Continuing Professional Development in Response to COVID-19: Knowledge Mobilization for Occupational Therapy and Physiotherapy via a Curated Web Site.

Purpose: Once the COVID-19 pandemic was declared, clinicians were redeployed to prepare for increased hospitalizations. This disruption necessitated rapid continuing professional development (CPD) resources for health care providers. This mixed-method study explored the experiences of occupational therapists and physiotherapists who accessed a CPD Web site that provided educational resources related to the pandemic to refresh their clinical knowledge and skills. Methods: Faculty from the Michener Institute of Education at the University Health Network and University of Toronto along with 60 collaborators created a Web site to support the need for rapid CPD. An occupational therapist and physiotherapist advisory group informed the evolving design of the occupational therapy and physiotherapy content. Results: In the occupational therapy profession 535 users created an account between April and November 2020 (236 practicing, 283 students, and 16 did not specify) and in the physiotherapy profession 829 created an account (532 practicing, 278 students and 19 did not specify). Each user viewed an average of 53 Web pages. Three themes emerged: (1)To prepare for practice changes, clinicians value a single repository of information; (2) Web site features can either facilitate or hinder access to the needed information; and (3) Participants described diverse learning needs. Conclusions: The Web site design features assisted participants in preparing for redeployment and patient care. Features to encourage self-directed learning, such as the grouping of relevant topics and self-check quizzes, can enhance the user experience.

Objectif: lorsque la pandémie de COVID-19 s'est déclarée, les cliniciens ont été redéployés pour se préparer à une recrudescence d'hospitalisations. Ce bouleversement a exigé la prestation rapide de ressources de perfectionnement professionnel continu (PPC) aux dispensateurs de soins. La présente étude à méthodologie mixte a exploré les expériences des ergothérapeutes et des physiothérapeutes qui ont accédé à un site Web de PPC contenant des ressources de formation liées à la pandémie pour mettre leurs connaissances et habiletés cliniques à niveau. Méthodologie: les professeurs du Michener Institute of Education du Réseau universitaire de santé et de l'Université de Toronto et 60 collaborateurs ont créé un site Web pour répondre au besoin de PPC rapide. Un groupe consultatif d'ergothérapeutes et de physiothérapeutes a éclairé la conception évolutive de la matière en ergothérapie et en physiothérapie. Résultats: En ergothérapie, 535 utilisateurs ont créé un compte entre avril et novembre 2020 (236 en exercice, 283 étudiants et 16 ne l'ont pas précisé) et en physiothérapie, ce chiffre est passé à 829 (532 en exercice, 278 étudiants et 19 ne l'ont pas précisé). Chaque utilisateur a visualisé une moyenne de 53 pages Web. Trois thèmes ont émergé : 1) pour se préparer aux changements de pratique, les cliniciens préfèrent un seul centre d'information; 2) les caractéristiques du site Web peuvent soit faciliter, soit freiner l'accès à l'information nécessaire et 3) les participants ont décrit des besoins d'apprentissage diversifiés. Conclusions: les caractéristiques de conception du site Web ont aidé les participants à se préparer au redéploiement et aux soins des patients. Des caractéristiques visant à encourager l'apprentissage autonome, comme le regroupement des sujets pertinents et les questionnaires d'autoévaluation, peuvent optimiser l'expérience de l'utilisateur.

Evolving global responses to the pandemic: sustaining interprofessional education and collaborative practice.

The COVID-19 pandemic created global disruption in health professions education and healthcare practice, necessitating an abrupt move to digital delivery. A longitudinal survey was conducted to track the evolution of global responses to the pandemic. During the initial stages, educational and health institutions were forced to adapt quickly without careful consideration of optimal pedagogy, practices, and effectiveness of implemented approaches. In this paper, we report the results of Phase 3 of the global survey that was distributed between November 2021 and February 2022 through InterprofessionalResearch.Global (IPR.Global). The Phase 3 qualitative survey received 27 responses, representing 25 institutions from 13 countries in 6 regions. Using inductive thematic analysis, the data analysis resulted in three emerging themes: Impact of the pandemic on the delivery of interprofessional education and collaborative practice (IPECP); Impact of the pandemic on the healthcare system (team, population/client health, clients); and Sustainability and innovation. This study highlights the evolving nature of health education and collaborative practices in response to the COVID-19 pandemic. IPECP educators need to be resilient and deal with the complexities of face-to-face and digital learning delivery. Preparing for emerging forms of teamwork is essential for new work contexts and optimal health services.

