Toward Interprofessional Education of Pharmacogenomics: An Interdisciplinary Assessment.

INTRODUCTION: Pharmacogenomics, which emerged from disciplines such as pharmacology and genetics, is an increasingly important interdisciplinary field of health research, as indicated by the rapid growth of related literature. The aim of this study was to evaluate knowledge among genetics and pharmacology health-care students and to evaluate their exposure to and perceptions of pharmacogenomics. METHODS: An anonymous, 28-item online survey was distributed to medical and pharmacy students enrolled at Yarmouk University, Jordan. RESULTS: The respondents (n = 300) had an overall moderate level of knowledge regarding genetics and pharmacology. Most respondents recognized the benefits of pharmacogenomics for therapy optimization, but they had insufficient exposure to the topic. Most respondents supported providing pharmacogenetic testing in Jordan. The most preferred educational format in pharmacogenomics was integration in pharmacology courses. DISCUSSION/CONCLUSION: Medical and pharmacy students are becoming increasingly aware of the importance of pharmacogenomics in therapy optimization. Challenges such as the complexity of the topic and low retention of previous knowledge should be addressed to promote pharmacogenomics education. More work is needed to increase students' exposure to pharmacogenomics information. A deeper integration of pharmacogenomics applications into pharmacology courses is proposed to emphasize applications of pharmacogenomics.

Health Professional Redeployment and Cross-Training in Response to the COVID-19 Pandemic.

The onset of the COVID-19 pandemic in March 2020 required hospitals to respond quickly and effectively to ensure the availability of healthcare professionals to care for patients. The Ottawa Hospital in Ottawa, ON, used a five-step process to ensure organizational readiness for redeployment of regulated health professionals as and when necessary: (1) define current scopes of practice; (2) obtain discipline-specific input; (3) develop strategies based on literature review and government dictates; (4) identify potential duties; and (5) ensure support for staff. With hospital management support, this plan was readily implemented. Results are discussed in terms of operational outcomes (e.g., number and type of deployments) and staff experience. Outcomes were positive and led to recommendations for improved organizational readiness.

Advancing interprofessional education in communication.

OBJECTIVE: The objective of this training project is to develop and host Interprofessional Communication courses to improve interdisciplinary communication in oncology care. The initial national course was held in a virtual format and included pre- and post-course participant data. The curriculum was developed with support from the National Cancer Institute. METHODS: A virtual two-day course was held to equip nurses, social workers, and chaplains with vital communication skills in oncology practice, so that they could return to their home institutions and teach communication skills to other healthcare professionals, with the intention of making improved communication a quality improvement goal. Fifty-two participants were selected through an application process to attend the virtual course in two-person interprofessional teams (e.g., nurse and chaplain, or social worker and nurse). The Interprofessional Communication Curriculum was based on the National Consensus Project for Quality Palliative Care's eight domains of quality palliative care. The six online modules developed by the investigators were presented in lectures, supplemented by discussion groups, role plays, and other methods of experiential learning. RESULTS: Pre- and post-course results identified areas of communication, which are a priority for improvement by oncology clinicians. Participant goals identified specific strategies to be implemented by participants in their settings. SIGNIFICANCE OF RESULTS: The need for communication training was clearly demonstrated across professions in this national training course. Participants were able to apply course content to their goals for quality improvement in cancer settings.

Navigate the Challenges of Simulation for Assessment: A Faculty Development Workshop.

