Bumsuk Lee

Changes in attitudes toward interprofessional health care teams and education in the first- and third-year undergraduate students

The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, implements a lecture style for the first-year students and a training style for the third-year students. Changes in the scores of modified Attitudes Toward Health Care Teams Scale (ATHCTS) and those of modified Readiness of health care students for Interprofessional Learning Scale (RIPLS) at the beginning and the end of the term were evaluated in the 2008 academic year. Two hundred and eighty-five respondents of a possible 364 completed the survey. In both the scales, the overall mean scores declined significantly after the lecture-style learning in the first-year students, while the scores improved significantly after the training-style learning in the third-year students. Exploratory factor analysis revealed that the modified ATHCTS was composed of three subscales, and the modified RIPLS two subscales. Analyses using regression factor scores revealed that the scores of “quality of care delivery” subscale in the modified ATHCTS and those of “expertise” subscale in the modified RIPLS declined significantly in the first-year students. Consequently, IPE programs may be introduced early in the undergraduate curriculum to prevent stereotyped perceptions for IPE, and comprehensive IPE curricula may result in profound changes in attitudes among participating students.

Attitudes toward interprofessional healthcare teams: A comparison between undergraduate students and alumni

The goal of effective interprofessional education (IPE) is high-quality patient-care delivery and attaining a high level of patient satisfaction in clinical settings. We aimed to examine if alumni who have studied in an IPE program at a pre-licensure stage maintain a positive attitude toward collaborative practice (CP) in the postgraduate clinical experience. This paper presents a cross-sectional descriptive study which employed the modified attitudes toward health care teams scale (ATHCTS) to examine the relationship between exposure to clinical practice and the attitudes toward interprofessional healthcare teams. Results indicated that the overall mean score of alumni was significantly lower than that of undergraduate students on the modified ATHCTS. Only “team efficacy” had a significantly lower regression factor score in alumni than undergraduate students. Our findings suggest that changes in professional identity in a team may be due to contact with patients after graduation in the postgraduate clinical healthcare experience. The reduction of attitudes toward healthcare teams in the postgraduate clinical experience may be related to “team efficacy”. We emphasize the need for in-service IPE for sustaining attitudes and providing a useful CP, which results in good clinical outcome.

Human brain response to visual stimulus between lower/upper visual fields and cerebral hemispheres

We studied the human brain response to visual stimulation in which a square area was randomly presented in upper and lower visual fields (VFs). Seven normal volunteers carried out a contrast-based visual search task. Magnetic responses were detected in the bilateral parietal regions at 200-250 ms after stimulus onset. We compared the response latencies and strengths of the essential single sensor and root mean square (RMS) of the regions. The former evaluates the strength of neural activity with relatively high spatial resolution, while the latter evaluates the global neural activity. The single sensor and RMS latencies for the lower left VF were significantly longer than that for the upper left (paired t-test, P<0.05). The strengths did not differ between the upper and lower left VFs. There was no significant difference in latency or strength between the upper right and lower right VFs. These findings suggest that only left VF has different response properties in the upper versus lower VF, and that both local and global extrastriate activities are responsible for this anisotropy.

Repeated cross-sectional study of the longitudinal changes in attitudes toward interprofessional health care teams amongst undergraduate students

Abstract The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, uses a lecture style for first-year students and a training style for third-year students. To investigate the comprehensive implications of IPE, the change pattern of attitudes toward health care teams was examined longitudinally in pre-qualified students. The modified Attitudes Toward Health Care Teams Scale (mATHCTS) was used. The overall mean score of the mATHCTS improved significantly after the training-style IPE in their third year. Two individual items in the factor “quality of care delivery” decreased significantly during the first year. In contrast, two individual items in the factor “patient-centered care” increased significantly during the third year. These changes over time were confirmed by analyses using regression factor scores. There are at least two independent attitudes toward collaborative practice (CP) or IPE in response to IPE interventions: the attitude toward “value of IPE for health care providers” may response negatively to IPE in the early stages, and the attitude toward “value of IPE for health care receivers” positively in the later stages. These findings suggest that the continuation of mandatory IPE, which must be designed on the basis of students’ high expectations for IPE and CP on entry, may result in profound changes in attitudes amongst participating students.

Attitudes of nursing school deans toward interprofessional education in Western Pacific Region countries

Abstract A previous survey distributed to medical school deans in the Western Pacific Region (WPR) showed positive attitudes toward collaborative practice and interprofessional education (IPE). This study aimed to clarify the present state of IPE and the attitudes of nursing school deans in the WPR. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) and the modified Readiness of healthcare students for Interprofessional Learning Scale (RIPLS) were used. Unexpectedly, the response rate was less than 20%. Deans of nursing schools with IPE courses showed significantly more positive attitudes than those of schools without IPE courses. The mean score of the modified ATHCTS and RIPLS of deans of nursing schools in rural areas were significantly higher than those in urban areas. Compared with medical schools, nursing schools in the WPR pay less attention to IPE and this may be one of the present characteristics of the region.