A critical interpretive synthesis of interprofessional education interventions.

Interprofessional practice can look quite different depending on a number of dynamics. Interprofessional education interventions may or may not orient toward this range of practice possibilities. This literature review explores: (1) how interprofessional education interventions relate to different kinds of interprofessional practice and (2) the range of interprofessional practices assumed by interprofessional education interventions. Four databases were searched for articles published between 2011-2021 describing pre-licensure level interprofessional education interventions, resulting in a dataset of 110 articles. Our analysis involved (1) descriptive summaries of the articles, and (2) content analysis of the rationale and description of the intervention. Of the articles, 93% (102/110) of interprofessional education interventions were designed and/or evaluated using the concept of interprofessional education competencies. "Teamwork" was the most relied upon competency. Most articles were not explicit about the different kinds of interprofessional practices that these competencies might be oriented toward. Our study substantiates earlier claims that interprofessional education literature tends to focus on competencies and orient toward undifferentiated understandings of "teamwork." This analysis is particularly important as interprofessional teams are engaging in increasingly complex, fluid, and distributed forms of interprofessional practice that may not be captured in an undifferentiated approach to "teamwork."

The status of interprofessional education (IPE) at regional and global levels - update from 2022 global IPE situational analysis.

This short report is based on the 2022 Global IPE Situational Analysis Results e-Book that is available at https://interprofessionalresearch.global/. As an up-to-date global environmental scan of interprofessional education (IPE), this cross-sectional study investigated institutional, administrative, and system-level processes that support IPE program development and implementation globally. Conducted by InterprofessionalResearch.Global (IPR.Global), the survey included 17 quantitative questions that were analyzed at global and regional levels. Three open-text questions were thematically analyzed. In total, 152 institutions from six regions worldwide contributed to this study. Results revealed that only 51.97% of all responding institutions have an established IPE program, with Canada and the USA having the highest (84%) and Africa (26%) having the lowest numbers. Globally, 37.33% of respondents reported no formal leadership positions and 41.33% reported the absence of a designated IPE Director or Coordinator. In addition, IPE funding varies considerably across the world, with 32.65% of institutions reporting no financial support. Over 48.22% of respondents indicated their institutions are rarely or not involved in IPE-related scholarly work or research. The open-text analysis revealed that supportive senior leadership, a culture of collaboration, and recognition of IPE as a strategic direction and/or priority at the institutional level, could foster the successful implementation of IPE. On the other hand, inadequate administrative support, lack of funding, poor attitudes regarding IPE, and limited dedicated time for research, seemed to impair successful implementation of scholarly activities in the field.

Enabling Patients as Partners on Virtual Teams: A Scoping Review.

Developing partnerships among patients and healthcare providers improves quality of virtual care. Successful patient engagement is influenced by digital literacy. Although adults (35-64) with chronic health challenges may be motivated to use virtual services, they may not have the required skills or orientation to effectively participate on their virtual team. This scoping review aimed to identify resources available to enable adults with chronic health challenges to participate as partners on their virtual teams. Peer-reviewed and grey literature data from 2011 to 2022 were searched. A total of 432 peer-reviewed and 357 grey literature sources were retrieved and screened, and 14 and 84 sources, respectively, met the inclusion criteria. Relevant information from the sources was extracted and analyzed in duplicate and synthesized qualitatively. Key findings include (1) virtual workflow processes/frameworks, (2) 'webside manner' guidelines which emphasize "the how" as opposed to "the what" of facilitating team interactions, and (3) virtual patient support personnel. Overall, analyses suggest there are persisting gaps to be addressed in synchronous virtual care resources for adults with chronic health challenges.

The perceived impact of the COVID-19 pandemic on interprofessional education and collaborative practice: preliminary results from phase I of a global survey.

