Monica Moran

Learning outcomes for interprofessional education (IPE): Literature review and synthesis.

As part of a World Health Organization (WHO) initiative we searched the literature to explore defined learning outcomes for interprofessional education between 1988, when the last WHO technical report on interprofessional education was published, and 2009. We describe and synthesize findings from 88 citations over this 21 year period. There is a variety in the way learning outcomes are presented but there are many similarities between specific outcomes and/or objectives. Papers describing educational interventions do not always include specific outcomes or objectives. Our findings have been integrated into a list of learning outcomes with six categories for further debate and discussion. This project is part of a wider initiative initiated by the WHO in 2007 to review the current position of interprofessional education worldwide. It is also a sub-project of a learning and teaching grant funded by the Carrick Institute for Learning and Teaching within Australia. In this paper we use the CAIPE definition of interprofessional education: “Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (Barr, ).

Making interprofessional education real: a university clinic model.

Interprofessional education (IPE) is an emerging focus in the professional training of allied health students. To date, IPE has occurred in classroom teaching or case simulations, rather than in the provision of client services. At the University of Queensland, students in occupational therapy, speech pathology and music therapy participate in both on-campus and community-based IPE clinics conducted by university staff. These clinics are planned and implemented to promote interprofessional learning for students, and to provide integrated service provision for children and young people in the community. An adapted version of Bronsteins model of interdisciplinary collaboration is used to guide IPE processes, including team orientation, joint goal-setting and intervention planning, and integrated delivery of therapy sessions. The development and implementation of these IPE clinics is described, together with challenges to clinical IPE in the university context.

Characteristics of student preparedness for clinical learning: clinical educator perspectives using the Delphi approach

BackgroundDuring clinical placements, clinical educators facilitate student learning. Previous research has defined the skills, attitudes and practices that pertain to an ideal clinical educator. However, less attention has been paid to the role of student readiness in terms of foundational knowledge and attitudes at the commencement of practice education. Therefore, the aim of this study was to ascertain clinical educators’ views on the characteristics that they perceive demonstrate that a student is well prepared for clinical learning.MethodsA two round on-line Delphi study was conducted. The first questionnaire was emailed to a total of 636 expert clinical educators from the disciplines of occupational therapy, physiotherapy and speech pathology. Expert clinical educators were asked to describe the key characteristics that indicate a student is prepared for a clinical placement and ready to learn. Open-ended responses received from the first round were subject to a thematic analysis and resulted in six themes with 62 characteristics. In the second round, participants were asked to rate each characteristic on a 7 point Likert Scale.ResultsA total of 258 (40.56%) responded to the first round of the Delphi survey while 161 clinical educators completed the second (62.40% retention rate). Consensus was reached on 57 characteristics (six themes) using a cut off of greater than 70% positive respondents and an interquartile deviation IQD of equal or less than 1.ConclusionsThis study identified 57 characteristics (six themes) perceived by clinical educators as indicators of a student who is prepared and ready for clinical learning. A list of characteristics relating to behaviours has been compiled and could be provided to students to aid their preparation for clinical learning and to universities to incorporate within curricula. In addition, the list provides a platform for discussions by professional bodies about the role of placement education.

An exploratory review of pre-qualification interprofessional education evaluations

Abstract There are diverse perceptions about the primary purpose of evaluation. In interprofessional education (IPE), there has been a perceived focus on evaluating against the outcome of improved collaborative practice and quality of care. This paper presents an exploration of the nature and purpose of evaluation methods commonly utilized in the IPE literature with its focus on outcomes-based evaluation and particularly the Kirkpatrick framework. It categorises recent evaluations of pre-qualification (pre-certification) IPE interventions. Of the 90 studies included, most evaluated soon after the educational intervention, only five specifically referred to an evaluation framework and the most frequently used tool was the RIPLS. There was a noteworthy reliance on students’ self-rated perceptions of their attitudes towards collaborative practice collected through surveys, focus groups and interviews. There appears to be a need to reconsider the type of evaluation required. In conclusion, this paper offers recommendations for evaluation practice that is moving towards realist approaches; describes the longer term effects of interventions on attitudes and behaviour; develops and validates data collection tools including direct observation of practice and more comprehensively engages with all stakeholders to ensure that evaluation activities are not only focused on improving IPE but also on enhancing our understanding of interprofessional practice.