Introduction: Given barriers to learner assessment in the authentic clinical environment, simulated patient encounters are gaining attention as a valuable opportunity for competency assessment across the health professions. Simulation-based assessments offer advantages over traditional methods by providing realistic clinical scenarios through which a range of technical, analytical, and communication skills can be demonstrated. However, simulation for the purpose of assessment represents a paradigm shift with unique challenges, including preservation of a safe learning environment, standardization across learners, and application of valid assessment tools. Our goal was to create an interactive workshop to equip educators with the knowledge and skills needed to conduct assessments in a simulated environment. Methods: Participants engaged in a 90-minute workshop with large-group facilitated discussions and small-group activities for practical skill development. Facilitators guided attendees through a simulated grading exercise followed by in-depth analysis of three types of assessment tools. Participants designed a comprehensive simulation-based assessment encounter, including selection or creation of an assessment tool. Results: We have led two iterations of this workshop, including an in-person format at an international conference and a virtual format at our institution during the COVID-19 pandemic, with a total of 93 participants. Survey responses indicated strong overall ratings and impactfulness of the workshop. Discussion: Our workshop provides a practical, evidence-based framework to guide educators in the development of a simulation-based assessment program, including optimization of the environment, design of the simulated case, and utilization of meaningful, valid assessment tools.

Physical Therapy and Health Information Management Students: Perceptions of an Online Interprofessional Education Experience.

This study described the results of online interprofessional education (IPE) between physical therapy and health information management students. Using the published Student Perceptions of Interprofessional Clinical Education - Revised, version 2 (SPICE-R2) survey, this study measured changes in perception about IPE before and after three online interactions. Survey results included an overall score and three factors: Interprofessional Teamwork and Team-Based Practice (T), Roles/Responsibilities for Collaborative Practice (R), and Patient Outcomes from Collaborative Practice (O). Data were analyzed using two-way analysis of variance tests using time and program as factors. The overall scores improved significantly for time (ρ=.019). The T factor demonstrated a significant change for program (ρ=.006) and the R factor improved significantly over time (ρ=.005) and by program (ρ=.022). Narrative student comments focused on role and responsibility clarification, communication and coordination, and participation in a realistic experience involving multiple professions. The students believed that the experience was beneficial and important.

Interprofessional Education: Reaching Health Professionals With an Interactive Professional Virtual/Online Event on Advocacy and Policy.

Competencies in health policy and advocacy should be developed by all health professionals to effectively advance their professions but also effectively collaborate in interprofessional teams to improve public health. However, the COVID-19 epidemic presents a challenge to reaching students of health professions through face-to-face offerings. To meet this need, the University of South Florida College of Public Health developed asynchronous and synchronous online health policy and advocacy modules delivered to an interprofessional group of students pursuing health careers. After learning policy and advocacy material individually through a self-paced online curriculum, faculty gathered the students for a synchronous online event where they formed collaborative groups. In interprofessional teams, students prepared and presented advocacy briefs that were critiqued by the faculty. Post-event evaluation results showed that most students strongly agreed that the interprofessional event was very effective, and they all would recommend the program to other students. Universities and colleges educating students of health professions can take advantage of the technologies employed to keep students safe in the COVID-19 pandemic and still reach students effectively with interprofessional health policy and advocacy content.

Application of telepresence systems in teaching - transfer of an interprofessional teaching module on digital aided communication into the block training "internal medicine" during the Covid-19 pandemic.

Objective: The contact restrictions caused by the Covid-19 pandemic fundamentally limit patient-centered teaching. To realize a patient-oriented education in the block training "Internal Medicine" at the University Hospital Halle (Saale) despite the challenges, the already established teaching module "Interprofessional Teleconsultation" was adapted. The short article outlines the interprofessional teaching module including first evaluation results and describes the adapted block training. Method: In the "Internal Medicine" block training, students in a lecture hall navigated a telepresence system, which was accompanied by a physician across the ward and conducted an anamnesis via video and audio transmission without actual patient contact. Results: Students, physicians, and patients were open-minded about this form of communication during the Covid-19 pandemic and quickly got accustomed to the use of the telepresence system. To be able to react to technical challenges (e.g. unstable connection between the communication partners), a careful preparation of the lecturers is necessary. Conclusion: In using a telepresence system, patient-oriented teaching of students in the block training "Internal Medicine" can be ensured with low-threshold technical effort during the Covid-19 pandemic. The telepresence system allows for the involvement of patients into teaching while adhering to the necessary hygiene measures. Despite technical challenges, the teaching format based on telepresence is suitable as an alternative to face-to-face teaching if actual patient contact is not possible.

