http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, 2015; 29(3): 253–255 ! 2015 Informa UK Ltd. DOI: 10.3109/13561820.2014.954283
SHORT REPORT
Attaining interprofessional competencies through a student interprofessional fellowship program Amy Blue1, Maralynne Mitcham2, Yiannis Koutalos3, David Howell4 and Amy Leaphart2 1
Office of Interprofessional Education, University of Florida, Gainesville, FL, USA, 2Office of Interprofessional Initiatives, 3Department of Ophthalmology, and 4College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
Abstract
Keywords
For students interested in enriching their interprofessional competencies beyond those required and offered by their academic programs, an elective interprofessional education fellowship can serve that need. We designed a fellowship for students linking a conceptual framework grounded in adult learning principles. During the fellowship, students progress through three levels of learning as they acquire, apply, and demonstrate interprofessional collaborative knowledge and skills; fellowship activities are self-directed. A content analysis of students’ fellowship summary reports sought to determine the effectiveness of the fellowship as a learning experience to acquire interprofessional collaborative competences. Results indicated that students most consistently report competencies associated with acquisition of values and ethics for interprofessional practice, roles/responsibilities, and teams/teamwork; interprofessional communication was implied. All students expressed commitment to interprofessional collaborative behavior when in practice. Based on the results from this study, this fellowship structure may serve as a model for other institutions to adapt and implement for best practice and best fit.
Collaborative competence, content analysis, interprofessional education
Introduction Interprofessional education (IPE) academic offerings for students are appearing in multiple forms, such as workshops, courses, and healthcare simulation experiences (Abu-Rish et al., 2012; Greer, Clay, Evans, & Garr, 2014). Extra-curricular activities, such as the CLARION competition (Johnson et al., 2006) or institutionally sponsored experiences (Blue, Mitcham, Smith, Raymond, & Greenberg, 2010) also provide students venues for interprofessional collaborative competency development. However, reports of programs that offer interested students an organized, longitudinal experience to develop their interprofessional collaborative competencies beyond that provided within their academic context and/or extra-curricular environment appear limited. As a component of our institution’s interprofessional education program, we established an interprofessional education (IPE) fellowship designed for students seeking to enrich their interprofessional competencies beyond those required by and offered in their academic programs and/or extra-curricular environment. In this short report, we describe the components of the fellowship, examine its effectiveness as a learning experience, and offer recommendations for other institutions that may wish to adapt and implement this model.
Background Based on our conceptual framework grounded in transformative adult learning principles (Blue et al., 2010), the IPE fellowship Correspondence: Dr Amy Blue, Office of Interprofessional Education, University of Florida, 1225 Center Drive, PO Box 100185, Gainesville, FL 32610, USA. E-mail: [email protected]
History Received 16 December 2013 Revised 2 June 2014 Accepted 10 August 2014 Published online 1 September 2014
requires students to progress through three phases of learning as they acquire, apply, and demonstrate interprofessional collaborative knowledge and skills through multiple and increasingly complex (i.e. classroom to clinical and community settings) learning contexts. During the ‘‘acquisition’’ phase, students are to acquire knowledge of other professions, fundamental teamwork skills, and recognition of the value of interprofessional collaboration. Students must (a) attend the institution’s Interprofessional Day and write a short paper about what was learned; (b) write a paper on teamwork based on evidence in the literature; and (c) participate in a minimum of 15 h of an interprofessional activity (in a community, clinical or research setting and hours may be divided among more than activity) and document this experience in short paper. This combination of activities is intended for students to acquire knowledge about health professions (the focus of Interprofessional Day), recognition of the value of interprofessional collaboration (from the teamwork paper), and fundamental teamwork skills (during the interprofessional activity). We recognize that multiple, intersecting types of learning occur during each of these activities, but in developing the fellowship structure, conceptualized that each required activity contributed unique interprofessional learning at an early phase of a learner’s development. During the application phase, students must complete one of the university’s interprofessional (IP) electives. All IP electives must meet institutional approval requirements, including that students’ learning occurs through meaningful interaction with students from other professions (i.e. learning about, from, and with each other). In these electives, students apply their interprofessional knowledge and team skills in classroom and structured community environments. During the demonstration
