http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, Early Online: 1–3 ! 2014 Informa UK Ltd. DOI: 10.3109/13561820.2014.969834
SHORT REPORT
Interprofessional education with a community fall prevention event Karyn Sullivan1, Ann Charrette2, Colleen Massey1, Donna Bartlett1, Carrie Walker3, Irena Bond4, Paula BylaskaDavies5, Natalie A. Scheidt3, and Jeffrey J. Fong1 School of Pharmacy, 2School of Physical Therapy, 3School of Physician Assistant Studies, 4Library and Learning Resources, and 5School of Nursing, MCPHS University, Worcester, MA, USA
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
1
Abstract
Keywords
Implementation of interprofessional education (IPE) among multiple professional degree programs has many challenges. Students from four health science programs: pharmacy; nursing; physician assistant studies and physical therapy participated in an interprofessional community fall prevention event. This paper briefly describes the development of this IPE opportunity and the assessment of changes on students’ attitudes about IPE after participation in the event. Differing views on teamwork and professional roles are reported by professions. Positive attitudes towards interprofessional teamwork were observed after participation in the event. Based on these data, it appears that an interprofessional community service event offers a useful approach forward for incorporating IPE into the curricula of different health care programs.
Education, interprofessional education, qualitative method, quantitative method, teamwork
Introduction Interprofessional education (IPE) occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (World Health Organization [WHO], 2010). However, creating academic opportunities for IPE can be challenging when multiple health care programs with rigid schedules are involved (Curran, Deacon, & Fleet, 2005). Fall prevention in older adults is an important topic that should be addressed by health care providers such as pharmacists, nurses, physical therapists and physician assistants (Close et al., 1999). All four of the aforementioned professions are located at the Worcester, Massachusetts campus of MCPHS University (MCPHS). The aims of this study were to develop an IPE opportunity through a community fall prevention event and to assess for changes in students’ attitudes about IPE after participation in the event.
Background Students from four programs (pharmacy, nursing, physician assistant and physical therapy) attended a pre-event session where they provided their colleagues with information about their respective profession and its contribution to fall prevention. Faculty organized a local community fall prevention event, which included health screenings to identify participants’ fall risks. Activities conducted by students and faculty included medication reviews, blood glucose testing, orthostasis testing, assessment of balance and mobility, and dissemination of general health information and resources. Student participants observed all activities by partnering with students from other professions. This rotation of roles allowed each profession to view the other faculty
Correspondence: Karyn Sullivan, School of Pharmacy, MCPHS University, Worcester, MA, USA. E-mail: [email protected]
History Received 5 September 2013 Revised 1 August 2014 Accepted 23 September 2014 Published online 14 October 2014
and students in action and reinforced the education from the preevent professional sharing session. Following the fall prevention event, a debriefing session was held to allow for reflection on the activities and benefits of such interventions in the community.
Methods The study employed a pre–post intervention approach to gather perceptions about students’ IPE experiences. Data collection Students completed a validated questionnaire, Readiness for Interprofessional Learning Scale (RIPLS), at both pre and postevent sessions (Reid, Bruce, Allstaff, & McLernon, 2006). An individual reflection on the event was completed by students at the post-event session. Analysis Wilcoxon Signed Rank Test using SPSS 18.0 (SPSS Inc., Chicago, IL) was used to compare pre- and post-event results for each RIPLS question. Student reflections were evaluated using an inductive analytical approach. Themes tables were developed and used to identify principle topics that were important across professional groups. Ethical considerations Due to the non-invasive nature of this study, it was given exempt approval by the local ethics review board.
Results Sixty-three (16 pharmacy, 17 physical therapy, 12 nursing, and 18 physician assistant) students participated in the fall prevention event, of which 46 completed both the pre and post RIPLS questionnaire (73% response rate). Table I summarizes the mean
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K. Sullivan et al.
J Interprof Care, Early Online: 1–3
Table I. Mean responses and important subgroups for select items of RIPLS survey participants prior to and after participation in fall prevention event. Question Q3: Team-working skills are essential for all health care professionals to learn.
