Dental student perceptions of teamwork during a community-engaged interprofessional learning experience.

INTRODUCTION: Dental professionals have been strong advocates for interprofessional education (IPE). During PFF, students in diverse, interprofessional teams of four are assigned a local volunteer family during their first academic year. Teams conduct four home visits and implement a health improvement project focused on the family's health and well-being. The purpose of our analysis was to examine dental student perspectives on the use of teamwork skills during this unique interprofessional educational experience. METHODS AND MATERIALS: Dental student responses from 2017 to 2018 and 2018 to2019 were qualitatively analysed. Open coding by hand was used to identify keywords and themes. The themes and open codes were compared and contrasted by the researchers until a consensus was reached on themes. RESULTS: Researchers discerned three meta-themes: value, skills and time. Researchers also found eight sub-themes prevalent in responses: teamwork, adaptability, mutual support, trust, interprofessional communication, time, feedback, coordination and accountability. DISCUSSION: Our findings indicate dental students understood the importance of interprofessional teamwork and experiential learning within the context of PFF. Students communicated an understanding of how teamwork skills can impact team-oriented outcomes. Dental students seemed to value many teamwork skills that contributed to their interprofessional team's success and experiential learning experience. CONCLUSION: Engagement in a longitudinal experience that is patient-centred, requiring time outside of the classroom, is valued by dental students for its interprofessional collaborative competency development.

Contemporary Challenges for Veterinary Medical Education: Examining the State of Inter-Professional Education in Veterinary Medicine.

Educational training in professional programs forms the foundation for how a person problem-solves throughout their career. However, training focused on only one profession ignores the value realized through collaborations among multiple professions for solving health-related problems. This is at the core of inter-professional education (IPE). Effective IPE programs can result in inter-professional collaboration and translation science endeavors across the health sciences and beyond. Recent events such as the COVID-19 pandemic and the opioid crisis highlight the importance of veterinary medicine in advancing One Health through IPE. The prevalence of IPE programs in veterinary curricula, and the process by which these have been established, has not been widely described in the literature. Through an 18-question survey sent to associate deans (ADs) of 50 veterinary schools, we sought to determine the status of IPE in the veterinary curriculum. Thirty-nine schools agreed to participate, representing primarily United States Doctor of Veterinary Medicine public and private programs with some representation from Canadian, United Kingdom, and Australasian programs. Schools that provide IPE courses developed their programs in collaboration with other health sciences programs across the 4-year curriculum. The perceived barriers for IPE offerings were no different between schools with or without opportunities; however, a lack of faculty and student-perceived value and lack of adequate space in the academic schedule were common threads. Our findings provide a snapshot of the current state of IPE in veterinary medical curricula, with a particular emphasis on the United States, and point to areas of programmatic need for the field.

Incorporating Inter-Professional Education into a Veterinary Medical Curriculum.

Inter-professional education (IPE) is identified as an important component of health profession training and is listed in the accreditation requirements for many fields, including veterinary medicine. The goals of IPE are to develop inter-professional skills and to improve patient-oriented care and community health outcomes. To meet these goals, IPE relies on enhanced teamwork, a high level of communication, mutual planning, collective decision making, and shared responsibilities. One Health initiatives have also become integral parts of core competencies for veterinary curricular development. While the overall objectives of an IPE program are similar to those of a One Health initiative, they are not identical. There are unique differences in expectations and outcomes for an IPE program. The purpose of this study was to explore veterinary medical students' perceptions of their interprofessional experiences following participation in a required IPE course that brought together beginning health profession students from the colleges of medicine, dentistry, nursing, pharmacy, nutrition, public health and health professions, and veterinary medicine. Using qualitative research methods, we found that there is powerful experiential learning that occurs for both the veterinary students and the other health profession students when they work together at the beginning of their curriculum as an inter-professional team.

Public health education at the University of Florida: synergism and educational innovation.

The College of Public Health and Health Professions at the University of Florida is composed of five public health departments and four clinical health professions departments, and the college is one of six that make up the university's Health Science Center. These organizational resources, along with the university's explicit emphasis on collaboration across professions, colleges, institutes, and centers and the strong leadership and full support of deans and other academic leaders, provide a strong foundation for educational innovations. Three key areas in which the college has built upon these opportunities are interprofessional education, development of One Health instructional programs, and application of cutting-edge technology to students' educational experiences. These innovations represent the types of creative approaches to preparing the 21st-century workforce that can be developed through collaboration among multiple disciplines in a major university.

Developing a comprehensive faculty development program to promote interprofessional education, practice and research at a free-standing academic health science center.

