Does Interprofessional Education Make a Difference to Students’ Attitudes to Practice?

KAREN COLEMAN , BEN DARLOW, E I LEEN MCKINLAY, LOUISE BECKINGSALE, SARAH DONOVAN, JAMES

STANLEY, PETER GALLAGHER, BEN GRAY, HAZEL NESER,

MEREDI TH PERRY, SUE PULLON

Does Interprofessional Education Make a Difference to Students’ Attitudes to Practice?

University of Otago, Wellington

Definition

Interprofessional Education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care.

The goal of IPE is to focus on patient-centred, team-based care through positive shared learning activities.

(Centre for the Advancement of Interprofessional Education, 2014)

University of Otago, Wellington3

Medicine - 4th 5th 6th Radiation TherapyPostgraduate Health Sciences

Dietetics & Physiotherapy - clinical

Radiation Therapy students join the programme

Objective

To investigate if participation in an IPE programme, focussing on long term condition (LTC) management influences student attitudes to:

Interprofessional education Interprofessional practice Functioning within health teams LTC management

Long Term Condition

LTC - any condition lasting more than 6 months and is not curable

(Wagner, 2001)

Most people have 2 or more

Diabetes Asthma Heart disease Arthritis Cancer

Background

Interprofessional practice (IPP) optimises skill sets to provide the best possible care to patients

(Pullon et al, 2013)

Improves patient safety (Reeves et al, 2008)

Improves patients satisfaction outcomes, especially when meeting the complex needs of people with LTC

(Strasser et al, 2008)

Enhances health professionals overall job satisfaction (Grumbach & Bodenheimer, 20014)

Initiatives

Internationally link between IPE and IPP (WHO, 2010)

HWNZ have funded pilot projects at Tairawhiti and Whakatane involving dietetics dental medicine nursing occupational therapy pharmacy physiotherapy (HWNZ, 2013)

IPE Programme

Students participate in… over a 5 week period:

An introductory lunch

A three hour interdisciplinary workshop on LTC

A home visit to a patient with LTCs (2-3 students with a disciplinary mix)

Preparation for the presentation

Small group presentations to class with invited guests(Pullon et al, 2013)

Methodology

Stratified quasi-randomised controlled trial

Approved by University of Otago Ethics Committee

Attitudes were measured pre and post intervention using validated tools

(Sharpe et al, 2008)

Attitude change in intervention and control groups were compared using the Analysis of Covariance

Trial Overview

Participant Characteristics

Characteristics Intervention   Control

  n %†   n %†

Age(years; mean) 40 21.9   42 22.5Gender            Female 30 75.0   30 71.4   Male 10 25.0   12 28.6 Ethnicity            NZ European 34 85.0   34 81.0   Māori 3 7.5   5 11.9   Asian 4 10.0   7 16.7   Other 0     0  Discipline            Dietetics 4 10.0   5 11.9   Medicine 17 42.5   18 42.9   Physiotherapy 6 15.0   6 14.3   Radiation Therapy 13 32.5   13 31.0

† unless otherwise specified. % = per cent; NZ = New Zealand

Baseline Scale Scores

Attitude Scale (score) Intervention   Control

  n Mean score†

(0 to 5)

  n Mean score†

(0 to 5)

Attitude To Health Care Teams Scale (ATHCTS)

39‡ 3.9   42 3.8

Readiness for Interprofessional Learning Scale (RIPLS)

 40 3.9    42 3.9

Team Skills Scale (TSS) 40 2.9   42 3.0

Long-Term Condition Management Scale (LTCMS)

40 3.1   42 2.9

† scored on 5-point Likert scale, higher scores represent more positive attitudes. ‡ one medical student provided insufficient valid responses to allow a mean to be calculated for the ATHCTS.

Results

Post-intervention scores in control and intervention group participants adjusted for baseline scores. * p < 0.05; ** p < 0.001

Discussion

The degree of attitude change was similar for all students irrespective of discipline, supporting the inclusion of radiation therapy students to the existing IPE programme

Findings indicate that even a short IPE intervention is effective in attitudes towards IPP

Limitations

Level of clinical in respective programmes

LTCM scale yet to be validated

Conclusion

The findings suggest that the programme not only achieved its interprofessional objectives, but also improved understanding of long-term condition management.

This study is not able to say if these attitudinal changes will be maintained over time, or translate into improved professional practice or patient outcomes.

But wouldn’t it be great if it did!

Further Research

Qualitative data from the students and lecturers has been gathered via focus groups and is currently being analysed.

For the UOW, this has led to further integrated work, amongst the lecturers and the students. integrated orientation day to the campus

Acknowledgments

The patients

This research was funded by a:

Committee for the Advancement of Learning and Teaching (CALT) Grant

University of Otago

References

1. Pullon S, McKinlay E, Beckingsale L, Perry M, Darlow B, Gray B, Gallagher P, Hoare K, Morgan S. Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme. J Prim Health Care. 2013;5(1):52-58.

2. Grumbach K, Bodenheimer T. Can health care teams improve primary care practice? JAMA. 2004;291(10):1246-1251.

3. Strasser DC, Falconer JA, Stevens AB, Uomoto JM, Herrin J, Bowen SE, Burridge AB. Team training and stroke rehabilitation outcomes: a cluster randomized trial. Arch Phys Med Rehabil. 2008;89(1):10-15.

4. Wagner EH. Meeting the needs of chronically ill people. BMJ. 2001;323(7319):945-946.

5. Centre For The Advancement Of Interprofessional Education. http://caipe.org.uk/resources/defining-ipe/. Accessed 9 May, 2014.

6. Reeves S, Zwarenstein M, Goldman J, Barr H, Freeth D, Hammick M, Koppel I. Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database of systematic reviews. 2008;1.

7. Sharpe D, Curran V. Collaborating for education and practice: An interprofessional education strategy for Newfoundland and Labrador. Memorial University of Newfoundland. Final project report. Health Canada IECPCP project. St. John’s, NL: Memorial University of Newfoundland. 2008.

8. World Health Organisation. (2010). Framework for action on interprofessional education and collaborative practice. Geneva: World Health Organisation.

9. Health Workforce NZ (2013) Interprofessional education programme breaking new ground http://healthworkforce.health.govt.nz/interprofessional-education-programme-breaking-new-ground accessed 11/8/14