Rosemary Saunders

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 learning in residential aged care: providing optimal care for residents

Since 2010, a residential aged care provider has been in collaboration with universities in Western Australia to deliver an interprofessional education (IPE) program in residential aged care facilities. The program takes place within a residential aged care setting where university student placements from seven disciplines are integrated into a dynamic interdisciplinary team approach for care delivery. This approach provides the opportunity for two or more professionals to learn together to provide optimal care for residents. In 2012, an extensive research evaluation was performed to demonstrate, among other outcomes, the benefits to the residents and staff involved in the program. Residents, family members and staff from a residential aged care facility were invited to participate in the mixed methods evaluation. The qualitative aspects were digitally recorded, transcribed and thematically analysed. SPSS (SPSS Inc., Chicago, IL, USA) was used to analyse the quantitative data. All were exceptionally satisfied with the IPE program.

Expanding the Caring Lens: Nursing and Medical Students Reflecting on Images of Older People

In changing higher education environments, health profession’s educators have been increasingly challenged to prepare future health professionals to care for aging populations. This article reports on an exploratory, mixed-method research study that used an innovative photo-elicitation technique and interprofessional small-group work in the classroom to enhance the reflective learning experience of medical and nursing students. Data were collected from pre- and postquestionnaires and focus groups to explore shifts in perceptions toward older persons following the reflective learning session. The qualitative data revealed how using visual images of older persons provides a valuable learning space for reflection. Students found meaning in their own learning by creating shared storylines that challenged their perceptions of older people and themselves as future health professionals. These data support the use of visual methodologies to enhance engagement, reflection, and challenge students to explore and deepen their understanding in gerontology.

Interprofessional health education in Australia: Three research projects informing curriculum renewal and development

PURPOSE This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. METHOD Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. RESULTS & CONCLUSION An important outcome was a curriculum renewal framework which has been used to explore the implications of the studys findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education.

Demystifying aged care for medical students

Residential aged care environments can provide valuable learning opportunities for health professional education. An aged care community–university partnership developed the Beyond the Teaching Nursing Home: Community Partnership of Learning and Care (BTTNH: CPLC) programme, where older adults volunteer in learning activities with health professional students. This article describes medical students’ experience of participating in a clinical learning activity as part of the broader programme.

An examination of students’ perceptions of their interprofessional placements in residential aged care

ABSTRACT It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely “teamwork & collaboration” (42.1–44.0; (p = 0.000)) and “positive professional identity” (18.2–19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student’s attitudes towards the older adult as well as increase student’s readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.

Depth of Field: Using photographs and narratives to explore and reflect on ageing

Abstract The learning landscape of the higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practise in today’s complex healthcare systems, including responding to changing demographics of population ageing. In this educational case study, we will share how we (a group of education, medical and nursing academics) developed ‘Depth of Field: Exploring Ageing’ a digital, consumer-driven, interprofessional reflective learning resource that uses photographs, narrative and small-group work to strengthen reflective capacity in current and/or future health professionals.

Nursing students’ reflections on an interprofessional placement in ambulatory care

Abstract Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.

Interprofessional learning in ambulatory care

Interprofessional practice amongst health care professionals can facilitate effective collaboration and can improve health outcomes for patients. Interprofessional clinical placements have mainly been established within inpatient settings; however, ambulatory care settings can also provide interprofessional education. This study evaluates an interprofessional placement in ambulatory care for medical and nursing students.

An eHealth Program for Patients Undergoing a Total Hip Arthroplasty: Protocol for a Randomized Controlled Trial

Background Total hip arthroplasty is an effective surgical procedure commonly used worldwide for patients suffering the disabling effects of osteoarthritis when medical therapy is unsuccessful. Traditionally pre- and postoperative information for patients undergoing a hip arthroplasty has been provided by paper-based methods. Electronic health (eHealth) programs to support individualized patient education on preoperative preparation, in-patient care, and home rehabilitation have the potential to increase patient engagement, enhance patient recovery, and reduce potential postoperative complications. Objective The aim of this study is to compare the addition of an eHealth program versus standard care for pre- and postoperative education on patient outcomes for primary total hip arthroplasty. Methods One hundred patients undergoing a primary elective total hip arthroplasty will be recruited from a metropolitan hospital in Western Australia to participate in a 6-month parallel randomized control trial. Participants will be randomized to either the standard care group (n=50) and will be given the education booklet and enrolled to attend a 1-hour education session, or the intervention group (n=50), and will receive the same as the standard care plus access to an eHealth program titled “My Hip Journey.” The eHealth program encourages the patient to log in daily, from 2 weeks prior to surgery to 30 days postsurgery. The information on the platform will be aligned with the patients individual surgical journey and will include exercises to be completed each day for the duration of the program. The primary outcome measure is the Hip Dysfunction and Osteoarthritis Outcome Score, version LK 2.0. Secondary outcome measures include the EuroQoL EQ-5D-5L, a 5-level 5-dimension quality of life measure, and the Self-Efficacy for Managing Chronic Disease Scale. Data will be collected at pre-admission (presurgery) and at 6 weeks, 3 months, and 6 months postsurgery. A patient satisfaction survey will be completed 6 weeks postsurgery and Web-based analytics will be collected 6 months postsurgery. A cost-effectiveness analysis, using the intention-to-treat principle, will be conducted from the hospital’s perspective. Results Enrollment in the study commenced in January 2018 with recruitment due for completion towards the end of the year. The first results are expected to be submitted for publication in 2019. Conclusions The outcomes and cost of using an eHealth program to support a patient’s recovery from a hip arthroplasty will be compared with standard care in this study. If the eHealth program is found to be effective, further implementation across clinical practice could lead to improvement in patient outcomes and other surgical areas could be incorporated. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12617001433392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657&isReview=true (Archived by WebCite at http://www.webcitation.org/6yzoTuggx). Registered Report Identifier RR1-10.2196/9654