Assessing Self Reported Interprofessional Competency in Health Care Education: Impact of New Curriculum
Purpose: The Interprofessional Education Collaborative Expert Panel (IPEC) has identified four competencies essential for interprofessional functioning in the health professions. Those four competencies are a) values/ethics for interprofessional practice, b) roles/responsibilities, c) interprofessional communication, and d) teams and teamwork. Design of effective curricula to develop competence in these skills will improve interprofessional functioning in healthcare. The purpose of this study was to examine impact of a small group interprofessional education (IPE) curriculum on student awareness of one of the competencies, understanding roles and responsibilities. Methods: Students enrolled in professional educations curriculums including counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant programs participated in two interprofessional events in the same semester (one large group introductory event and one small group case event) Students were divided into groups of 8 to 10 students from participating academic programs forming interprofessional groups. They completed a 13 item self report questionnaire based on the four competencies after each of the two interprofessional events. Results: Results of Multivariate Analysis of Variance (MANOVA) revealed a significant difference between the first and second events, multivariate F (13, 476) 24.61, p 0.001. Results of univariate ANOVAs revealed significant differences for each variable, with scores from the small case study session higher on each item than scores for the large introductory event. Factor analysis of data from the introductory event yielded a single factor that accounted for 63.4% of the variance in the scale. Factor analysis of data from the small group case event also yielded a single factor accounting for 65.9% of scale variance. Cronbach's alpha revealed a very high internal consistency of 0.951 and 0.952 for the two events, respectively. Conclusions: IPE events can positively increase self report measures of IPE competencies. The assessment tool used may have measured one overarching construct of collaboration. The tool represents an initial effort toward measurement of each of the four specific competencies, an area in need of refinement. This study demonstrated the impact of IPE events housed within an IPE curriculum. INTRODUCTION Healthcare delivery has been undergoing dramatic changes in the past few decades regarding the collaboration necessary to manage the breadth and depth of information required to treat patients. The majority of healthcare visits now entail complex treatment regimens and require multiple professionals to provide optimal care.1 Because of the need to communicate among and between professionals, education preparing students for interprofessional collaboration is essential. Different healthcare fields have their own language, set of procedures, and expected ways of interacting. As a result, there has been a significant increase of interest in interprofessional education (IPE) Such education would typically occur for practitioners as part of their continuing professional education. Unfortunately, such education usually occurs along professional demarcations, with individuals attending educational programs with same profession attendees and content. There has been limited focus and opportunity for Assessing Self Reported Interprofessional Competency in Health Care Education: Impact of New Curriculum 2 (c) The Internet Journal of Allied Health Sciences and Practice, 2016 interprofessional learning at professional conferences, though this appears to be changing recently, with several professional organizations offering continuing education activities at their professional meetings.2 4 In addition to experienced professionals being able to work collaboratively across disciplines, there is a need for newly hired healthcare professionals to be able to integrate quickly within the workplace environment. Hence, there is a real need for IPE to take place during university education. Riesen et al found that an interprofessional activity increased student interprofessional competence as evidenced by increases in observer ratings of performance in clinical simulation activities.5 There were also concomitant increases in self perceived changes of one's own interprofessional competence and attitudes towards interprofessional care. Although the concept of IPE originated in the clinical domain to help professionals learn how to deal with complex patient situations, several reasons exist for its inclusion into the academic training of professionals.6 One reason is that health care professionals, who are charged with providing the most efficient and effective patient care, have found that collaborative communication among various professionals is one potential method to meet this goal.7 Consistent with this, the Institute of Medicine (IOM) stated that health care professionals communicate best and work most effectively when they gain an understanding of others' roles.8 In addition, organizing pre licensure students into interprofessional groups with the purpose of learning about each other's roles while engaged in a collaborative environment is one potential factor that could aid in increasing readiness for entry level clinicians to function on an interprofessional team.9,10 Finally, recent changes in the health care delivery system are having an impact on expectations of entry level health science graduates; health care employers now expect entry level clinicians to use a high level of clinical decision making in a short period of time.11 Health Science education programs are introducing the concepts of IPE into their curricula in varying ways and amounts. For example, Brashers et al described their attempts to develop and integrate IPE into their medical and nursing curricula.12 They noted that their initiative has increased support for, and interest in, IPE at both the medical and nursing schools as well as in their associated healthcare system. Hamilton suggested that combining interprofessional with cultural competence training could increase interprofessional tolerance and decrease barriers to interprofessional competence.13 Hallin et al evaluated the impact of a clinical teamwork training program in a real world context.14 They discovered that students in medicine, occupational therapy, nursing, and physiotherapy who actively participated in the clinical teamwork training program evidenced increases in perceived interprofessional competence, improved knowledge of the other professions involved in client care, clarity of their own roles, and improved communication and teamwork as evidenced by students' answers on questionnaires. To develop collaborative expertise, it is essential to determine specific competencies required to be an effective interprofessional collaborator and to design activities which develop those skills.15 Several recent studies have attempted to identify specific interprofessional competencies required for successful practice among health care providers.16,17 As a result, the Interprofessional Education Collaborative Expert Panel (IPEC) convened and identified four competencies that transcend professional boundaries and are essential for interprofessional functioning; those four competencies are a) values/ethics for interprofessional practice, b) roles/responsibilities, c) interprofessional communication, and d) teams and teamwork.18 An important next step is assessment of these competencies. Hunter et al utilized a small sample of 21 students from 8 professions (child life studies, medicine, nursing, occupational therapy, pharmacy, physical therapy, radiation sciences, and social work) to assess improvement in competency of students completing a pain interprofessional education placement over a five week period.19 Hunter et al found significant increases in IPE competencies as measured by the Interprofessional Care Core Competencies Global Rating Scales.19 This represents one attempt to assess the newly established IPE competencies, but additional work with larger sample sizes is needed. The authors of the current paper have incorporated IPE into their health sciences curricula for the past six years. Students from multiple programs (counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant programs) have attended grand rounds style presentations and participated in large group programs discussing roles of various providers in patient care and health delivery. The authors recently instituted a comprehensive 2 year curriculum that systematically covers each of the four competencies developed by the Interprofessional Education Collaborative Expert Panel (IPEC) The purpose of this study was to begin to examine impact of the 1st semester of the curricular program on student self assessment in interprofessional education. METHODS Participants Data was collected from 296 students enrolled in professional educational programs, including counseling psychology, nursing, occupational therapy, physical therapy, and physician assistant, who attended two IPE events as part of course requirements within their programs. The nursing program is a diploma program, physical therapy is a clinical doctorate degree program, and the Assessing Self Reported Interprofessional Competency in Health Care Education: Impact of New Curriculum 3 (c) The Internet Journal of Allied Health Sciences and Practice, 2016 remaining three are master's degree programs. All students were in their first professional semester, except for counseling psychology students, whose length of time in the program was variable due to the non cohort nature of their curriculum. Students were placed into interprofessional groups of 8 10 students per group, with groups comprised of members from each of the participating academic programs to form an interprofessional group. Interprofessio