Challenges and opportunities of evaluating work based interprofessional learning: insights from a pediatric interprofessional training ward.

Introduction: Interprofessional collaboration among healthcare professionals is fostered through interprofessional education (IPE). Work-based IPE has demonstrated effectiveness within interprofessional training wards. We developed the Interprofessional Training Ward in Pediatrics (IPAPED) and employ a combination of established assessment tools and a newly created IPAPED questionnaire, directed at to assess both students' learning experiences and program structure. This paper presents the development and analysis of the psychometric properties of the IPAPED questionnaire. Methods: Nursing trainees and medical students participated in IPAPED. The IPAPED questionnaire was developed to complement established instruments, based on IPE frameworks. Interprofessional collaboration and communication were represented in subscales in part 1 of the questionnaire. Part 2 focused on the IPAPED program itself. Statistical analyses included calculation of internal consistency for part 1 and exploratory factor analyses for part 2. Results: All IPAPED participants between November 2017 and November 2022 completed the questionnaire (n = 105). 94 of 105 questionnaires were analyzed. Internal consistency for part 1 was low (Cronbach's α <0.58). Exploratory factor analyses revealed three distinct factors: teaching and learning material, interprofessional learning facilitation and professional guidance by nurses on the ward. Discussion: Our results illustrate the challenge of performing high quality, theory based evaluation in a work-based setting. However, exploratory factor analyses highlighted the opportunity of focusing on both learning facilitators and staff on the wards to ensure a maximum learning output for participants. Developing program-specific questionnaires to gain insight into local structures has the potential to improve work-based IPE formats.

'We just did it as a team': Learning and working on a paediatric interprofessional training ward improves interprofessional competencies in the short- and in the long-term.

PURPOSE: Interprofessional (IP) education is essential for healthcare professionals to prepare them for future IP collaboration. IP training wards (ITWs) have been established for work-based IP education. Short-term effects of ITW placements have been published but long-term results are scarce. There are no reports on ITWs in paediatrics. We established the Interprofessional Training Ward in Paediatrics (IPAPAED) for paediatric nursing trainees and medical students. The aim of the study is to evaluate both short- and long-term outcomes regarding IP competencies of IPAPAED participants. METHODS: The study was designed as a prospective, non-randomized trial, using a mixed-methods design. The Interprofessional Socialization and Valuing Scale (ISVS-9A/B) and the Interprofessional Collaboration Scale (ICS) were used for quantitative evaluation, qualitative data were gathered from structured group discussions and free-text comments. Data were collected from 68 IPAPAED participants, before and after the rotation, and 6-34 months later.Results: IPAPAED participants showed increased global scores in the ISVS 9 A/B and rated their communication competencies and their accommodation in IP teams better (ICS). Improvements in communication competency and accommodation persisted at 6-34 months.Conclusions: IP learning and working on IPAPAED had positive short-term effects on interprofessional competencies. Some of these effects persisted on a long-term.

Position paper of the GMA Committee Interprofessional Education in the Health Professions - current status and outlook.

In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare.

SIESTA: a quick interprofessional learning activity fostering collaboration and communication between paediatric nursing trainees and medical students.

BACKGROUND: Interprofessional education has emerged as a key concept in education of health professionals over the last 20 years. Positive effects of interprofessional education have been shown, but it has proved to be more time-consuming than traditional teaching methods. We therefore developed a 30-minute interprofessional learning activity, using peer-teaching methods. We were interested in effects on and ways of interprofessional learning, including conditions and resources that make it successful despite limited time. METHODS: Speed InterprofESsional Peer Teaching PaediAtric (SIESTA) was developed in the context of an interprofessional training ward. 20 paediatric nursing trainees and 20 medical students were enrolled in the study. Two students from each profession participated in a total of four SIESTA sessions each, supervised by registered paediatric nurses and paediatricians. We used a mixed-methods approach of quantitative and qualitative data (questionnaires, semi-guided focus group interviews) to evaluate self-perceived interprofessional competencies, interprofessional learning gains and ways of interprofessional learning. RESULTS: Questionnaires were obtained from all participants (n = 40) and n = 26 took part in the group interviews. Participants from both professions reported an increase in self-perceived understanding of interprofessional roles and tasks. Communication and cooperation emerged as important aspects. The workplace-based nature of SIESTA promoted interprofessional learning, while peer teaching fostered a safe learning environment. Regarding time constraints participants suggested thorough preparation and structuring by facilitators as a solution. CONCLUSIONS: Our short interprofessional peer teaching activity showed promising results. Participants reported enhanced interprofessional competencies and provided suggestions for successful learning in limited time. Further studies should include an objective assessment of the interprofessional learning progress. The SIESTA concept can be easily adapted to other medical fields, providing interprofessional learning opportunities for many more health care professionals to come.