The COVID-19 pandemic has had a sizable effect on interprofessional education and collaborative practice (IPECP) globally, yet much of the available literature on the topic remains anecdotal and locally bounded. This body of literature reflects celebratory and aspirational reports, with many case studies of successful response and perseverance under conditions of extreme pressure. There is, however, a more worrisome narrative emerging that pointed to differences in pandemic response with concerns raised about the sustainability of IPECP during and after the pandemic. The COVID-19 task force of InterprofessionalResearch.Global (IPRGlobal) set out to capture the successes and challenges of the interprofessional community over the pandemic through a longitudinal survey, with a view to inform global attempts at recovery and resilience. In this article, we report preliminary findings from Phase 1 of the survey. Phase 1 of the survey was sent to institutions/organizations in IPRGlobal (representing over 50 countries from Europe, North and South America, Australia, and Africa). The country-level response rate was over 50%. Key opportunities and challenges include the abrupt digitalization of collaborative learning and practice; de-prioritization of interprofessional education (IPE); and rise in interprofessional collaborative spirit. Implications for IPECP pedagogy, research, and policy post-pandemic are considered.

Combining adaptive expertise and (critically) reflective practice to support the development of knowledge, skill, and society.

Adaptive expertise (AE) and reflective practice (RP), two influential and resonant theories of professional expertise and practice in their own right, may further benefit health professions education if carefully combined. The current societal and systemic context is primed for both AE and RP. Both bodies of work position practitioners as agentive, learning continually and thoughtfully throughout their careers, particularly in order to manage unprecedented situations well. Similar on the surface, the roots and practices of AE and RP diverge at key junctures and we will focus on RP's movement toward critically reflective practice. The roots of AE and RP, and how they relate to or diverge from present-day applications matter because in health professions education, as in all education, paradigmatic mixing should be undertaken purposefully. This paper will explore the need for AE and RP, their shared commitments, distinctive histories, pedagogical possibilities both individually and combined, and next steps for maximizing their potential to positively impact the field. We argue that this exploration is urgently needed because both AE and RP hold much promise for improving health care and yet employing them optimally-whether alone or together-requires understanding and intent. We build an interprofessional education case situated in long-term care, throughout the paper, to demonstrate the potential that AE and RP might offer to health professions education individually and combined. This exploration comes just in time. Within the realities of uncertain practice emphasized by the pandemic, practitioners were also called to act in response to complex and urgent social movements. A combined AE and RP approach, with focus on critically reflective practice in particular, would potentially prepare professionals to respond effectively, compassionately, and equitably to future health and social crises and challenges.

Ten-year mixed-method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum.

Introduction: Student perspectives on interprofessional pain education are lacking. Objectives: The purpose of this study was to evaluate ratings of knowledge acquisition and effective presentation methods for prelicensure health professional students attending the University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum (Canada). Methods: A 10-year (2009-2019) retrospective longitudinal mixed-methods approach comprising analysis and integration of quantitative and qualitative data sets was used to evaluate 5 core University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum learning sessions. Results: A total of 10, 693 students were enrolled (2009-2019) with a mean annual attendance of 972 students (±SD:102). The mean proportion of students rating "agree/strongly agree" for knowledge acquisition and effective presentation methods across sessions was 79.3% (±SD:3.4) and 76.7% (±SD:6.0), respectively. Knowledge acquisition or presentation effectiveness scores increased, respectively, over time for 4 core sessions: online self-study pain mechanisms module (P = 0.03/P < 0.001), online self-study opioids module (P = 0.04/P = 0.019), individually selected in-person topical pain sessions (P = 0.03/P < 0.001), and in-person patient or interprofessional panel session (P = 0.03). Qualitative data corroborated rating scores and expanded insight into student expectations for knowledge acquisition to inform real-world clinical practice and interprofessional collaboration; presentation effectiveness corresponded with smaller session size, individually selected sessions, case-based scenarios, embedded knowledge appraisal, and opportunities to meaningfully interact with presenters and peers. Conclusion: This study demonstrated positive and increasing prelicensure student ratings of knowledge acquisition and effective presentation methods across multifaceted learning sessions in an interfaculty pain curriculum. This study has implications for pain curriculum design aimed at promoting students' collaborative, patient-centered working skills.See commentary: Trouvin A-P. "Ten-year mixed method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum": a view on pain education. PAIN Rep 2022;7:e1031.Students attending learning sessions at the University of Toronto Interfaculty Pain Curriculum (2009-2019) in Toronto, Canada, self-report high ratings of knowledge acquisition and effective presentation methods.