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
DPT Q8: Shared learning with other health care professionals helps me to think positively about other professions. DPT Q10: I would welcome the opportunity to work on small-group projects with other health care professionals. DPT Q15: The function of nurses, pharmacists, physician assistants, and physical therapists is mainly to provide support for doctors. DPT Q16: There is little overlap between my role and that of other health care professionals. MPAS Q17: I would feel uncomfortable if another health care professional knew more about a topic than I did. PharmD
PRE (n ¼ 46)
POST (n ¼ 46)
p Value
4.57 4.47 4.24
4.77 4.88 4.60
0.046 0.020 0.007
4.12 4.24
4.57 4.65
0.005 0.003
4.18 1.82
4.82 1.52
0.015 0.060
1.94 2.20 2.19 2.15
1.53 1.73 1.46 1.96
0.035 0.021 0.088 0.320
2.55
1.82
0.038
Partially completed surveys were excluded from the analysis. Results are truncated to those with statistical significance or close to significance. 1 ¼ strongly disagree; 2 ¼ disagree; 3 ¼ neutral; 4 ¼ agree; 5 ¼ strongly agree; DPT ¼ Doctor of Physical Therapy; MPAS ¼ Master of Physician Assistant Studies; PharmD ¼ Doctor of Pharmacy; RIPLS ¼ Readiness for Interprofessional Learning Scale.
responses for all participants and associated subgroup responses by profession for selected items of the RIPLS survey prior to and after participating in the event. Mean scores demonstrate positive improvement toward greater receptiveness of IPE and interprofessional teamwork. Forty-eight students completed the reflective activity. When asked what was learned about another profession, 40% of students commented about the physical therapist’s role in fall prevention. When asked what surprised them most about the event, 67% reflected on health behaviors of the senior population. Regarding what students hope to incorporate into their practice after the event, 43% discussed interprofessional collaboration. Sample reflection excerpts include, ‘‘Physical therapists can play a larger role than I originally thought. I thought they were more for injured patients/ recovery’’. ‘‘Some patients were extremely reluctant to talk about their medications while others would not talk about them at all, no matter how I asked’’. ‘‘I want to work in a practice where I can work with other professions and rely on their expertise to make myself a better clinician’’. Overall, reflective responses also displayed openness towards IPE and interprofessional teamwork.
requirements within six months. It is best to involve students in IPE activities with equivalent levels of education (Buring et al., 2009). However, multiple professional curricular schedules do not always allow for this. Post-event findings revealed a statistically significant change among pharmacy students (compared with pre-event findings) in their level of discomfort if another health care professional knew more about a specific topic. Collectively, the discomfort level was reduced. Pharmacy instructors often refer to pharmacists as the ‘‘drug expert’’ which may lead to feelings of discomfort when in a situation where other professionals have more knowledge in a particular area of patient care. This IPE event demonstrated the expertise and value that each profession contributes to a team approach towards fall prevention efforts. The small number of nursing students participating in the preand post-questionnaire did not lend itself to detecting any significant differences in attitudes toward IPE. The study involved one community interprofessional event with a pre- and postsession. Guidance received from faculty members at the community event might have influenced the experience of students.
Discussion
Concluding comments
The community fall prevention event and associated pre/postsessions included all required elements of an IPE opportunity: didactic instruction, intervention focusing on learners’ attitudes, knowledge and skills related to interprofessional care, and reflection/feedback on students’ role/value in fall prevention (Remington, Foulk, & Williams, 2006). The goal of this project was to investigate the perceptions around participation in a community fall prevention event on students’ attitudes about IPE. Aggregate student responses indicated an initial favorable attitude toward IPE which, in general, became more favorable after participation in the IPE event. This corresponds with previously published findings on the impact of a specific event or program on students’ attitudes towards IPE (Saini et al., 2011). Overall, physical therapy students had the most significant changes in attitudes towards team work and the roles of the other professions. This may be explained by their relative inexperience, since the cohort was newly enrolled at the time of the event. Participating students from nursing and pharmacy programs expected to complete their degree
The four participating programs plan to continue to offer this event annually and to incorporate additional IPE opportunities into the required curriculum. We expect that these opportunities will reinforce positive attitudes towards the team-based approach to patient care. It is clear from our results that most students welcome and value working in interprofessional teams. An interprofessional community service event offers one approach for incorporating IPE into the rigid curricula of multiple health care programs.