254
A. Blue et al.
phase, students must complete a ‘‘practicum experience’’ that consists of a minimum of 25 h of interprofessional collaborative work, such as completion of a community service project, international health trip, quality improvement project, or the local CLARION competition. The intention of the practicum experience is that students demonstrate interprofessional collaboration through sustained and focused activity and at a higher level of engagement than expected during the earlier phases of the fellowship experience. Students must write a brief reflective paper about their practicum experience. Fellowship activities are designed to be self-directed and available within campus, community, and global environments to maximize the number and variety of interprofessional experiences students may leverage to develop and refine their interprofessional learning. Students interested in participating in the fellowship apply through the university’s Office of Interprofessional Initiatives, which provides oversight for the experience. At the fellowship conclusion, students write a synthesis paper describing their participation in the activities they selected and their reflections on the learning that took place, including knowledge and skills developed. Reflective writing allows learners to review their attained knowledge and skills, and gain further insights into their own professional development (White, 2008). Following review of fellowship papers and completion of requirements, students’ completion of the fellowship is included on their transcript and noted in the university’s commencement bulletin. A letter of fellowship completion outlining specific fellowship activities is provided for students wishing to document the components of their fellowship experience and its enhancement of their ability to work effectively with other professionals.
Methods We conducted a content analysis of fellowship synthesis reports to examine the following study questions: (1) the nature of ‘‘how’’ the fellowship is effective for students’ development of development of interprofessional teamwork abilities, (2) what types of learning experiences most contributed to such effectiveness, and (3) additional influences of the fellowship experience on students’ development. Data collection The fellowship synthesis reports from all students who completed the fellowship between 2009 and 2012 were used for data analysis. This time period represented when the fellowship was established (2009) and existed for a sufficient number of students to complete the fellowship. The number of completed fellows and their reports was 63. Analysis Two reviewers independently read all the fellowship synthesis reports. Each reviewer identified and coded themes and then met together to discuss themes identified, with attention to (a) the types of IP experiences undertaken by students; and (b) how these experiences appeared to promote students’ development of the Interprofessional Collaborative (IPC) Competencies (IPEC, 2011). Additional themes that appeared during the content analysis related to the influence of the fellowship on students’ development were also identified and discussed. Following this discussion, a tally was conducted to determine the overall number of IPC competencies reflected in the reports. The reviewers met again to resolve any discrepancies. Ethical considerations The institution’s human subjects review board approved the research.
J Interprof Care, 2015; 29(3): 253–255
Table I. Most common types of activities/settings students used to complete particular fellowship requirements. Fellowship requirement
Activities/settings used for completion
Interprofessional Service Activity
Interprofessional student-run clinic Community-based non-profit organizations, such as summer camps for children with disabilities University-based Student Government Association MUSC Presidential Scholars Program (work on community health project) Local CLARION Competition International health trip
Practicum
Results The results from the content analyses associated with the study questions are presented below. Types of IP experiences undertaken Learning activities used by the students to complete the fellowship aligned with the fellowship structure. Table I presents the types of activities most frequently referenced for completion of the interprofessional service activity and practicum requirements. The Interprofessional Day requirement appeared to be particularly effective with providing students’ knowledge of other professions and their role in health care delivery. The practicum experiences appeared to transform to a distinctly heightened level students’ appreciation and value of interprofessional collaboration. Themes referencing learning from the practicum experience indicated these provided the most depth for use of interprofessional knowledge of other professions, communication, and teamwork skills. Interprofessional collaborative competencies promoted The majority (76%) of students’ statements referenced at least three of the four IPC competency domains in the context of greater appreciation of and/or use of that competency domain. Values and ethics, roles/responsibilities, and teams/teamwork were reflected most clearly and consistently; the need for interprofessional communication within teamwork was inferred in students’ writing. For example, based on the experience in the student-run clinic elective, a student wrote: ‘‘I learned during the CARES elective that one person cannot do it, but with teamwork in the healthcare community, a lot can be accomplished in a short period of time.’’ (physician assistant studies student) From the experience of an international health trip, a student wrote, ‘‘Communication and teamwork between triage, providers, PT/OT, and pharmacy was essential to the success of our clinics.’’ (physician assistant studies student). Students’ statements indicated commitment to use their interprofessional collaborative competencies in practice: ‘‘I vow to continue to advocate for an interprofessional perspective within health care delivery, especially early on in the post-graduate educational setting as this only improves quality of care so that no patient becomes victim of miscommunication again.’’ (physical therapy student) Influences of the fellowship experience on students’ development Two additional themes related to how the fellowship experience influenced students’ professional development were identified. One was the students formed new friendships as a result of their
Interprofessional student fellowship
DOI: 10.3109/13561820.2014.954283
255
interprofessional experiences. The other theme was that for some students, their interprofessional work influenced career decisions. This was illustrated by statements of intentional seeking of medical residencies or employment environments that emphasize interprofessional collaborative patient-centered care.