There is an on-going transformation in health professions education to prepare students to function as competent members of an interprofessional team in order to increase patient safety and improve patient care. Various methods of health education and practice directed toward students have been implemented, yet descriptions of faculty development initiatives designed to advance interprofessional education and practice are scarce. This article describes a faculty development program at the Medical University of South Carolina, USA, based on the conceptual framework of adult transformational learning theory. Three components comprise the faculty development program: an institute, fellowship and teaching series. Evaluations of the three components indicate that the faculty development program aided in the sustainability of the university's interprofessional program, and built capacity for improvement and growth in interprofessional endeavors.

Attaining interprofessional competencies through a student interprofessional fellowship program.

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.

Interprofessional service-learning in a community setting: findings from a pilot study.

Interprofessional education is becoming more popular in higher education and service-learning has been a successful method to facilitate experiences that foster teamwork between professions. This report shares the results from an interprofessional service-learning project (ISLP) targeting students across eight disciplines (physician assistant, medicine, pharmacy, dietetic internship, physical therapy, master in health administration, nursing and biomedical science). The project used an existing resource, the South Carolina Area Health Education Consortium (SC-AHEC), to coordinate student learning across multiple regions and an established health promotion program curriculum for student outreach content. Participating students (n = 149) were evaluated to determine how the activity affected student appreciation and knowledge of their own and other professions, their interaction with other professional students, and student teamwork skills. Students found the most value in learning with students from other professions as part of the activity with lesser value placed on students increasing their knowledge about their profession's role in interprofessional work.

Perceived Success After Participation in the Summer Health Professions Education Program.

Importance: The number of active health care professionals has not kept pace with the increasing number of minoritized individuals in the US. The Summer Health Professions Education Program (SHPEP) was developed to alleviate this underrepresentation in the health workforce. Objective: To evaluate students' changes in perceived barriers and motivators for entering and succeeding in professional school after SHPEP participation. Design, Setting, and Participants: For this cohort study, anonymous electronic surveys were sent to the 2017 to 2021 SHPEP participants at an academic health center at a large university in the southern US. Participants were first- and second-year undergraduates interested in the health professions and enrolled in the SHPEP. Program participants were invited to complete the study. Exposures: An anonymous electronic survey was administered before and immediately after program completion. Main Outcomes and Measures: The SHPEP Career Barriers Survey (SCBS) is composed of 22 questions on motivators and 20 questions on barriers to entering and succeeding in health professional school. Students responded using a 5-point Likert scale, with 1 indicating strongly disagree and 5 indicating strongly agree. Mixed analysis of variance was used to analyze the program's latent factors. Results: Of all 402 SHPEP participants (mean [SD] age, 19.32 [0.88] years) from 2017 to 2021, 325 completed the preprogram survey and 259 also completed the postprogram survey. Of the 325 initial participants, 4 identified as American Indian or Alaska Native, Native Hawaiian, or Pacific Islander (1.2%); 12 as Asian (3.7%); 188 as Black (57.8%); 95 as Hispanic or Latino (29.2%); 7 as White (2.2%); and 16 as multiracial (4.9%). Two hundred twelve participants were female (65.2%), and 226 were first-generation college students (69.5%). Results of the SCBS indicate that the SHPEP had a significant small to moderate association on perceived motivators (mean [SD] x̅ = 84.60 [9.67] vs 80.95 [8.93]; P = .001) and decreases in perceived barriers (mean [SD] x̅ = 48.02 [13.20] vs 51.72 [11.39]; P = .008). There was no significant difference in program success between studied years. Conclusions and Relevance: In this cohort study, the SHPEP appeared to provide essential support for underrepresented students as measured by improved perceived motivators and reduced perceived barriers to entering professional education. Knowledge from this study can assist educators and health care professionals who wish to implement similar enrichment programs.

Interprofessional Education: An Innovative Approach to Increase the Human Immunodeficiency Virus Workforce.

Ending the human immunodeficiency virus (HIV) epidemic relies on a robust clinical workforce. The Southeast AIDS Education and Training Center's interprofessional education program is a novel approach to increasing the interest and ability of early health professional learners to provide high-quality, comprehensive, person-first care for people with HIV. Key Points: Interprofessional education (IPE) focusing on multidisciplinary care for people with HIV can serve as a novel way to increase the HIV workforce. This brief report describes the IPE program of the Southeast AIDS Education and Training Center.

Design of a Situational Judgment Test for Preclinical Interprofessional Collaboration.