Declaration of interest The authors report no declarations of interest. The authors are responsible for the writing and content of the paper.
References Buring, S.M., Bhushan, A., Broeseker, A., Conway, S., Duncan-Hewitt, W., Hansen, L., & Westberg, S. (2009). Interprofessional education: Definitions, student competencies, and guidelines for implementation. American Journal of Pharmaceutical Education, 73, 4, Article 59, 1–8.
DOI: 10.3109/13561820.2014.969834
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C. (1999). Prevention of falls in the elderly trial (PROFET): A randomized controlled trial. Lancet, 353, 93–97. Curran, V.R., Deacon, D.R., Fleet, L. (2005). Academic administrators’ attitudes towards interprofessional education in Canadian schools of health professional education. Journal of Interprofessional Care, 19, 76–86. Reid, R., Bruce, D., Allstaff, K., & McLernon, D. (2006). Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: Are healthcare professionals ready for IPL? Medical Education, 40, 415–422.
Interprofessional education with a community event
3
Remington, T.L., Foulk M.A., Williams, B.C. (2006). Evaluation of evidence for interprofessional education. American Journal of Pharmaceutical Education, 70, Article 66, 1–7. Saini B., Shah, S., Kearey P., Bosnic-Anticevich, S., Grootjans, J., & Armour, C. (2011). An interprofessional learning module on asthma health promotion. American Journal of Pharmaceutical Education, 75, Article 30, 1–10. World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Retrieved from: http://whqlibdoc.who.int/hq/2010/WHO_HRH_ HPN_10.3_eng.pdf.
SHORT REPORT
Interprofessional education with a community fall prevention event Karyn Sullivan1, Ann Charrette2, Colleen Massey1, Donna Bartlett1, Carrie Walker3, Irena Bond4, Paula BylaskaDavies5, Natalie A. Scheidt3, and Jeffrey J. Fong1 School of Pharmacy, 2School of Physical Therapy, 3School of Physician Assistant Studies, 4Library and Learning Resources, and 5School of Nursing, MCPHS University, Worcester, MA, USA
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
1
Abstract
Keywords
Implementation of interprofessional education (IPE) among multiple professional degree programs has many challenges. Students from four health science programs: pharmacy; nursing; physician assistant studies and physical therapy participated in an interprofessional community fall prevention event. This paper briefly describes the development of this IPE opportunity and the assessment of changes on students’ attitudes about IPE after participation in the event. Differing views on teamwork and professional roles are reported by professions. Positive attitudes towards interprofessional teamwork were observed after participation in the event. Based on these data, it appears that an interprofessional community service event offers a useful approach forward for incorporating IPE into the curricula of different health care programs.
Education, interprofessional education, qualitative method, quantitative method, teamwork
Introduction Interprofessional education (IPE) occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (World Health Organization [WHO], 2010). However, creating academic opportunities for IPE can be challenging when multiple health care programs with rigid schedules are involved (Curran, Deacon, & Fleet, 2005). Fall prevention in older adults is an important topic that should be addressed by health care providers such as pharmacists, nurses, physical therapists and physician assistants (Close et al., 1999). All four of the aforementioned professions are located at the Worcester, Massachusetts campus of MCPHS University (MCPHS). The aims of this study were to develop an IPE opportunity through a community fall prevention event and to assess for changes in students’ attitudes about IPE after participation in the event.