Ten years of interfaculty pain curriculum at the University of Toronto: impact on student learning.

INTRODUCTION: Delivery of interprofessional pain education for prelicensure healthcare professionals is strongly recommended to advance a workforce ready for collaborative practice and to improve the quality and outcomes of pain care. OBJECTIVES: We report a 10-year (2009-2019) longitudinal evaluation of a 20-hour undergraduate Interfaculty Pain Curriculum (IPC) delivered to students in the Faculties of Dentistry, Nursing, Pharmacy, and Medicine (also including the Departments of Physical Therapy, Occupational Therapy and Physician Assistant) at the University of Toronto, Canada. The IPC follows a constructivist approach to facilitate interactive and multifaceted learning. METHODS: Evaluation methods based on the Kirkpatrick model were used to appraise changes in participating students' pain knowledge and beliefs and their ability to collaboratively develop an interprofessional pain management plan. RESULTS: A total of 10,693 students participated over the 10-year study period. The mean annual attendance was 972 students and participation to the program increased significantly over the years. Overall, the IPC was effective in improving students' mean pain knowledge and beliefs scores; however, the mean knowledge score gains were negatively correlated with time, likely related to increased uniprofessional pain education. Although an increasing trend in mean interprofessional pain management plan scores was observed, the scores were not significantly correlated with time. CONCLUSIONS: The interactive and multifaceted IPC is consistently effective in improving knowledge and beliefs and interprofessional pain management care plan development among participating student cohorts. Future inquiry is required to better understand the mechanisms behind student learning in interprofessional pain education to enhance pain curriculum development and delivery.

Approaches to Indigenous health within interprofessional education: a scoping review protocol.

OBJECTIVE: This scoping review will explore the depth, breadth, and nature of existing literature on educational approaches to Indigenous health within interprofessional education learning activities, and provide a summary of available literature, identify gaps in the research, and recommend areas for further exploration. INTRODUCTION: Interprofessional education learning activities comprise sessions where health care learners work collaboratively to address and improve the health outcomes of a given population, such as health needs among Indigenous communities. A preliminary search for existing reviews was conducted across several databases. Published literature on Indigenous health within interprofessional education learning activities exists; however, there is no comprehensive review on this topic. INCLUSION CRITERIA: This review will consider literature on existing educational approaches to Indigenous health within interprofessional education learning activities, in particular the approaches used to teach cultural awareness, sensitivity, competency, safety, and/or humility. It will consider all forms of English-language evidence, including quantitative studies, qualitative studies, mixed-method studies, and gray literature. Participants include health care and social care professionals, educators, and students within interprofessional education learning activities. METHODS: The JBI scoping review methodology will be used to guide our research. The following databases will be searched: MEDLINE, CINAHL Plus, PsycINFO, ProQuest ASSIA, Indigenous Studies Portal, and ERIC. We will also hand search reference lists and explore gray literature. Two reviewers will screen the search results and extract included studies using data extraction forms. The data will be presented in summary tables and a narrative summary.

The COVID-19 crisis silver lining: interprofessional education to guide future innovation.

Globally, the advent and rapid spread of the COVID-19 virus has created significant disruption to health professions education and practice, and consequently interprofessional education, leading to a model of learning and practicing where much is unknown. Key questions for this ongoing evolution emerge for the global context leading to reflections on future directions for the interprofessional education field and its role in shaping future practice models. Health professions programs around the world have made a dramatic shift to virtual learning platforms in response to closures of academic institutions and restrictions imposed on learners accessing practice settings. Telemedicine, slow to become established in many countries to date, has also revolutionized practice in the current environment. Within the state of disruption and rapid change is the awareness of a silver lining that provides an opportunity for future growth. Key topics explored in this commentary include reflection on the application of existing competency frameworks, consideration of typology of team structures, reconsideration of theoretical underpinnings, revisiting of core dimensions of education, adaptation of interprofessional education activities, and the role in the future pandemic planning. As an international community of educators and researchers, the authors consider current observations relevant to interprofessional education and practice contexts and suggest a response from scholarship voices across the globe. The current pandemic offers a unique opportunity for educators, practitioners, and researchers to retain what has served interprofessional education and practice well in the past, break from what has not worked as well, and begin to imagine the new.