While our evaluation was limited to inductive content analysis of students’ written reports and actual behavioral demonstration of competencies was not observed, students’ reference to enhanced appreciation for interprofessional collaboration and desire to engage in such behavior as future practitioners was evident.
Discussion
Declaration of interest
While there is evidence of increased interprofessional learning experiences for students (e.g. Abu-Rish et al., 2012; Greer et al., 2014), for those students who desire to develop their interprofessional collaborative skills beyond that offered within their institutional academic and/or extra-curricular settings, there appear to be few models in the literature. The IPE Fellowship provides an adaptable model that allows interested students opportunity to gain additional knowledge and skill acquisition and formal recognition of such attainment. Our evaluation results indicated opportunities for demonstration of interprofessional collaborative skills through sustained interprofessional interactions provide particularly significant value. For institutions that wish to develop a similar type of fellowship experience, we recommend the following principles for design and implementation: (a) determine the unique institutional elements that have potential to enrich interprofessional collaboration; (b) use a simple overarching framework for the fellowship that provides rationale and allows progressive levels of engagement; (c) at each level of engagement provide multiple experiences and allow students to make self-directed choices that meet their interests and professional development needs; (d) provide a mechanism for central oversight, connection with the students’ home units, and a meaningful marker of completion.
The authors report that they have no conflicts of interest. The authors alone are responsible for the writing and content of this paper.
References Abu-Rish, E., Kim, S., Choe, L., Varpio, L., Malik, E., White, A.E., Craddick, K., et al. (2012). Current trends in interprofessional education of health sciences students: A literature review. Journal of Interprofessional Care, 26, 444–451. Blue, A.V., Mitcham, M., Smith, T., Raymond, J., & Greenberg, R. (2010). Changing the future of health professions: Embedding interprofessional education within an academic health center. Academic Medicine, 85, 1290–1295. Greer, A.G., Clay, M., Evans, C.H., & Garr, D. (2014). The status of interprofessional education and interprofessional prevention education in academic health centers: A national baseline study. Academic Medicine, 89, 1–7. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative. Johnson, A.W., Potthoff, S.J., Carranza, L., Swenson, H.M., Platt, C.R., & Rathbun, J.R. (2006). CLARION: A novel interprofessional approach to health care education. Academic Medicine, 81, 252–256. White, J. (2008). The use of reflective writing in exploring student experiences in surgery. Journal of Surgical Education, 65, 518–520.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
SHORT REPORT
Attaining interprofessional competencies through a student interprofessional fellowship program Amy Blue1, Maralynne Mitcham2, Yiannis Koutalos3, David Howell4 and Amy Leaphart2 1
Office of Interprofessional Education, University of Florida, Gainesville, FL, USA, 2Office of Interprofessional Initiatives, 3Department of Ophthalmology, and 4College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
Abstract
Keywords
For students interested in enriching their interprofessional competencies beyond those required and offered by their academic programs, an elective interprofessional education fellowship can serve that need. We designed a fellowship for students linking a conceptual framework grounded in adult learning principles. During the fellowship, students progress through three levels of learning as they acquire, apply, and demonstrate interprofessional collaborative knowledge and skills; fellowship activities are self-directed. A content analysis of students’ fellowship summary reports sought to determine the effectiveness of the fellowship as a learning experience to acquire interprofessional collaborative competences. Results indicated that students most consistently report competencies associated with acquisition of values and ethics for interprofessional practice, roles/responsibilities, and teams/teamwork; interprofessional communication was implied. All students expressed commitment to interprofessional collaborative behavior when in practice. Based on the results from this study, this fellowship structure may serve as a model for other institutions to adapt and implement for best practice and best fit.
Collaborative competence, content analysis, interprofessional education
Introduction Interprofessional education (IPE) academic offerings for students are appearing in multiple forms, such as workshops, courses, and healthcare simulation experiences (Abu-Rish et al., 2012; Greer, Clay, Evans, & Garr, 2014). Extra-curricular activities, such as the CLARION competition (Johnson et al., 2006) or institutionally sponsored experiences (Blue, Mitcham, Smith, Raymond, & Greenberg, 2010) also provide students venues for interprofessional collaborative competency development. However, reports of programs that offer interested students an organized, longitudinal experience to develop their interprofessional collaborative competencies beyond that provided within their academic context and/or extra-curricular environment appear limited. As a component of our institution’s interprofessional education program, we established an interprofessional education (IPE) fellowship designed for students seeking to enrich their interprofessional competencies beyond those required by and offered in their academic programs and/or extra-curricular environment. In this short report, we describe the components of the fellowship, examine its effectiveness as a learning experience, and offer recommendations for other institutions that may wish to adapt and implement this model.