Interprofessional learning during SARS-CoV-2 (COVID-19) pandemic conditions: the learning project I-reCovEr as a substitute for a rotation on an interprofessional training ward.

The COVID-19 pandemic has led to massive and aprupt changes in the training of health care professionals. Especially hands-on training can no longer take place in the usual form in everyday clinical practice. Rotations on the interprofessional training ward in Pediatrics (IPAPAED) at the University Medical Center Freiburg, had to be suspended starting March 2020. This report presents the interprofessional Covid-19 Replacement Program (I-reCovEr) as an alternative learning format for a rotation on the IPAPAED at the Center for Pediatric and Adolescent Medicine. I-reCovEr offers opportunities for pediatric nursing trainees (n=6) and medical students (n=9) to learn together, taking hygienic and distancing measures into account. Based on a case study, selected learning aspects regarding interprofessional cooperation and communication are targeted. The participants report increased knowledge about the work of the other professional group in the evaluation using the Interprofessional Socialization and Valuing Scale (ISVS) -9A. In comparison to participants of the IPAPAED, however, the self-evaluation did not reveal any self-perceived acquisition of other interprofessional skills or competences. I-reCovEr can therefore serve as an introduction to interprofessional training, but it cannot replace interprofessional learning and working on an interprofessional training ward.

Nursing staff's and physicians' acquisition of competences and attitudes to interprofessional education and interprofessional collaboration in pediatrics.

BACKGROUND: Interprofessional education (IPE) is deemed essential for interprofessional collaboration (IPC) in healthcare systems. IPC has positive effects for both patients and healthcare professionals. Especially in pediatrics, IPC is paramount for adequate care of patients and their families though there is a lack of data on the attitudes towards IPE and IPC and acquisition of respective competences in pediatric nursing and medical staff. METHODS: Frequencies of interactions and attitudes towards IPE and IPC, with a focus on acquisition of competences for IPE and IPC, of nurses (N = 79) and physicians (N = 70) in a large pediatric university hospital were evaluated with an online questionnaire. RESULTS: All participants worked as part of interprofessional teams, mostly consisting of nurses and physicians. The majority (94.9% (n = 75) of nurses and 100% (n = 70) of physicians) highly valued IPC. Medical doctors acquired most competences important for IPC during day-to-day work and reported a substantial lack of IPE. Nursing staff on the other hand did report significant interprofessional education during their training as well as ongoing interprofessional learning during day-to-day work. Nurses also appreciated IPE more. CONCLUSIONS: Even though IPC is commonly reported in nurses and physicians working at a large pediatric university hospital there is a lack of structured IPE. A focus should be on IPE for nurses and physicians to enable them to effectively collaborate together. Political and local initiatives for IPE are gaining momentum but still need to be established nationally and internationally.

Protecting children across borders - child protection in an international context (Germany/Switzerland) as an interprofessional teaching unit.

Introduction: Interprofessional collaboration (IPC) in everyday clinical practice is a prerequisite for good patient care but currently this is not sufficiently anchored in the education of health care professionals. Project description: A course on child protection in the interprofessional and international domain was established at the Medical School, University of Freiburg. In this course, students of medicine, nursing science and social work acquire skills for successful interprofessional cooperation. Its participants learn across professional and national borders, not only with but also from and about each other. In this way, they deepen their insights into international IPC through a key topic that is relevant to many disciplines. The course is run as a one-day campus day. This paper presents the course setup and evaluation results. Methods: The evaluation was carried out online and in writing in a before and after format using the Freiburg Questionnaire for Interprofessional Learning Evaluation (FILE) in addition to oral feedback. Learning objectives for IPC and child protection were formulated and the participants were asked about their subjective achievements. Results: From summer semester (SuSe) 2017 to SuSe 2018, 39 participants took part in the course. It was rated as m=1.5 (using German school grades where 1=very good, 6=unsatisfactory). In 18 of the 26 FILE items, participants report a self-assessed increase in knowledge or skills/abilities. This growth in learning coincides with the learning objectives set. Discussion & conclusion: From the perspective of the participants, the course teaches interprofessional competencies in an international setting and is seen as an informative course offer. The continuation or expansion of such courses as a supplement to purely single-country interprofessional courses is desirable.