Interprofessional collaborative practice: A deconstruction

This paper uses (and perhaps abuses) deconstruction to revisit the meanings of collaboration and practice. We start with a description of deconstruction itself, as espoused by Jacques Derrida, and then move onto challenging the notion that words, such as collaboration, can have fixed meanings. And, in the spirit of Derrida, “I can foresee the impatience of the bad reader: this is the way I name or accuse the fearful reader, the reader in a hurry to be determined, decided upon deciding (in order to annul, in other words to bring back to oneself, one has to wish to know in advance what to expect…)” (Derrida, 1987, p. 4 – original italics), we move straight into the text.

International consensus statement on the assessment of interprofessional learning outcomes.

Abstract Regulatory frameworks around the world mandate that health and social care professional education programs graduate practitioners who have the competence and capability to practice effectively in interprofessional collaborative teams. Academic institutions are responding by offering interprofessional education (IPE); however, there is as yet no consensus regarding optimal strategies for the assessment of interprofessional learning (IPL). The Program Committee for the 17th Ottawa Conference in Perth, Australia in March, 2016, invited IPE champions to debate and discuss the current status of the assessment of IPL. A draft statement from this workshop was further discussed at the global All Together Better Health VIII conference in Oxford, UK in September, 2016. The outcomes of these deliberations and a final round of electronic consultation informed the work of a core group of international IPE leaders to develop this document. The consensus statement we present here is the result of the synthesized views of experts and global colleagues. It outlines the challenges and difficulties but endorses a set of desired learning outcome categories and methods of assessment that can be adapted to individual contexts and resources. The points of consensus focus on pre-qualification (pre-licensure) health professional students but may be transferable into post-qualification arenas.

Taking stock of interprofessional learning in Australia.

Changes in health service delivery and issues of quality of care and safety are driving interprofessional practice, and interprofessional learning (IPL) is now a requirement for medical school accreditation. There is international agreement that learning outcomes frameworks are required for the objectives of IPL to be fully realised, but there is debate about the most appropriate terminology. Interprofessional skills can be gained in several ways — from formal educational frameworks, at pre‐ and post‐registration levels to work‐based training. Research activity suggests that many consider that IPL delivers much‐needed skills to health professionals, but some systematic reviews show that evidence of a link to patient outcomes is lacking. Australian efforts to develop an evidence base to support IPL have progressed, with new research drawing on recommendations of experts in the area. The focus has now shifted to curriculum development. The extent to which IPL is rolled out in Australian universities will depend on engagement and endorsement from curriculum managers and the broader faculty.

Introducing the individual Teamwork Observation and Feedback Tool (iTOFT): Development and description of a new interprofessional teamwork measure

ABSTRACT The individual Teamwork Observation and Feedback Tool (iTOFT) was devised by a consortium of seven universities in recognition of the need for a means of observing and giving feedback to individual learners undertaking an interprofessional teamwork task. It was developed through a literature review of the existing teamwork assessment tools, a discussion of accreditation standards for the health professions, Delphi consultation and field-testing with an emphasis on its feasibility and acceptability for formative assessment. There are two versions: the Basic tool is for use with students who have little clinical teamwork experience and lists 11 observable behaviours under two headings: ‘shared decision making’ and ‘working in a team’. The Advanced version is for senior students and junior health professionals and has 10 observable behaviours under four headings: ‘shared decision making’, ‘working in a team’, ‘leadership’, and ‘patient safety’. Both versions include a comprehensive scale and item descriptors. Further testing is required to focus on its validity and educational impact.

The Health Care Team Challenge™: developing an international interprofessional education research collaboration

Interprofessional education (IPE) to improve and increase interprofessional collaborative practice (IPC) has been documented for over 50 years in Canada, but it is within the last 15 years that it has gained attention in research, education and practice contexts. IPE is defined as two or more professions that learn with from and about each other to improve collaboration and the quality of care (CAIPE 2002). Early drivers for a renewed interest in IPE and IPC derive from an emerging interest in new health service delivery models such as integrated care clinics and primary health care and IPE and IPC have taken the center stage nationally and globally...

Outcomes of a Rehabilitation Programme for Patients with Chronic Back Pain

In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge. The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.