PROBLEM: There is an unmet need for economically feasible, valid, reliable, and contextually relevant assessments of interprofessional collaborative knowledge and skills, particularly at the early stages of health professions education. This study sought to develop and gather content and internal structure validity for an Interprofessional Situational Judgement Test (IPSJT), a tool for the measurement of students' interprofessional collaborative intentions during the early stages of their professional development. APPROACH: After engaging in an item development and refinement process (January-June 2018), an 18-question IPSJT was administered to 953 first-year students enrolled in 10 health professions degree programs at the University of Florida Health Science Center in October 2018. The IPSJT's performance was evaluated using item-level analyses, item difficulty, test-retest reliability, and exploratory factor analysis. OUTCOMES: Seven hundred thirty-seven (77.3%) students consented to the use of their data. Student IPSJT scores ranged from 0 to 69, averaging 42.68 (standard deviation = 12.28), with some statistically significant differences in student performance by health professions degree program. IPSJT item difficulties ranged from 0.13 to 0.92. Once one item with poor properties was excluded from analysis, the IPSJT demonstrated an overall reliability of 0.62. Students were more successful at identifying the least effective than the most effective responses. Test-retest reliability provided evidence of consistency (r = 0.50, P < .001) and similar item difficulty across administrations. An exploratory factor analysis indicated a 3-factor model with multiple cross-factor loadings. NEXT STEPS: This work represents the first step toward the development of a valid, reliable IPSJT for early learners. The emergent 3-factor model provides evidence that multiple competencies can be assessed in early learners via this tool. Additional research is necessary to build a more robust question bank, explore different scoring and response methods, and gather additional sources of validity evidence, including relations to other variables.

Assessing professionalism in health profession degree programs: A scoping review.

BACKGROUND: To identify and classify methods for assessing professionalism across health profession degree programs and identify gaps in the literature regarding types of assessments. METHODS: The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professionalism dimension, and Barr's modified Kirkpatrick hierarchy. RESULTS: Authors classified 277 articles meeting inclusion criteria. Most articles were from medical education (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%). IMPLICATIONS: The classification scheme identified in current literature on professionalism assessment does not align with International Ottawa Conference Working Group on the Assessment of Professionalism recommendations. Gaps identified were limited description of professionalism assessment during admissions, infrequent longitudinal assessment, limited use of methods for both formative and summative assessment, and limited reports of assessments applicable to interprofessional education settings.

Promoting students' community service during medical school: the MUSC Gives Back Office.

BACKGROUND: Health professions education recognizes the value of students' engagement in community service, exemplified by the Liaison Committee on Medical Education's adoption in 2007 of a standard requiring service learning opportunities to be available for medical students. DESCRIPTION: At our institution, a community service office was established in 1993 to provide students information about volunteer community service opportunities. EVALUATION: Since 1993, more than 150,000 service hours have been performed by students in the community. There has been a clear increase in medical student participation. We have found that medical school community service participation is positively associated with better academic performance and can influence residency selection and participation in service following graduation. CONCLUSIONS: With the increased need to develop service opportunities for students, institutions will be required to establish infrastructures to support this. We offer recommendations to others interested in a creating a similar office or program for students.

The level of evidence of medical marijuana use for treating disabilities: a scoping review.

Purpose: Twenty-nine states have bypassed federal regulations by legalizing marijuana (MJ) either medicinally, recreationally or both. The FDA states that there is no empirical evidence that MJ is effective to treat these disorders. With over a billion individuals living with a disability across the globe, it is crucial to fully research the efficaciousness and safety of medical MJ to treat this population. The purpose to present the results of a scoping review of studies focused on the levels of evidence currently available on medical MJ's efficacy in treatment across a large range of disabilities.Methods: Databases were searched for research articles on the current level of evidence to support medical MJ use among people with disabilities.Results: Forty-one peer reviewed articles met the inclusion criteria. Articles focused on attention deficit hyperactivity disorder, post-traumatic stress disorder, depression, schizophrenia, spinal cord injury, multiple sclerosis/movement disorders, fibromyalgia, epilepsy, with some that focused on multiple disabilities.Conclusions: The level of evidence for the use of medical MJ among people with disabilities varies greatly, and has a clear lack of methodologically sound studies. Overall, medical MJ does not improve the level of functioning, but it may improve the overall quality of life for people with disabilities.Implications for RehabilitationEpilepsy can be a disabling chronic disorder which not only impacts physically but can restricts quality of life.Quality of life is diminished even more with treatment resistant epilepsy.Chronic pain is the leading cause of disability and is the most common cause of long-term disability.There is sufficient evidence that medical marijuana is effective in treating epileptic seizures and chronic pain.Medical marijuana may improve the level of functioning and quality of life for individuals with certain disabilities.

Physician Cultural Competency Training and Impact on Behavior: Evidence From the 2016 National Ambulatory Medical Care Survey.

