Journal of Interprofessional Education and Practice最新文献

The COVID-19 pandemic prompted increased use of online education, including for interprofessional education (IPE). This study evaluates the comparative efficacy of two pedagogical approaches (i.e., flipped classroom, and 100 % online education) used to deliver a two semester long, IPE course offered at a large academic medical center. Through this quasi-experimental investigation of retrospective outcomes, this study compares the impact of these two pedological approaches on student learning outcomes. Pre- and post-course Interprofessional Collaborative Competencies Attainment Survey (ICCAS) student scores were collected across two academic years where either the flipped-classroom approach or online approach was utilized, 2019–2020 (n = 442) and 2020–2021 (n = 515) respectively. Using a general linear model, changes in total mean ICCAS scores were determined; then t-tests assessed for item level changes. Findings from this study reinforce the idea that 100 % online learning is not only possible for IPE but is a powerful way to engage learners from differing professions.

This interprofessional service-learning course focused on exploring how social determinants of health such as economic stability, education, social and community environment, and health and health care affect populations. Through reading narratives and eliciting stories from participants and students during their volunteer hours at a local hospital, students increased their understanding of social determinants and learned effective interprofessional communication and collaboration strategies. The paper outlines the process and steps to building a partnership with a health care institution and supporting students as they engaged in service learning. Reflections from the instructors, facilitators, and students are discussed.

Interprofessional education is a requirement for both medical and pharmacy graduate program accreditation and it prepares students to work as high functioning healthcare teams. Since patients with chronic diseases often require care from various providers across multiple healthcare settings, efficient care coordination directly correlates with improved clinical outcomes and cost savings based on prudent use of resources. This curricular resource describes outcomes from an interprofessional transitions of care simulation completed by third year medical (MD) and pharmacy (PharmD) students at the University of South Florida in 2021 and 2022. We evaluate changes in students' perceptions about working with interprofessional teams and changes in their clinical knowledge following the simulation. This simulation presented students with one of two clinical vignettes (a pediatric asthma exacerbation or an acute chest syndrome sickle cell crisis), and students progressed through patient management in the emergency room, intensive care unit, medical floor, and discharge planning. This activity was conducted via Microsoft Teams in 2021 secondary to the coronavirus pandemic, and implementation continued to be on Microsoft Teams thereafter due to its success. Student outcomes were measured with matched pre- and post-simulation surveys including nine questions regarding perceptions and knowledge. In total, 300 medical students and 261 pharmacy students participated in the surveys. Students showed statistically significant improvement in each domain, including perceived understanding of roles and abilities to work in an interprofessional environment. Cohorts benefited to similar extents both years, and interprofessional and clinical knowledge improved for both medical and pharmacy students, although not equally. This experience provides an interactive, efficient, and effective method to fulfill accreditation requirements while improving students’ perceptions of healthcare teams and their ability to clinically manage a patient. The evaluation methods used in this study are available in Tables 1–3 The clinical vignettes, preparation materials, standardized patient scripts, and faculty evaluation form to guide feedback can be found in a Box Drive link provided in section eight.

Learners from six health professions programs (athletic training, nursing, optometry, osteopathic medicine, pharmacy, and physical therapy) participated in a telehealth primary care simulation. The learners’ purpose of the simulated visit was to evaluate and manage a patient experiencing complications of type 2 diabetes, including vision changes, frequent falls, and a foot wound.

Objectives

The objectives of the activity were to: 1) assess changes in perceived interprofessional abilities in the areas of communication, collaboration, roles and responsibilities, patient/family-centered care, conflict management and resolution, and team functioning, and 2) assess learner perceptions regarding the value of the interprofessional primary care simulation.

Activity

Learners were divided into teams with 1–2 learners from each program (8–9 total learners per team) and each team interacted face-to-face in small individual classrooms. Trained faculty served as simulation facilitators in each classroom. Each team conducted a two-phase videoconference encounter with a trained standardized patient and family member. Between the two phases, each team conducted an interprofessional care planning session. Learner evaluation of the exercise used two validated tools, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS-R), and the modified Simulation Effectiveness Tool (SET-M) to inform the faculty.

Findings

Paired t-test values on all 20 items of the ICCAS-R indicated statistically significant results (p < .001), and SET-M results indicated that over 88 % of learners strongly agreed or somewhat agreed with questions pertaining to their satisfaction with the activity. Findings from this activity can be used by other educational institutions to develop a primary care simulation based on the health professions available, thus enhancing interprofessional learning opportunities and overcoming a common barrier of limited clinical sites for interprofessional practice.

Tooth decay is the most common chronic disease in children, and children often see their primary care practitioners more frequently than dentists (Adjaye-Gbewonyo and Black 2019-2020; National Center for Health Statistics 2019-2020). This Infant Oral Health Education Program included two online training sessions for trainees in social work, nursing, medicine, and dentistry. Trainees were assessed on anticipated changes to their practice related to children's oral health. During the first training session, trainees received a lecture on infant oral health, and then discussed a case study in interprofessional groups to reinforce the content. Trainees in medicine and nursing completed training to receive Medicaid reimbursement for performing preventive oral health services. The second training session was profession specific with tailored instructions in the form of videos, as well as a demonstration on fluoride varnish application. Of the 78 trainees (22 social work, 4 pediatric nurse practitioner, 38 pediatric medicine residents, and 14 pediatric dentistry residents), 91 % (n = 70) reported that they were introduced to at least one new health information resource or tool. Four-fifths of the eligible trainees (n = 16/20, 80 %) who completed the evaluation had fulfilled the State's requirements to receive Medicaid reimbursement for performing preventive oral health services. Three-fourths of trainees (n = 22/29, 75 %) reported that they are likely to promote children's oral health in future clinical practice. Trainees from all four professions provided positive feedback about the content.

Background

Severe Persistent Mental Illness (SPMI) is associated with increased morbidity compared with the general population. Our clinic serves a high percentage of SPMI patients.

Purpose

A Substance Abuse and Mental Health Services Administration (SAMHSA) grant enabled our clinic to integrate medical and mental health services with the aim of decreasing morbidity in SPMI patients.

Methods

This multiyear integration project included protocols for metabolic screening, increased staff to coordinate medical and mental health care, formation of an integrated treatment team, and increased patient engagement. Outcomes included biometrics and clinician feedback.

Discussion

Despite significant challenges from the COVID-19 pandemic and civil unrest in our community, we saw improvements in patient biometric measurements by year 3 of the project.

Conclusion

The results of this care model transformation project suggest that integration of primary and mental health care is a promising approach to decrease the burden of physical comorbidities in patients with SPMI.