Background Based on our conceptual framework grounded in transformative adult learning principles (Blue et al., 2010), the IPE fellowship Correspondence: Dr Amy Blue, Office of Interprofessional Education, University of Florida, 1225 Center Drive, PO Box 100185, Gainesville, FL 32610, USA. E-mail: [email protected]
History Received 16 December 2013 Revised 2 June 2014 Accepted 10 August 2014 Published online 1 September 2014
requires students to progress through three phases of learning as they acquire, apply, and demonstrate interprofessional collaborative knowledge and skills through multiple and increasingly complex (i.e. classroom to clinical and community settings) learning contexts. During the ‘‘acquisition’’ phase, students are to acquire knowledge of other professions, fundamental teamwork skills, and recognition of the value of interprofessional collaboration. Students must (a) attend the institution’s Interprofessional Day and write a short paper about what was learned; (b) write a paper on teamwork based on evidence in the literature; and (c) participate in a minimum of 15 h of an interprofessional activity (in a community, clinical or research setting and hours may be divided among more than activity) and document this experience in short paper. This combination of activities is intended for students to acquire knowledge about health professions (the focus of Interprofessional Day), recognition of the value of interprofessional collaboration (from the teamwork paper), and fundamental teamwork skills (during the interprofessional activity). We recognize that multiple, intersecting types of learning occur during each of these activities, but in developing the fellowship structure, conceptualized that each required activity contributed unique interprofessional learning at an early phase of a learner’s development. During the application phase, students must complete one of the university’s interprofessional (IP) electives. All IP electives must meet institutional approval requirements, including that students’ learning occurs through meaningful interaction with students from other professions (i.e. learning about, from, and with each other). In these electives, students apply their interprofessional knowledge and team skills in classroom and structured community environments. During the demonstration
254
A. Blue et al.
phase, students must complete a ‘‘practicum experience’’ that consists of a minimum of 25 h of interprofessional collaborative work, such as completion of a community service project, international health trip, quality improvement project, or the local CLARION competition. The intention of the practicum experience is that students demonstrate interprofessional collaboration through sustained and focused activity and at a higher level of engagement than expected during the earlier phases of the fellowship experience. Students must write a brief reflective paper about their practicum experience. Fellowship activities are designed to be self-directed and available within campus, community, and global environments to maximize the number and variety of interprofessional experiences students may leverage to develop and refine their interprofessional learning. Students interested in participating in the fellowship apply through the university’s Office of Interprofessional Initiatives, which provides oversight for the experience. At the fellowship conclusion, students write a synthesis paper describing their participation in the activities they selected and their reflections on the learning that took place, including knowledge and skills developed. Reflective writing allows learners to review their attained knowledge and skills, and gain further insights into their own professional development (White, 2008). Following review of fellowship papers and completion of requirements, students’ completion of the fellowship is included on their transcript and noted in the university’s commencement bulletin. A letter of fellowship completion outlining specific fellowship activities is provided for students wishing to document the components of their fellowship experience and its enhancement of their ability to work effectively with other professionals.
Methods We conducted a content analysis of fellowship synthesis reports to examine the following study questions: (1) the nature of ‘‘how’’ the fellowship is effective for students’ development of development of interprofessional teamwork abilities, (2) what types of learning experiences most contributed to such effectiveness, and (3) additional influences of the fellowship experience on students’ development. Data collection The fellowship synthesis reports from all students who completed the fellowship between 2009 and 2012 were used for data analysis. This time period represented when the fellowship was established (2009) and existed for a sufficient number of students to complete the fellowship. The number of completed fellows and their reports was 63. Analysis Two reviewers independently read all the fellowship synthesis reports. Each reviewer identified and coded themes and then met together to discuss themes identified, with attention to (a) the types of IP experiences undertaken by students; and (b) how these experiences appeared to promote students’ development of the Interprofessional Collaborative (IPC) Competencies (IPEC, 2011). Additional themes that appeared during the content analysis related to the influence of the fellowship on students’ development were also identified and discussed. Following this discussion, a tally was conducted to determine the overall number of IPC competencies reflected in the reports. The reviewers met again to resolve any discrepancies. Ethical considerations The institution’s human subjects review board approved the research.
