Does Interprofessional Education Make a Difference to Students’ Attitudes to Practice?

1. Does Interprofessional Education Make a Difference to Students’ Attitudes to Practice? Karen Coleman, Ben Darlow, Eileen McKinlay, Louise Beckingsale, Sarah Donovan, James Stanley, Peter Gallagher, Ben Gray, Hazel Neser, Meredith Perry, Sue Pullon University of Otago, Wellington

2. Definition Interprofessional Education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. The goal of IPE is to focus on patient-centred,team-basedcare through positive shared learning activities. (Centre for the Advancement of Interprofessional Education, 2014)

3. University of Otago, Wellington Medicine - 4th 5th 6th Radiation Therapy Postgraduate Health Sciences Dietetics & Physiotherapy - clinical

4. Radiation Therapy students join the programme

5. Objective • To investigate if participation in an IPE programme, focussing on long term condition (LTC) management influences student attitudes to: • Interprofessionaleducation • Interprofessionalpractice • Functioning within health teams • LTC management

6. Long Term Condition • LTC - any condition lasting more than 6 months and is not curable (Wagner, 2001) • Most people have 2 or more • Diabetes • Asthma • Heart disease • Arthritis • Cancer

7. Background Interprofessional practice (IPP) optimises skill sets to provide the best possible care to patients (Pullon et al, 2013) Improves patient safety(Reeves et al, 2008) Improves patients satisfaction outcomes, especially when meeting the complex needs of people with LTC (Strasser et al, 2008) Enhances health professionals overall job satisfaction(Grumbach & Bodenheimer, 20014)

8. Initiatives • Internationally link between IPE and IPP(WHO, 2010) • HWNZ have funded pilot projects at Tairawhiti and Whakataneinvolving • dietetics • dental • medicine • nursing • occupational therapy • pharmacy • physiotherapy (HWNZ, 2013)

9. IPE Programme Students participate in… over a 5 week period: An introductory lunch A three hour interdisciplinary workshop on LTC A home visit to a patient with LTCs (2-3 students with a disciplinary mix) Preparation for the presentation Small group presentations to class with invited guests (Pullon et al, 2013)

10. Methodology Stratified quasi-randomised controlled trial Approved by University of Otago Ethics Committee Attitudes were measured pre and post intervention using validated tools(Sharpe et al, 2008) Attitude change in intervention and control groups were compared using the Analysis of Covariance

11. Trial Overview

12. Participant Characteristics † unless otherwise specified. % = per cent; NZ = New Zealand

13. Baseline Scale Scores † scored on 5-point Likert scale, higher scores represent more positive attitudes. ‡ one medical student provided insufficient valid responses to allow a mean to be calculated for the ATHCTS.

14. Results Post-intervention scores in control and intervention group participants adjusted for baseline scores. * p < 0.05; ** p < 0.001

15. Discussion The degree of attitude change was similar for all students irrespective of discipline, supporting the inclusion of radiation therapy students to the existing IPE programme Findings indicate that even a short IPE intervention is effective in attitudes towards IPP

16. Limitations Level of clinical in respective programmes LTCM scale yet to be validated

17. Conclusion The findings suggest that the programme not only achieved its interprofessional objectives, but also improved understanding of long-term condition management. This study is not able to say if these attitudinal changes will be maintained over time, or translate into improved professional practice or patient outcomes. But wouldn’t it be great if it did!

18. Further Research • Qualitative data from the students and lecturers has been gathered via focus groups and is currently being analysed. • For the UOW, this has led to further integrated work, amongst the lecturers and the students. • integrated orientation day to the campus

19. Acknowledgments The patients This research was funded by a: Committee for the Advancement of Learning and Teaching (CALT) Grant University of Otago

20. References 1. Pullon S, McKinlay E, Beckingsale L, Perry M, Darlow B, Gray B, Gallagher P, Hoare K, Morgan S. Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme. J Prim Health Care. 2013;5(1):52-58. 2. Grumbach K, Bodenheimer T. Can health care teams improve primary care practice? JAMA. 2004;291(10):1246-1251. 3. Strasser DC, Falconer JA, Stevens AB, Uomoto JM, Herrin J, Bowen SE, Burridge AB. Team training and stroke rehabilitation outcomes: a cluster randomized trial. Arch Phys Med Rehabil. 2008;89(1):10-15. 4. Wagner EH. Meeting the needs of chronically ill people. BMJ. 2001;323(7319):945-946. 5. Centre For The Advancement Of Interprofessional Education. http://caipe.org.uk/resources/defining-ipe/. Accessed 9 May, 2014. 6. Reeves S, Zwarenstein M, Goldman J, Barr H, Freeth D, Hammick M, Koppel I. Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database of systematic reviews. 2008;1. 7. Sharpe D, Curran V. Collaborating for education and practice: An interprofessional education strategy for Newfoundland and Labrador. Memorial University of Newfoundland. Final project report. Health Canada IECPCP project. St. John’s, NL: Memorial University of Newfoundland. 2008. 8. World Health Organisation. (2010). Framework for action on interprofessional education and collaborative practice. Geneva: World Health Organisation. 9. Health Workforce NZ (2013) Interprofessional education programme breaking new ground http://healthworkforce.health.govt.nz/interprofessional-education-programme-breaking-new-ground accessed 11/8/14