Transcript Interprofessional Education

Does Interprofessional Education
Make a Difference to Students’
Attitudes to Practice?
KAREN COLEMAN, BEN DARLOW, EILEEN MCKINLAY,
LOUISE BECKINGSALE, SARAH DONOVAN, JAMES STANLEY,
PETER GALLAGHER, BEN GRAY, HAZEL NESER,
MEREDITH PERRY, SUE PULLON
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, Wellington
3
 Medicine - 4th 5th 6th
 Radiation Therapy
 Postgraduate 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:

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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
 Most people have 2 or more





Diabetes
Asthma
Heart disease
Arthritis
Cancer
(Wagner, 2001)
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
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
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


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
Age(years; mean)
Gender
Female
Male
Ethnicity
NZ European
Māori
Asian
Other
Discipline
Dietetics
Medicine
Physiotherapy
Radiation Therapy
Intervention
Control
n
%†
n
%†
40
21.9
42
22.5
30
10
75.0
25.0
30
12
71.4
28.6
34
3
4
0
85.0
7.5
10.0
34
5
7
0
81.0
11.9
16.7
4
17
6
13
10.0
42.5
15.0
32.5
5
18
6
13
11.9
42.9
14.3
31.0
† unless otherwise specified. % = per cent; NZ = New Zealand
Baseline Scale Scores
Attitude Scale (score)
Intervention
n
Mean score†
Control
n
(0 to 5)
Mean score†
(0 to 5)
Attitude To Health Care
Teams Scale (ATHCTS)
Readiness for
Interprofessional Learning
Scale (RIPLS)
39‡
3.9
42
3.8
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.
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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