J Interprof Care, 2015; 29(3): 253–255
Table I. Most common types of activities/settings students used to complete particular fellowship requirements. Fellowship requirement
Activities/settings used for completion
Interprofessional Service Activity
Interprofessional student-run clinic Community-based non-profit organizations, such as summer camps for children with disabilities University-based Student Government Association MUSC Presidential Scholars Program (work on community health project) Local CLARION Competition International health trip
Practicum
Results The results from the content analyses associated with the study questions are presented below. Types of IP experiences undertaken Learning activities used by the students to complete the fellowship aligned with the fellowship structure. Table I presents the types of activities most frequently referenced for completion of the interprofessional service activity and practicum requirements. The Interprofessional Day requirement appeared to be particularly effective with providing students’ knowledge of other professions and their role in health care delivery. The practicum experiences appeared to transform to a distinctly heightened level students’ appreciation and value of interprofessional collaboration. Themes referencing learning from the practicum experience indicated these provided the most depth for use of interprofessional knowledge of other professions, communication, and teamwork skills. Interprofessional collaborative competencies promoted The majority (76%) of students’ statements referenced at least three of the four IPC competency domains in the context of greater appreciation of and/or use of that competency domain. Values and ethics, roles/responsibilities, and teams/teamwork were reflected most clearly and consistently; the need for interprofessional communication within teamwork was inferred in students’ writing. For example, based on the experience in the student-run clinic elective, a student wrote: ‘‘I learned during the CARES elective that one person cannot do it, but with teamwork in the healthcare community, a lot can be accomplished in a short period of time.’’ (physician assistant studies student) From the experience of an international health trip, a student wrote, ‘‘Communication and teamwork between triage, providers, PT/OT, and pharmacy was essential to the success of our clinics.’’ (physician assistant studies student). Students’ statements indicated commitment to use their interprofessional collaborative competencies in practice: ‘‘I vow to continue to advocate for an interprofessional perspective within health care delivery, especially early on in the post-graduate educational setting as this only improves quality of care so that no patient becomes victim of miscommunication again.’’ (physical therapy student) Influences of the fellowship experience on students’ development Two additional themes related to how the fellowship experience influenced students’ professional development were identified. One was the students formed new friendships as a result of their
Interprofessional student fellowship
DOI: 10.3109/13561820.2014.954283
255
interprofessional experiences. The other theme was that for some students, their interprofessional work influenced career decisions. This was illustrated by statements of intentional seeking of medical residencies or employment environments that emphasize interprofessional collaborative patient-centered care.
While our evaluation was limited to inductive content analysis of students’ written reports and actual behavioral demonstration of competencies was not observed, students’ reference to enhanced appreciation for interprofessional collaboration and desire to engage in such behavior as future practitioners was evident.
Discussion
Declaration of interest
While there is evidence of increased interprofessional learning experiences for students (e.g. Abu-Rish et al., 2012; Greer et al., 2014), for those students who desire to develop their interprofessional collaborative skills beyond that offered within their institutional academic and/or extra-curricular settings, there appear to be few models in the literature. The IPE Fellowship provides an adaptable model that allows interested students opportunity to gain additional knowledge and skill acquisition and formal recognition of such attainment. Our evaluation results indicated opportunities for demonstration of interprofessional collaborative skills through sustained interprofessional interactions provide particularly significant value. For institutions that wish to develop a similar type of fellowship experience, we recommend the following principles for design and implementation: (a) determine the unique institutional elements that have potential to enrich interprofessional collaboration; (b) use a simple overarching framework for the fellowship that provides rationale and allows progressive levels of engagement; (c) at each level of engagement provide multiple experiences and allow students to make self-directed choices that meet their interests and professional development needs; (d) provide a mechanism for central oversight, connection with the students’ home units, and a meaningful marker of completion.
The authors report that they have no conflicts of interest. The authors alone are responsible for the writing and content of this paper.
References Abu-Rish, E., Kim, S., Choe, L., Varpio, L., Malik, E., White, A.E., Craddick, K., et al. (2012). Current trends in interprofessional education of health sciences students: A literature review. Journal of Interprofessional Care, 26, 444–451. Blue, A.V., Mitcham, M., Smith, T., Raymond, J., & Greenberg, R. (2010). Changing the future of health professions: Embedding interprofessional education within an academic health center. Academic Medicine, 85, 1290–1295. Greer, A.G., Clay, M., Evans, C.H., & Garr, D. (2014). The status of interprofessional education and interprofessional prevention education in academic health centers: A national baseline study. Academic Medicine, 89, 1–7. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative. Johnson, A.W., Potthoff, S.J., Carranza, L., Swenson, H.M., Platt, C.R., & Rathbun, J.R. (2006). CLARION: A novel interprofessional approach to health care education. Academic Medicine, 81, 252–256. White, J. (2008). The use of reflective writing in exploring student experiences in surgery. Journal of Surgical Education, 65, 518–520.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