Teaching About Partnerships Between Patients and the Team: Exploring Student Perceptions.

Health profession educators are responding to shifting approaches where patients are increasingly recognized as partners in an interprofessional care process. To foster competencies related to partnerships between patients and the team, educators have advanced the role of patient partners; however, an appreciation of resulting student learning is in its early stages. First-year students from 9 programs interacted with patient partners and participated in a Reader's Theater that explored partnerships with patients in an interprofessional team. Students completed reflective assignments; an inductive thematic analysis explored student learning. The following 4 overarching themes were recognized: developing insights through patient perspective, promoting partnerships with patients, recognizing attitudes that promote therapeutic relationships, and advocating for the patient to be a team member. Accompanying subthemes provide enhancement of each of the identified themes. Students discussed the effect of poor collaboration, identified attitudes that promote collaboration, and expressed the value of advocacy for patient partnership. An enriched appreciation of student learning will guide educator engagement of patient partners in both health professional and interprofessional curricula.

Investigating the provision of occupational therapy services: A case study.

BACKGROUND.: The World Health Organization has identified occupational therapists as integral human resources on health care teams, yet in many contexts, occupational therapy services are not adequately provided. One example is occupational therapy in mental health care in Saskatchewan. PURPOSE.: This study aimed to uncover what is known about the case of occupational therapy in the context of mental health services in Saskatchewan. METHOD.: An instrumental case study design was employed, applying a critical interpretive approach and thematic analysis to examine 40 publicly available documents. FINDINGS.: Three main themes (with subthemes) were identified: access (representation, funding, rural communities), awareness (comprehension, value, collaboration), and advocacy (leadership, education). IMPLICATIONS.: This study illuminates how restricted access to, limited awareness of, and ineffective advocacy for occupational therapy impacts mental health services in Saskatchewan and provides a replicable process for other contexts where occupational therapy is underrepresented.

Patient involvement in health professionals' education: a meta-narrative review.

More than 100 years ago, Osler inspired educators to consider health professions education (HPE) as intricately reliant on patients. Since that time, patient involvement in HPE has taken on many different meanings. The result is a disparate body of literature that is challenging to search, making it difficult to determine how to continue to build knowledge in the field. To address this problem, we conducted a review of the literature on patient involvement in HPE using a meta-narrative approach. The aim of the review was to synthesize how questions of patient involvement in HPE have been considered across various research traditions and over time. In this paper, we focus on three scholarly communities concerned with various interpretations of patient involvement in HPE-patient as teachers, real patients as standardized patients, and bedside learning. Focus on these three research communities served as a way to draw out various meta-narratives in which patients are thought of in particular ways, specific rationales for involvement are offered, and different research traditions are put to use in the field. Attending to the intersections between these meta-narratives, we focus on the potentially incommensurate ways in which "active" patient engagement is considered within the broader field and the possible implications. We end by reflecting on these tensions and what they might mean for the future of patient involvement, specifically patient involvement as part of future iterations of competency based education.

Patient Experience in Health Professions Curriculum Development.

To enhance student learning, many health profession programs are embracing involvement of patients in their curricula, yet little is known about the impact of such an experience on patients. OBJECTIVE: To understand the experiences of patients who contributed to the creation of a Verbatim Reader's Theater used in health professions curriculum. METHODS: A semi-structured interview was conducted with a focus group of 3 patients who participated in curriculum development. The interview was recorded, transcribed verbatim, and analyzed for themes using van Manen approach to hermeneutic phenomenology. RESULTS: Five themes emerged: (1) contextualizing contribution, (2) addressing expectations, (3) changing health-care service delivery, (4) sharing common experiences, and (5) coordinating participation. CONCLUSION: Patients had a positive experience contributing to curriculum development and found meaning in sharing their lived experience to shape the values of future clinicians. Strategies to promote continued success in partnership between patients and health professional curriculum developers include clear communication about the project's direction and early discussion of patient role and expectations.