BACKGROUND AND OBJECTIVES: The number of racially and culturally diverse patients in the medical practices of US physicians is increasing. It is unclear how well culturally and linguistically appropriate services (CLAS) standards have been integrated into physician practice. The objective of this study was to determine the prevalence of US-based physicians who received training in cultural competency and describe their behavior. METHODS: This survey study utilized data from a supplement of the 2016 National Ambulatory Medical Care Survey (NAMCS). The NAMCS Supplement on CLAS for Office-based Physicians (National CLAS Physician Survey) is a nationally representative survey of ambulatory physicians. We determined the proportion and characteristics of physicians who reported receiving cultural competency training in medical school or in practice. RESULTS: The unweighted sample of 363 yielded a weighted sample of 290,109 physicians, 66.3% of whom reported that they had received cultural competence training at some point. Only 35.5% of the sample had ever heard of the CLAS standards, suggesting a low level of awareness of the standards. Further, only 18.7% reported that training in cultural competency is required for newly hired physicians who join their practice. There were no statistically significant differences between those who had been trained and those who had not in terms of self-reported consideration of race/ethnicity or culture in assessing patient needs, diagnosis, treatment and patient education (P>.05). CONCLUSIONS: Fewer than half of practicing physicians reported receiving cultural and linguistic competency training in medical school or residency. It is possible that cultural competence training is being seamlessly integrated into medical education.

Assessment of matriculating medical students' knowledge and attitudes towards professionalism.

BACKGROUND: Students' perceptions of traditional attributes of professionalism are important for understanding their professional development needs, and determining appropriate curricular initiatives and assessment methods. AIM: This study assessed the knowledge and attitudes towards professionalism of three classes of matriculating students at two institutions. METHODS: Subjects completed four instruments: a multiple-choice test and a clinical scenario instrument assessed knowledge; and a semantic differential scale and Likert-format statement instrument assessed attitudes. Items reflected traditional professionalism attributes. Factor analysis identified scales and descriptive statistics were computed for each scale. RESULTS: Six hundred and forty six students (82%) completed the instruments. Correlations among scales were low to moderate. Knowledge scores were highest for the attributes 'humanism' and 'professional responsibility' and lowest for the attribute 'professional commitment'. Attitude scores were highest for 'humanistic values' and lowest for 'subordinating self-interests'. CONCLUSIONS: Results indicate students' attitudes are positive about several of the attributes associated with traditional professionalism definitions; however, there were cases where students' knowledge and attitudes towards professionalism appear incongruent with traditional definitions. Further development of self-assessments of knowledge and attitudes towards professionalism are suggested.

Impact of the foundations of clinical medicine course on USMLE scores.

BACKGROUND: The synthesis of basic and clinical science knowledge during the clerkship years has failed to meet educational expectations. OBJECTIVES: We hypothesized that a small-group course emphasizing the basic science underpinnings of disease, Foundations of Clinical Medicine (FCM), could be integrated into third year clerkships and would not negatively impact the United States Medical Licensure Examination (USMLE) step 2 scores. DESIGN: In 2001-2002, all third year students met weekly in groups of 8-12 clustered within clerkships to discuss the clinical and basic science aspects of prescribed, discipline-specific cases. PARTICIPANTS: Students completing USMLE step 2 between 1999 and 2004 (n = 743). MEASUREMENTS: Course evaluations were compared with the overall institutional average. Bivariate analyses compared the mean USMLE steps 1 and 2 scores across pre- and post-FCM student cohorts. We used multiple linear regression to assess the association between USMLE step 2 scores and FCM cohort controlling for potential confounders. RESULTS: Students' average course evaluation score rose from 66 to 77 (2001-2004) compared to an institutional average of 73. The unadjusted mean USMLE step 1 score was higher for the post-FCM cohort (212.9 vs 207.5, respectively, p < .001) and associated with step 2 scores (estimated coefficient = 0.70, p < .001). Post-FCM cohort (2002-2004; n = 361) mean step 2 scores topped pre-FCM (1999-2001; n = 382) scores (215.9 vs 207.7, respectively, p < .001). FCM cohort remained a significant predictor of higher step 2 scores after adjustment for USMLE step 1 and demographic characteristics (estimated coefficient = 4.3, p = .002). CONCLUSIONS: A curriculum integrating clinical and basic sciences during third year clerkships is feasible and associated with improvement in standardized testing.

Performance outcomes associated with medical school community service.

BACKGROUND: Providing medical students with community service opportunities during medical school is believed to foster altruism. Little is known whether voluntary community service is associated with students' academic and clinical skill performance. This study examined the relationship between students' volunteer community service hours during medical school and their medical school academic performance, measures of clinical skills, and residency performance. METHOD: Subjects were 2001 and 2002 graduates of the institution. Performance measures were: United States Medical Licensing Examination (USMLE) Step 2 score, grade point average, fourth-year clinical skills examination scores, and two types of residency director assessments. Associations between performance measures and community service hour categories were analyzed using descriptive statistics, chi-square, and t-tests. RESULTS: Students in the highest service group (>/=18.5 hours) had significantly higher grade point averages, USMLE Step 2 scores, and scores on both residency director assessment when compared to students with no community service hours. CONCLUSIONS: Community service involvement in medical school appears associated with medical school academic and residency performances.