Patients' and parents' percetion of care on a paediatric interprofessional training ward.

BACKGROUND: Interprofessional training wards (ITWs) have been established in different fields of adult medicine to promote interprofessional learning and interprofessional collaboration of health care profession students. High patient satisfaction rates have been reported for ITWs. No data of parents' and especially patients' evaluation of care on a paediatric ITW have been reported so far. This study aims to evaluate parents' and patients' perceptions of medical and nursing care on a paediatric ITW. METHODS: In 2017 we established and started an interprofessional training ward in the setting of a general paediatric ward (IPAPAED). Medical students and nurse trainees care for 4-6 patients under supervision of registered nurses and certified physicians. All parents and all patients older than 8 years were invited to evaluate different aspect of their care on the IPAPAED. RESULTS: Since November 2017 until February 2019 parents (n = 109) rated the overall care of their children on the IPAPAED ward with m = 1.21 (SD ± .43) (1 = "excellent", 4 = "poor"). Patients (n = 56) rated their overall care with m = 1.29 (SD ± 0.5). Other aspects of care and interprofessional collaboration were rated equally well. Analysis of the (limited) free-text commentaries revealed that perceived quality of care, friendliness and communication were especially valued by patients and parents. DISCUSSION & CONCLUSION: On a paediatric ITW, in the view of parents and patients in our sample, a high level of care is delivered and satisfaction rates are excellent. An ITW seems, from a patient and parent point of view, feasible, even in paediatrics.

Student-perceived exam difficulty may trump the effects of different quality improvement measures regarding the students' evaluation of a pediatric lecture series.

BACKGROUND: Lectures are still an important part of today's medical education at many medical schools. The pediatric lecture series at the Center for Pediatrics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany had been evaluated poorly in recent terms. METHODS: To improve lecture quality and possibly evaluation results a combination of measures consisting of peer lecturer coaching, use of an audience response system, in depth analysis of the end of term evaluation results and changes to the exam itself were implemented. RESULTS: Peer lecturer coaching was performed successfully and both the audience response system evaluation as well as the end of term evaluation results improved significantly in the following term. Analysis of the students' comments revealed more approval of lecture content and presentation after the organization of the lecture series was changed towards less lecturers and focus on less topics. Student-perceived high exam difficulty influenced the evaluation negatively. CONCLUSION: The student-perceived exam difficulty can supersede the effects of different measures to improve lecture quality measured via evaluation. Whether better evaluation of the lecture series after different improvement measures was due to better match of the curriculum with the exam content or that an improved curriculum led to better exam performance remains to be elucidated.

Interprofessional education in pediatrics-Child protection and family services as a teaching example.

Interprofessional collaboration between different professional groups in the health care system is essential to efficient and effective patient care. Especially in pediatrics, in the field of child protection, and family services it is mandatory to involve experts from different health-care professions to optimize support for children and their families. Interprofessional education in medical schools and specifically in pediatrics is rare in Germany, but is called for by the German National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). We developed an interprofessional course aimed at bringing medical students together with students of psychology, social work, clinical education, and educational science to learn from, about and with each other in the context of child protection and family services. This offers opportunities for all participants to understand profession-specific competencies, roles, attitudes, and limits of their professional roles. The course is led by an interprofessional teaching tandem (social scientist & physician); further input is provided by other health and social care professionals. After the students get a brief overview about the requirements for a successful interprofessional cooperation they solve case studies in interprofessional teams with online support by the teaching tandem. We assess the feasibility and acceptability of this interprofessional course and describe challenges encountered when conducting this kind of learning concept for health care professions. All conducted courses over five consecutive terms were evaluated with an arithmetic mean of AM=1.32 on a 6-point scale (1="excellent", 6="insufficient"), the teaching tandem was evaluated with AM=1.1. All participants (N=85 complete evaluations) voted for the course to be continued in the following terms. Especially the opportunity to discuss cases with students from different degree programs was highly valued as were interprofessional discussions and more in-depth understanding of other professions' competencies and roles.