Background Students from four programs (pharmacy, nursing, physician assistant and physical therapy) attended a pre-event session where they provided their colleagues with information about their respective profession and its contribution to fall prevention. Faculty organized a local community fall prevention event, which included health screenings to identify participants’ fall risks. Activities conducted by students and faculty included medication reviews, blood glucose testing, orthostasis testing, assessment of balance and mobility, and dissemination of general health information and resources. Student participants observed all activities by partnering with students from other professions. This rotation of roles allowed each profession to view the other faculty
Correspondence: Karyn Sullivan, School of Pharmacy, MCPHS University, Worcester, MA, USA. E-mail: [email protected]
History Received 5 September 2013 Revised 1 August 2014 Accepted 23 September 2014 Published online 14 October 2014
and students in action and reinforced the education from the preevent professional sharing session. Following the fall prevention event, a debriefing session was held to allow for reflection on the activities and benefits of such interventions in the community.
Methods The study employed a pre–post intervention approach to gather perceptions about students’ IPE experiences. Data collection Students completed a validated questionnaire, Readiness for Interprofessional Learning Scale (RIPLS), at both pre and postevent sessions (Reid, Bruce, Allstaff, & McLernon, 2006). An individual reflection on the event was completed by students at the post-event session. Analysis Wilcoxon Signed Rank Test using SPSS 18.0 (SPSS Inc., Chicago, IL) was used to compare pre- and post-event results for each RIPLS question. Student reflections were evaluated using an inductive analytical approach. Themes tables were developed and used to identify principle topics that were important across professional groups. Ethical considerations Due to the non-invasive nature of this study, it was given exempt approval by the local ethics review board.
Results Sixty-three (16 pharmacy, 17 physical therapy, 12 nursing, and 18 physician assistant) students participated in the fall prevention event, of which 46 completed both the pre and post RIPLS questionnaire (73% response rate). Table I summarizes the mean
2
K. Sullivan et al.
J Interprof Care, Early Online: 1–3
Table I. Mean responses and important subgroups for select items of RIPLS survey participants prior to and after participation in fall prevention event. Question Q3: Team-working skills are essential for all health care professionals to learn.
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
DPT Q8: Shared learning with other health care professionals helps me to think positively about other professions. DPT Q10: I would welcome the opportunity to work on small-group projects with other health care professionals. DPT Q15: The function of nurses, pharmacists, physician assistants, and physical therapists is mainly to provide support for doctors. DPT Q16: There is little overlap between my role and that of other health care professionals. MPAS Q17: I would feel uncomfortable if another health care professional knew more about a topic than I did. PharmD
PRE (n ¼ 46)
POST (n ¼ 46)
p Value
4.57 4.47 4.24
4.77 4.88 4.60
0.046 0.020 0.007
4.12 4.24
4.57 4.65
0.005 0.003
4.18 1.82
4.82 1.52
0.015 0.060
1.94 2.20 2.19 2.15
1.53 1.73 1.46 1.96
0.035 0.021 0.088 0.320
2.55
1.82
0.038
Partially completed surveys were excluded from the analysis. Results are truncated to those with statistical significance or close to significance. 1 ¼ strongly disagree; 2 ¼ disagree; 3 ¼ neutral; 4 ¼ agree; 5 ¼ strongly agree; DPT ¼ Doctor of Physical Therapy; MPAS ¼ Master of Physician Assistant Studies; PharmD ¼ Doctor of Pharmacy; RIPLS ¼ Readiness for Interprofessional Learning Scale.
responses for all participants and associated subgroup responses by profession for selected items of the RIPLS survey prior to and after participating in the event. Mean scores demonstrate positive improvement toward greater receptiveness of IPE and interprofessional teamwork. Forty-eight students completed the reflective activity. When asked what was learned about another profession, 40% of students commented about the physical therapist’s role in fall prevention. When asked what surprised them most about the event, 67% reflected on health behaviors of the senior population. Regarding what students hope to incorporate into their practice after the event, 43% discussed interprofessional collaboration. Sample reflection excerpts include, ‘‘Physical therapists can play a larger role than I originally thought. I thought they were more for injured patients/ recovery’’. ‘‘Some patients were extremely reluctant to talk about their medications while others would not talk about them at all, no matter how I asked’’. ‘‘I want to work in a practice where I can work with other professions and rely on their expertise to make myself a better clinician’’. Overall, reflective responses also displayed openness towards IPE and interprofessional teamwork.