Rethinking Educational Space(s): Exploring the Impact of Co-Curricular Programming on Undergraduate Belonging, Career Exploration, and Interprofessional Education.

This mixed-methods study examined the impact of educational space on undergraduate belonging and learning by analyzing the post-event evaluations of 259 healthcare living-learning program (LLP) students who attended co-curricular programming designed to enhance belonging, career exploration, and interprofessional awareness. Students were broken into two groups based on program location. Post-event evaluations were analyzed using a Mann Whitney U-test and thematic analysis. Themes of career exploration and interprofessional awareness/identity formation emerged in the open-ended responses of both groups. Belonging was enhanced/muted by program location. Seemingly superficial, this variable actually reflects the institution's performance of educational space. The study includes a short discussion regarding the goal of constructing more inclusive educational spaces that support student belonging and success for all students.

Preparing Students to Serve a Refugee Population Through a Health-Focused Interprofessional Education Experience.

Refugees may arrive to their destination country with complex mental and physical health challenges. However, healthcare providers often are unprepared to manage refugees' health-related challenges. An interprofessional team of faculty developed an interprofessional education (IPE) training to help prepare health professions students to address refugees' health needs. This paper describes the development and assessment of the training. A three-hour case-based training was created with the following format: online pre-assessment; introduction; radio story about the experience of local refugees; pre-recorded presentation about healthcare in a detention facility; interprofessional group work in small teams; large group discussion; profession-specific group reflections; and online post-assessment. The training was implemented twice (across two successive years), and an investigation of the study participants' self-perceived learning was completed after each training. In the first training, 62 participants (representing medicine, occupational therapy, pharmacy, physical therapy, and social work) completed the assessments. In the second training, 151 participants (representing medicine, nursing, occupational therapy, physical therapy, public health, and social work) completed the assessments. In each study, a statistically significant increase in each of four outcome variables was found at post-assessment. The findings of each study suggested that perceived learning about refugees' health and health care improved after participation in a three-hour IPE training.

The Academic Fellowship in Physician Assistant Education.

The rapid growth of the physician assistant (PA) profession has required PA programs to increase their efforts in the recruitment and retention of experienced faculty. One approach was the establishment of the academic fellowship concept in 1998. Since then, 5 PA programs have designed fellowships, 3 of which were implemented and graduated fellows. To institute and develop an academic fellowship takes time, resources, and buy-in from faculty and students. The structure of the curricula within the fellowships has been similar since 1998 and includes faculty development opportunities, lecture development and delivery, student assessment, small group facilitation, interprofessional education, and committee work. Most fellowship-trained educators have entered faculty positions after completion of their fellowship. They appear to use sound educational strategies in their teaching and are successful in their scholarly productivity. Academic fellowships are just one route in the transition to PA education, and while they may require a significant investment from the sponsoring institution and program, they can provide a unique opportunity for PAs to immerse themselves in the faculty experience before the full commitment to a career change.

Measuring Student Interprofessional Skills in the Roles/Responsibilities Competency.

PURPOSE: To assess students' perceptions and knowledge of interprofessional collaborative practice related to the Interprofessional Education Collaborative (IPEC) Roles/Responsibilities (RRs) competency after engagement in interprofessional education experiences. METHODS: Thirty physician assistant students were surveyed 3 times during the clinical year to assess the level of collaborative engagement with 5 professions. The level of engagement was assessed utilizing a 5-point Likert scale, and an open-ended question measured student knowledge of other professionals' roles. RESULTS: Student responses indicated that the level of engagement was greatest during the first clinical semester overall for all 3 levels of engagement. An increase in the level of engagement was noted for 2 professions over the one-year study period. Students also provided examples of opportunities where they relied on the expertise of another profession during the clinical rotation year. CONCLUSION: Study results confirm student acquisition of 2 IPEC RR subcompetencies during clinical rotations. However, there remains a gap in correlating interprofessional education with interprofessional collaborative practice.

Creating COVID-19 alternate care site trainings for interprofessional teams.

