Virtual Interprofessional Education: Lessons Learned.

INTRODUCTION: Several universities modified interprofessional education (IPE) to a virtual format, showing similar outcomes as IPE delivered through an in-person format. This study aimed to describe perceptions of 106 students from programs in occupational therapy, dietetics, nursing, athletic training, and speech-language pathology (SLP) following an established IPE activity in a virtual format. This information will add to previous literature through inclusion of 5 healthcare programs as well as identifying attitudes from each discipline. both of which will enhance future IPE curriculum development. METHODS: Following the IPE event with a case study, participants wrote reflective essays describing their perceptions of the virtual IPE experience. Four researchers analyzed the reflective essays using thematic analysis. RESULTS: Findings revealed four themes: beneficial learning experience, roles, the more the merrier, and logistics. Participants felt overall that the virtual IPE experience was beneficial, but the logistical issues of the online format as well as students' amount of participation created negative perceptions. Participants from dietetics expressed the most positive comments (70%), followed by occupational therapy (69%), athletic training (67%), speech-language pathology (54%) and nursing (48%). Undergraduate students (dietetics and nursing) made 4% more positive comments than graduate students (SLP, athletic training, occupational therapy). DISCUSSION: Participants shared that the virtual IPE experience is beneficial for optimal holistic care and felt some components of the IPE experience prepared them for real-world clinical practice. However, logistical issues (large group size and online format) prevented equal participation and establishing a connection with other participants.

Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity.

Background: Virtual healthcare has forced clinicians to modify or eliminate parts of the musculoskeletal evaluation such as motion assessment. Although acceptable to excellent levels of in-person goniometric reliability is achievable, reliability of virtual assessments is unknown. Purpose: To determine if similar upper extremity goniometric measurements could be obtained in-person and virtually. Study Design: Reliability study; classroom setting. Methods: Publicly recruited sample over 18 years of age with no upper extremity injuries. Each subject was tested in a standing position with dominant arm facing the clinicians to visualize the landmarks for goniometer placement. Flexion and extension of the shoulder, elbow and wrist were measured. Prior to performing in-person goniometric measurements for each joint, an image was captured of each pre-determined joint position using a mobile device with a camera. This image represented the screenshot on a virtual platform. Four clinicians performed in-person measurements twice during the same session on each subject. The following week clinicians measured virtual images using the same techniques. Inter-rater and intra-rater reliability were determined via intraclass correlation coefficients (ICC). Results: Inter-rater reliability for five of the six in-person (ICC≥0.81) and virtual measurements (ICC≥0.78 ) were classified as excellent. In-person wrist extension (ICC=0.60) and virtual wrist flexion (ICC=0.65) were classified as good. Intra-rater reliability for individual clinicians were between good and excellent for the in-person measurements (ICC:0.61-0.96) and virtual measurements (ICC:0.72-0.97). There were a greater number of excellent ICC values for the virtual measurements (90%) compared to in-person measurements (70%). There were statistically significant differences between in-person and virtual sessions for five of six measurements (p≤0.006). Only elbow extension did not differ between sessions (p=0.966). Conclusion: Virtual assessment compared to goniometric measurements showed good to excellent inter- and intra-rater reliabilities (ICC > 0.60), which suggests clinicians can utilize goniometry either in person or on a virtual platform. Level of Evidence: 3b©The Author(s).

Women's Experiences after Hormone Positive Breast Cancer: Beginning of Radiation to 3-4 Years Post-Radiation.

This study found that a breast cancer survivor cohort who were 3-4 years post-treatment returned to near baseline activity levels, and their important activity categories were nearly evenly distributed among instrumental activities of daily living, high-demand leisure, and social participation. When describing their experiences, three themes emerged: exercise is important physically and emotionally, participating in important activities feels good, and plans have been made to continue engaging in important activities. Further research is needed to compare activity resumption among those receiving or not receiving occupational therapy-at different timepoints-to understand when occupational therapy can make the greatest impact.

Occupational Therapy Utilization in Veterans With Dementia: A Retrospective Review of Root Cause Analyses of Falls Leading to Adverse Events.

INTRODUCTION: Falls in persons with dementia are associated with increased mortality. Occupational therapy (OT) is a rehabilitation discipline, which has, among its goals, the promotion of safety and fall prevention in older adults and those with dementia. The purpose of this study was to evaluate root cause analysis (RCA) data to identify causes of falls with adverse events in patients with dementia who were referred to or receiving OT services within the Veterans Health Administration (VHA). METHODS: This study used retrospective review of RCAs within the National Center for Patient Safety database for the VHA. The RCA database was searched using these terms: falls with adverse events, dementia, and OT. Descriptive statistical analysis of demographic information, location, occurrence of orthopedic fracture, and mortality was used. All root causes were qualitatively categorized using thematic analysis of determined causes. RESULTS: Eighty RCAs were included in analysis. Mean age of veterans included was 80 years; 96% were male; 76% resulted in hip fracture; and 20% died as a result of the fall. Occupational therapy evaluations occurred within 7 days of admission to VHA and falls most frequently occurred within 4 days of OT evaluation. Most common causes included inappropriate or lack of equipment (21%), need for falls/rehabilitation assessment (20%), compliance/training to fall protocol of all staff (19%), and behavior/medical status (17%). CONCLUSIONS: Earlier identification for OT evaluation need may improve access to services, and use of proper equipment to decrease frequency of falls may improve patient safety for older adults with dementia.

Test/Re-Test reliability of the readiness for interprofessional education learning scale and interdisciplinary education perception scale in health science students.

This study aimed to establish the test/re-test reliability of two common interprofessional education (IPE) instruments, the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS), and to compare results based on previous IPE experience. The RIPLS and the IEPS were distributed to 251 students within five academic health science programs at one university. Both instruments were distributed at a second session 10-14 days later. Weighted Kappa, intraclass correlation coefficients (ICC), standard error of measurement, and minimal detectable change were calculated for each instrument's composite scores and subscales. Assessments occurred for all subjects and between students with and without previous IPE experience. Overall and between-group composite score reliability for the RIPLS and IEPS were excellent (ICC≥0.81). RIPLS subscale ICCs were variable per previous IPE experience, ranging from fair-excellent (ICC = 0.56-0.86). IEPS subscale ICCs were excellent for students with previous IPE experience (ICC≥0.76), and fair-excellent for students without previous experience (ICC = 0.64-0.84). Students with previous IPE experience had significantly higher scores within and between sessions for the RIPLS (p ≤ 0.031) but not the IEPS. Both instruments have acceptable measurement consistency; however, the RIPLS varied in repeatability compared to the IEPS. Previous IPE experience should be accounted for when distributing/interpreting the results.