Professional identity acquisition process model in interprofessional education using structural equation modelling: 10-year initiative survey

ABSTRACT The mandatory interprofessional education (IPE) programme at Gunma University, Japan, was initiated in 1999. A questionnaire of 10 items to assess the students’ understanding of the IPE training programme has been distributed since then, and the factor analysis of the responses revealed that it was categorised into four subscales, i.e. “professional identity”, “structure and function of training facilities”, “teamwork and collaboration”, and “role and responsibilities”, and suggested that these may take into account the development of IPE programme with clinical training. The purpose of this study was to examine the professional identity acquisition process (PIAP) model in IPE using structural equation modelling (SEM). Overall, 1,581 respondents of a possible 1,809 students from the departments of nursing, laboratory sciences, physical therapy, and occupational therapy completed the questionnaire. The SEM technique was utilised to construct a PIAP model on the relationships among four factors. The original PIAP model showed that “professional identity” was predicted by two factors, namely “role and responsibilities” and “teamwork and collaboration”. These two factors were predicted by the factor “structure and function of training facilities”. The same structure was observed in nursing and physical therapy students’ PIAP models, but it was not completely the same in laboratory sciences and occupational therapy students’ PIAP models. A parallel but not isolated curriculum on expertise unique to the profession, which may help to understand their professional identity in combination with learning the collaboration, may be necessary.

A plan for embedding an interprofessional education initiative into an existing programme in a Southeast Asian university

ABSTRACT An interprofessional education (IPE) initiative was recently launched at the University of Health Sciences in the Lao People’s Democratic Republic, a country located in southeast Asia. During the process of reviewing the current curriculum, it was realised that the university has been providing a kind of IPE programme for more than a decade. Medical, pharmacy, dentistry, and nursing students were participating together in a community education programme. After identifying the programme’s strengths and challenges, a 4-year plan for embedding the IPE concept into the programme was developed. The plan was divided into four phases—sharing the key concepts of IPE, designing the programme, organising the interprofessional programme committee, and evaluating the effectiveness of the programme. In this short article, we describe the process that led to the plan’s creation and the experiences from the first two phases already completed.

Health science students’ attitudes towards healthcare teams: A comparison between two universities

ABSTRACT There have been few studies comparing the attitudes towards healthcare teams between different universities. This study analysed the differences in attitudes towards healthcare teams between health science students at Gunma University, Japan, which implements a comprehensive interprofessional education (IPE) programme, and Kanazawa University, a similar national university. Study populations were first- and third-year students at the Gunma University School of Health Sciences and the Kanazawa University School of Health Sciences. The present study was performed just after the IPE and multi-professional education subjects at Gunma University in the first term of the 2012 academic year. The first-year students were different cohort from the third-year students. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) was used to measure attitudes towards healthcare teams. The overall mean score on the modified ATHCTS of students at Gunma University was significantly higher than that of those at Kanazawa University. In both first- and third-year students, the regression factor score of “patient-centred care” was significantly higher at Gunma University than at Kanazawa University. Based on the present study, it can be stated that IPE may foster the value of collaborative practice (CP) among health science students.

Muscle activation patterns in acceleration-based phases during reach-to-grasp movement

[Purpose] An earlier study divided reaching activity into characteristic phases based on hand velocity profiles. By synchronizing muscle activities and the acceleration profile, a phasing approach for reaching movement, based on hand acceleration profiles, was attempted in order to elucidate the roles of individual muscle activities in the different phases of the acceleration profile in reaching movements. [Subjects and Methods] Ten healthy volunteer subjects participated in this study. The aim was to electromyographically evaluate muscles around the shoulder, the upper trapezius, the anterior deltoid, the biceps brachii, and the triceps brachii, most of which have been used to evaluate arm motion, as well as the acceleration of the upper limb during simple reaching movement in the reach-to-grasp task. [Results] Analysis showed the kinematic trajectories of the acceleration during a simple biphasic profile of the reaching movement could be divided into four phases: increasing acceleration (IA), decreasing acceleration (DA), increasing deceleration (ID), and decreasing deceleration (DD). Muscles around the shoulder showed different activity patterns, which were closely associated with these acceleration phases. [Conclusion] These results suggest the important role of the four phases, derived from the acceleration trajectory, in the elucidation of the muscular mechanisms which regulate and coordinate the muscles around the shoulder in reaching movements.

The validity and reliability of the Korean version of the Cancer-chemotherapy Concerns Rating Scale

OBJECTIVE The Cancer-chemotherapy Concerns Rating Scale was developed in Japan for outpatients undergoing chemotherapy, and its validity and reliability have been reported. The purpose of the study was to test the reliability and validity of the Korean version of the Cancer-chemotherapy Concerns Rating Scale. METHODS The questionnaire was filled out by 199 cancer patients, who were currently undergoing outpatient chemotherapy. The data were analyzed using exploratory factor analysis with Promax Rotation to determine the factor construct validity. The reliability of the Cancer-chemotherapy Concerns Rating Scale was investigated by Cronbachs alpha and the Spearman Brown coefficient. RESULTS Four factors were obtained and the overall structure was similar to that of the Japanese version; reorganization of daily life, self-existence, disease progress, and social and economic concerns. Cronbachs alpha for the total scale was 0.91 and the Spearman Brown coefficient was 0.85. CONCLUSIONS We found that the Korean version of the Cancer-chemotherapy Concerns Rating Scale could be clinically useful. It could provide health-care providers with information useful to understand the psychological state of patients undergoing outpatient chemotherapy.