PURPOSE: To describe the planning and development of alternate care site (ACS) trainings for community COVID care delivery. METHODS: A timeline of activities by the core training team is presented from the lens of the State of Colorado Emergency Operations, leading to the pilot test of a templated training that was completed during the first week of June 2020. Lessons learned and training topics are described. CONCLUSION: This case study of the Colorado experience developing training for community-based COVID care delivery sites can inform other public health planners creating the same in their locales. And, public access materials from this project may supplement training for both public health and community health nurse educators.

Simulation of realistic nephrology case scenarios to facilitate intra-professional team learning.

BACKGROUND: Learning in the workplace maximises relevance to clinical practice and facilitates the education of the whole multiprofessional team. Provision of structured teaching is becoming increasingly challenging with shift pattern working and staff shortages. This article describes a simulation course designed to facilitate team learning to improve the care of nephrology patients, and presents outcome data over 2 years. METHODS: A full-day course, using high fidelity manikins, was designed for nephrology specialty trainees and nurse specialists. Nineteen learners (eleven specialty trainees and eight nurse specialists) and nine multidisciplinary team faculty members attended. Evaluation used pre- and post-course assessments, with a 1-year follow-up questionnaire. RESULTS: Following the course, improved knowledge scores, 56% to 72% (P<0.05), and confidence scores, 57% to 71% (P<0.005), were demonstrated. Qualitative analysis found 'intra-disciplinary interaction', 'reflection' and 'practical skills' were the greatest enablers of learning. In the 1-year follow-up questionnaire, specialty trainees reported that the course improved clinical practice and helped preparation for consultant roles. CONCLUSIONS: This course improved knowledge and confidence in managing nephrology scenarios across the multidisciplinary learning group, and the model could be used in other hospital specialties.

Impact of peer-trainer leadership style on uptake of a peer led educational outreach intervention to improve tuberculosis care and outcomes in Malawi: a qualitative study.

BACKGROUND: Little is known about how to build leadership capacity to support implementation of evidence-based practices within health systems. We observed substantial variability across sites in uptake and sustainability of a peer-led educational outreach intervention for lay health workers (LHWs) providing tuberculosis care in Malawi. Feedback from peer-trainers (PTs) suggested that leadership may have contributed to the variation. We sought to assess the impact of PT leadership style on implementation, and to identify leadership traits of more successful PTs, to inform future implementation planning and to identify targets for leadership capacity building. METHODS: Qualitative study employing interviews with PTs and LHWs at high and low implementation sites, and review of study team and quarterly PT meeting notes. High implementation sites achieved high uptake, sustainability and fidelity of implementation including: close adherence to training content and process, high levels of coverage (training most or all eligible LHWs at their site), and outcomes were achieved with high levels of self reported competence with the intervention among both PTs and LHWs. Low implementation sites achieved limited coverage (<= 50% of LHWs trained), and intervention fidelity. RESULTS: Eight PTs and 10 LHWs from eight high and 10 low implementation sites participated in interviews. Leadership traits of more successful PTs included: flexibility in their approach to training, role modeling and provision of supportive supervision to support learning; addressing challenges proactively and as they occurred; collaborative planning; knowledgeable; and availability to support implementation. Traits unique to less successful PTs included: a poor attitude toward their role as PT and a passive-avoidant approach to challenges. CONCLUSION: This study identified leadership traits more common among unit level leaders at sites with higher uptake, sustainability, and fidelity of implementation. These findings provide a starting point for development and evaluation of a leadership capacity building intervention for unit level leaders to support implementation.

Constructing Doctoral Leadership Scholarly Role Boundaries Through Intraprofessional Nursing Education.

We conducted an intraprofessional education pilot in which students created DNP/PhD leadership parameters through naturalistic classroom experience. Agile, participatory, action research methodology framed a project spanning 3 semesters. Students' multiple ways of knowing influenced a dynamic cycle of noticing, interpreting, acting, and reflecting. Faculty revised course content "in the moment" to meet unique student needs. Researchers analyzed data using qualitative, interpretive descriptive approach. Four key themes interpreted from intraprofessional education included (1) persistent evolutionary progression toward doctoral collaboration, (2) accelerating uptake of research- into-practice continuum, (3) intentional convergent/divergent curriculum, and (4) mutuality of leadership parameters.

