changes after the education intervention persisted at five-month follow-up.Conclusions: Interprofessional learning in classroom and practice settings positively impacted participants' knowledge, attitudes, perceptions and values, and skills regarding interprofessional teamwork. Use of a longitudinal study with a control group provided evidence that pre-licensure interprofessional learning would increase awareness of the need to collaborate. Findings encourage longerterm study of how interprofessional learning in various settings could improve how future practitioners approach patient care
The Development of Competencies in Interprofessional Health Care for Use in Health Science Educational Programs
Get PDFBackground: The Health Education Technology Research Unit (HETRU) at the University of Ontario Institute of Technology (UOIT) has developed an interprofessional framework for use as a learning map to create computer-based simulations that can automatically assess interprofessional competencies of undergraduate health sciences students.Methods: Our interprofessional competency framework was developed through an iterative process of competency mapping. Each iteration involved: 1) a literature review of interprofessional competencies, 2) the mapping of these competencies within a meaningful taxonomy, and 3) the review of the mapping by an expert panel of educators and clinicians.Findings and Conclusions: After three iterations, the research team developed a competency taxonomy that mapped interprofessional competencies from our literature reviews into six competency domains and three cross-cutting themes for each domain. The competency matrix was then used as a learning map to define learning resources related to interprofessional education and learning activities associated with such resources to help students develop competencies in interprofessional healthcare planning and delivery. Interactive, computer-based clinical simulations were then developed to portray opportunities in which the learning resources and activities could be explored and to provide more realistic exposure to complexities in healthcare planning and delivery
Through Teaching Are We Learning? Learning Through Teaching: Facilitating Interprofessional Education Experiences
Get PDFBackground: Despite a growing recognition of the value of collaborative patientcentred practice (CPCP) there is a lack of evidence identifying key elements and approaches to an effective interprofessional (IP) education intervention for clinical team members. The present study was conducted to address the paucity of rigorous mixed methods research to address the question: Does clinician team facilitation and mentorship of senior pre-licensure learners participating in IP clinical placements improve team members' attitudes, knowledge, skills, and perceived behaviours in CPCP?Methods: Based on the assumption that Geriatric Day Hospital clinical teams were already highly collaborative, educational experiences for clinical team members were not designed a priori. Rather, the educational experience was grounded in Mezirow's transformative learning theory, proposing that learning is a process of becoming aware of one's assumptions and revising these assumptions based on critical self-reflection. The option to participate in structured observation and feedback by an external observer using the Team Observation Scale provided important and unique opportunities for team reflection. Using the Controlled Before and After (CBA) design, the Attitudes Toward Health Care Teams Scale (ATHCTS), Team Skills Scale (TSS), and Knowledge Questionnaire were administered pre- and post-clinical placements to intervention and control groups. Data were analyzed by descriptive, bivariate, and repeated measures ANOVA. Qualitative data (evaluation and self-reflective forms) were analyzed using content analysis techniques.Results: Eleven IP clinical placements at 3 sites occurred between January 2007 and March 2008 (intervention N = 48; control N = 7). There was no significant change over time between intervention and control groups for the ATHCTS Quality of Care or Physician Centrality subscale scores, the TSS scores, or the Knowledge scores. Qualitative results suggested that participants were more aware of IP teaming, reflective of their own practice, and reported making changes in their own practice and mentorship of students as a result of their engagement in the study.Conclusions: This study demonstrated the viability of using structured observation and feedback processes as a reflective learning exercise. Further research is required to help identify key approaches and elements to an effective IPE intervention in clinical practice
Influencing Student Beliefs about Poverty and Health through Interprofessional Community-Based Educational Experiences
Get PDFBackground: Pre-licensure students from medicine, physical therapy, kinesiology, nursing, and social work participated in a population health project at the University of Saskatchewan. We assessed the effect of this interactive, interprofessional, community-based educational experience on students’ attitudes and beliefs about poverty and health.Methods and Findings: Participants (N = 119) completed two measures at the beginning and end of the five-week project: the 37-item Attitudes toward Poverty Scale (APS) and the 8-item Beliefs about the Relationship between Poverty and Health (BRPH). APS scores showed a modest significant increase toward more positive attitudes over time (F(1, 110) = 7.97, p < .01). On the BRPH, participants agreed significantly less at Week 5 with two behavioral explanations (F(1, 114) = 5.07, p < .05; F(1, 114) = 11.00, p < .01) and one structural explanation (F(1, 112) = 11.09, p < .01) about relationships between poverty and health. There was some evidence that face-to-face interactions with community members had more impact than a simulation exercise. Students gave positive evaluations of the interprofessional format of the project. Attrition effects may limit the interpretation of these results.Conclusions: Results demonstrate that brief interprofessional community-based learning experiences can positively influence students’ attitudes and beliefs about the relationship between poverty and health
Exploring Effects of Interprofessional Education on Undergraduate Students Behaviour: A Randomized Controlled Trial
Get PDFBackground: One way to improve the quality of palliative care for elderly patients is to use an interprofessional team approach, which may be encouraged through interprofessional education (IPE). However, the effectiveness of IPE interventions has yet to be proven. We therefore designed a randomized controlled trial using a simulated practice setting to measure the effects of an IPE intervention on medical students’ clinical behaviour.Methods: Undergraduate nursing (N = 20) and medical (N = 20) students were evenly assigned to either an intervention or a control group. Students in the intervention group received interprofessional curriculum (12 teaching units), and the control group was given written material containing the content of the IPE curriculum. Using a pre-post design, clinical behaviour of matched pairs of nursing and medical students was analyzed for qualitative (care objectives) and quantitative aspects of communication (initiation, interruptions, speaking time, and exchanged information items). Statistical analyses included chi-square, Fisher’s exact, and t-tests, where appropriate.Results: Care objective scores improved in both groups (categories N = 6, p-range = intervention group: .001–.630; control group: .001–.888). Interruptions and speaking time showed no change between or within groups, while the number of nursing student-initiated contacts increased (p = .0007). The number of information items exchanged increased significantly in both the intervention group (Pre: M = 9.65, SD = 1.79; Post: M = 12.35, SD = 1.87; p = .001) and the control group (Pre: M = 8.75, SD = 2.59; Post: M = 11.75, SD = 2.22; p = .001).Conclusions:We found a moderate effect of IPE on a change in interprofessionalcommunication style
A Qualitative Study of Workplace Factors Influencing Expertise in the Delivery of Children’s Education and Mental Health Services
Get PDFBackground: Interest in professional expertise is growing. Interactional and developmental perspectives are being adopted to understand the nature of expertise and the environmental factors that influence its development. This article provides qualitative information about the workplace factors and experiences considered important by individuals providing education or mental health services to children, with one group working within an interprofessional team approach (service providers) and the other working in a discipline-specific manner (teachers).Methods and Findings: Two focus groups were held: one involving 5 elementary or secondary school teachers and principals, and one involving 9 therapists who provide specialized children’s mental health services. Information arising in these group sessions was used to develop themes reflecting key elements discussed; the themes were then contrasted to infer differences between the two groups. The findings point to the importance of establishing a collaborative, learning-oriented workplace culture, including opportunities for varied work experiences, peer interaction and dialogue, and feedback.Conclusions: Implications include adopting relationship-oriented and collaborative service delivery models and ensuring that workplace settings encourage natural learning opportunities involving interaction, dialogue, and feedback, as well as meaningful professional development experiences of value to participants