Mapping of pain curricula across health professions programs at the University of Toronto.

BACKGROUND: There is a growing societal need for health professional competency in pain care. The University of Toronto Centre for the Study of Pain-Interfaculty Pain Curriculum (UTCSP-IPC) has been offered since 2002. Content and process have been updated annually. In addition, participating health professions programs have advanced their pain teaching. A curricular scan was needed to creatively and constructively advance the UTCSP-IPC. AIM: The aim of this study was to map curricular pain content in participating health professions programs onto the UTCSP-IPC content as a first step to further curriculum design. METHODS: UTCSP-IPC committee members and faculty representatives from six health profession programs completed a 27-item online survey in this collaborative action study. Descriptive statistics were completed in Microsoft Excel. RESULTS: The UTCSP-IPC provided an average of 43.3% (range 32%-62%) of total pain content teaching hours to participating health professions students and a range of 8% to 100% of total opioid-related teaching hours. Curricular overlaps and gaps in pain content were identified and will be used to update and inform the iterative design of the UTCSP-IPC. Ninety-three percent of participating health professions faculty indicated that the interprofessional focus on pain care in the UTCSP-IPC was important. CONCLUSION: This study highlighted the value of the UTCSP and areas of curricular refinement to ensure continued relevance in relationship to pain content within the six participating health professions programs. Mapping a coordinated approach between uniprofessional and interprofessional teaching will both meet the demands of professional competence and create greater applicability to future practice settings.

Contexte : Il est de plus en plus nécessaire que les professionnels de la santé aient les compétences nécessaires pour la prise en charge de la douleur au sein de la société. Le Programme interfacultaire sur la douleur du Centre pour l'étude de la douleur de l'Université de Toronto (UTCSP-IPC) est offert depuis 2002. Son contenu et son processus ont été mis à jour chaque année. Les programmes des professions du domaine de la santé participantes ont eux aussi perfectionné leur enseignement sur la douleur. Une radiographie du programme était donc nécessaire afin d'améliorer l'UTCSP-IPC de manière créative et constructive.Objectif : Recenser le contenu sur la douleur dans les programmes des professions du domaine de la santé participantes afin de l'inclure dans l'UTCSP-IPC en tant que première étape pour améliorer la conception du programme.Méthodes : Des membres du comité de l'UTCSP-IPC et des représentants des facultés de six programmes de professions du domaine de la santé ont répondu à un sondage en ligne comprenant 27 énoncés dans le cadre de cette étude collaborative. Des statistiques descriptives ont ensuite été compilées dans Microsoft Excel™.Résultats : Au total, l'UTCSP-IPC a donné en moyenne 43,4 % (entre 32 et 62 %) d'heures d'enseignement sur la douleur aux étudiants des professions du domaine de la santé participantes, et de huit à 100 % d'heures d'enseignement liées aux opioïdes. Les lacunes et les chevauchements dans le contenu portant sur la douleur ont été répertoriés. Cette information sera utilisée pour la mise à jour et la conception itérative de l'UTCSP-IPC. Quatre-vingt-treize pour cent des facultés des professions du domaine de la santé participantes ont souligné l'importance de continuer à mettre l'accent sur l'aspect interprofessionnel de la prise en charge de la douleur dans l'UTCSP-IPC.Conclusion : Cette étude a mis en évidence l'importance de l'UTCSP ainsi que les aspects du programme qui doivent être peaufinés pour maintenir sa pertinence en ce qui concerne le contenu sur la douleur au sein des six programmes des professions du domaine de la santé participantes. L'élaboration d'une approche coordonnée entre l'enseignement uniprofessionnel et l'enseignement interprofessionnel permettra à la fois de répondre aux exigences en matière de compétences professionelles et d'améliorer l'applicabilité dans les futurs milieux de pratique.