requirements within six months. It is best to involve students in IPE activities with equivalent levels of education (Buring et al., 2009). However, multiple professional curricular schedules do not always allow for this. Post-event findings revealed a statistically significant change among pharmacy students (compared with pre-event findings) in their level of discomfort if another health care professional knew more about a specific topic. Collectively, the discomfort level was reduced. Pharmacy instructors often refer to pharmacists as the ‘‘drug expert’’ which may lead to feelings of discomfort when in a situation where other professionals have more knowledge in a particular area of patient care. This IPE event demonstrated the expertise and value that each profession contributes to a team approach towards fall prevention efforts. The small number of nursing students participating in the preand post-questionnaire did not lend itself to detecting any significant differences in attitudes toward IPE. The study involved one community interprofessional event with a pre- and postsession. Guidance received from faculty members at the community event might have influenced the experience of students.
Discussion
Concluding comments
The community fall prevention event and associated pre/postsessions included all required elements of an IPE opportunity: didactic instruction, intervention focusing on learners’ attitudes, knowledge and skills related to interprofessional care, and reflection/feedback on students’ role/value in fall prevention (Remington, Foulk, & Williams, 2006). The goal of this project was to investigate the perceptions around participation in a community fall prevention event on students’ attitudes about IPE. Aggregate student responses indicated an initial favorable attitude toward IPE which, in general, became more favorable after participation in the IPE event. This corresponds with previously published findings on the impact of a specific event or program on students’ attitudes towards IPE (Saini et al., 2011). Overall, physical therapy students had the most significant changes in attitudes towards team work and the roles of the other professions. This may be explained by their relative inexperience, since the cohort was newly enrolled at the time of the event. Participating students from nursing and pharmacy programs expected to complete their degree
The four participating programs plan to continue to offer this event annually and to incorporate additional IPE opportunities into the required curriculum. We expect that these opportunities will reinforce positive attitudes towards the team-based approach to patient care. It is clear from our results that most students welcome and value working in interprofessional teams. An interprofessional community service event offers one approach for incorporating IPE into the rigid curricula of multiple health care programs.
Declaration of interest The authors report no declarations of interest. The authors are responsible for the writing and content of the paper.
References Buring, S.M., Bhushan, A., Broeseker, A., Conway, S., Duncan-Hewitt, W., Hansen, L., & Westberg, S. (2009). Interprofessional education: Definitions, student competencies, and guidelines for implementation. American Journal of Pharmaceutical Education, 73, 4, Article 59, 1–8.
DOI: 10.3109/13561820.2014.969834
J Interprof Care Downloaded from informahealthcare.com by Nyu Medical Center on 10/16/14 For personal use only.
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C. (1999). Prevention of falls in the elderly trial (PROFET): A randomized controlled trial. Lancet, 353, 93–97. Curran, V.R., Deacon, D.R., Fleet, L. (2005). Academic administrators’ attitudes towards interprofessional education in Canadian schools of health professional education. Journal of Interprofessional Care, 19, 76–86. Reid, R., Bruce, D., Allstaff, K., & McLernon, D. (2006). Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: Are healthcare professionals ready for IPL? Medical Education, 40, 415–422.
Interprofessional education with a community event
3
Remington, T.L., Foulk M.A., Williams, B.C. (2006). Evaluation of evidence for interprofessional education. American Journal of Pharmaceutical Education, 70, Article 66, 1–7. Saini B., Shah, S., Kearey P., Bosnic-Anticevich, S., Grootjans, J., & Armour, C. (2011). An interprofessional learning module on asthma health promotion. American Journal of Pharmaceutical Education, 75, Article 30, 1–10. World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. Retrieved from: http://whqlibdoc.who.int/hq/2010/WHO_HRH_ HPN_10.3_eng.pdf.