Effect of Experiential Competency-Based Interprofessional Education on Pre-Professional Undergraduate Students: A Pilot Study.

The purpose of this pilot study was to evaluate the effectiveness of an interdisciplinary faculty team-led competency-based interprofessional undergraduate course for health and human services pre-professional students. Today's complex health and social problems require inter-professional knowledge and skills. Most interprofessional education occurs in graduate-level healthcare programs. Students graduating from health and allied health professions at the undergraduate level are ill prepared to work on interprofessional teams. Using a quasi-experimental design, this study examined the impact of an innovative experiential course on interprofessional competencies. Eleven undergraduate students in human services, public health, and nursing participated in the course. Students and faculty completed a modified Interprofessional Education Collaborative Competency Survey after each simulation and results were compared. At the end of the semester, each student also responded to open-ended prompts describing their reflections pertaining to team experiences. The results of this study indicate that an undergraduate course can increase students' interprofessional competencies, and that group dynamics influence how students view their skill levels. Consistent with other studies on this topic, students' self-ratings on the survey were mostly higher than those completed by faculty members. Educators need to process group dynamics (e.g., storming, norming) and individual styles of work regularly throughout the semester in order to maximize students' development of interprofessional competencies. Pre-professional students should be provided interprofessional learning opportunities to improve their competencies for addressing complex health and social challenges.

Implementing Automated Prone Ventilation for Acute Respiratory Distress Syndrome via Simulation-Based Training.

BACKGROUND: Prone position ventilation (PPV) is recommended for patients with severe acute respiratory distress syndrome, but it remains underused. Interprofessional simulation-based training for PPV has not been described. OBJECTIVES: To evaluate the impact of a novel interprofessional simulation-based training program on providers' perception of and comfort with PPV and the program's ability to help identify unrecognized safety issues ("latent safety threats") before implementation. METHODS: A prospective observational quality improvement study was done in the medical intensive care unit of an academic medical center. Registered nurses, physicians, and respiratory therapists were trained via a didactic session, simulations, and structured debriefings during which latent safety threats were identified. Participants completed anonymous surveys before and after training. RESULTS: A total of 73 providers (37 nurses, 18 physicians, 18 respiratory therapists) underwent training and completed surveys. Before training, only 39% of nurses agreed that PPV would be beneficial to patients with severe acute respiratory distress syndrome, compared with 96% of physicians and 70% of respiratory therapists (P < .001). Less than half of both nurses and physicians felt comfortable taking care of prone patients. After training, perceived benefit increased among all providers. Comfort taking care of proned patients and managing cardiac arrest increased significantly among nurses and physicians. Twenty novel latent safety threats were identified. CONCLUSION: Interprofessional simulation-based training may improve providers' perception of and comfort with PPV and can help identify latent safety threats before implementation.

Values-based interprofessional education: how interprofessional education and values- based practice interrelate and are vehicles for the benefit of patients and health and social care professionals.

The 2016 All Together Better Health VIII Oxford conference brought together interprofessional education (IPE) and values-based practice (VBP) communities. As there is a paucity of research and publications in the area, following the event a working party consisting of representatives from both communities continued to meet and has developed a joint community of practice. This report describes the work achieved by the group so far and is intended for those involved in the planning and implementation of IPE and collaborative working. The authors consider that incorporating principles of VBP within a framework of IPE can provide a different perspective and understanding of the complexities involved in delivering realistic, student centered learning for collaborative practice, relevant in the 21st century workplace. In particular the authors suggest that using the principles of values and VBP in this way can inform the transition between IPE and collaborative practice facilitating effective person centered collaborative care. This process will require not only the incorporation of these principles within IPE sessions, but also incorporation within the training and support of new and established teachers involved in IPE.