Self-perceived attitudes toward interprofessional collaboration and interprofessional education among different health care professionals in pediatrics.

Interprofessional education (IPE) is the basis for interprofessional collaboration (IPC) in health care systems. It has beneficial effects for both patients and health care professionals. IPC is paramount for adequate care of patients and their families, especially in pediatrics. To determine the attitudes of medical doctors (n=121), nurses (n=15), psychologists (n=14), and social workers (n=19) toward IPE and IPC in a tertiary pediatric university teaching hospital, as well as the inpatient and outpatient settings in pediatrics, we developed a questionnaire with 21 items in four categories based on established questionnaires. All participants worked as part of interprofessional teams, and the overwhelming majority valued IPC highly. Most competencies important for IPC were acquired on the job. There was a substantial lack of interprofessional education, especially for medical doctors and psychologists. IPE still needs to be established as part of the undergraduate curriculum at German universities.

Design and evaluation of an IPE module at the beginning of professional training in medicine, nursing, and physiotherapy.

AIM: Interprofessional education (IPE) is a central feature of modern education in the health care professions. Despite this, empirically founded and systematically structured IPE courses are absent from many curricula. To answer the WHO's call for improved interprofessional collaboration in the health care system, a seminar was designed, implemented and evaluated. The target group consisted of students beginning nursing and medical studies (first and second semesters) and physiotherapy students (first year of training). The aim was to develop a basic IPE module focusing not only on the demands placed by academia and politics, but also the interests of the target group. This module was evaluated on the basis of the modified four-level Kirkpatrick approach. METHOD: Based on focus group interviews analyzed qualitatively using Mayring's content analysis, it was possible to define five learning objectives and develop four practice-oriented modules. The seminar was then implemented and evaluated using written pre- and post-seminar evaluations and group discussions. RESULTS: Analysis confirmed the success of the IPE concept in that the seminar was positively rated by attendees not only in terms of their immediate reactions, but also attitude, knowledge and skills according to Kirkpatrick. CONCLUSION: In the future, it is intended to offer the IPE module on a permanent basis and assess the competencies acquired in the seminar using observation. Courses to ensure sustained learning outcomes would also be desirable.

Audience-response systems for evaluation of pediatric lectures--comparison with a classic end-of-term online-based evaluation.

AIM: Course evaluations are often conducted and analyzed well after the course has taken place. By using a digital audience response system (ARS), it is possible to collect, view and discuss feedback during or directly following a course or lecture session. This paper analyzes a student evaluation of a lecture course with ARS to determine if significant differences exist between the results of the ARS lecture evaluation and those of the online evaluation at the end of the semester. In terms of the overall evaluation, consideration is given to the level of students' prior knowledge, the presentation of the lecture material by the lecturers and the relevance of the lecture topic for students. METHOD: During the 2011-12 winter semester, the lecture on Pediatrics at the Freiburg Center for Pediatric and Adolescent Medicine (Zentrum für Kinder- und Jugendmedizin (ZKJ) Freiburg) was evaluated using ARS. Thirty-four lectures were evaluated by an average of 22 (range 8-44) students, who responded to four questions each time an evaluation took place. RESULTS: On a 6-point Likert scale (1=very good to 6=deficient), the students rated their level of preparedness with a mean of 3.18, the presentation of the lecture with 2.44, and the relevance of the lecture topic with 2.19. The overall evaluation of the lecture course by means of ARS resulted in 2.31. The online evaluation conducted at the end of the semester yielded a score of 2.45. Highly significant correlations were seen between the results of the ARS for the overall evaluation, assessment of prior knowledge, lecture presentation, and the estimated relevance of the lecture topic. CONCLUSION: The use of ARS is suitable for immediate evaluation of lectures, in particular regarding timely feedback for the individual lecturer/lecturers. In comparison with an end-of-term evaluation, ARS yielded a better assessment.