Interprofessional Education: Preregistration Health and Social Care Students Views

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Inter-professional Education Pre-registration
Health and Social Care Students Views

• Deborah Craddock
• University of Southampton

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Introduction

• Interprofessional education aims to reinforce
  inter-professional practice (DOH 1999 DOH 2000a
  DOH 2000b SCIE, 2005).
• Varying models of interprofessional education in
  undergraduate curricula (Roberts et al., 2000)
• Effectiveness and impact of interprofessional
  education remains relatively unknown (McPherson
  et al., 2001 Mandy, Milton and Mandy, 2004 Kwan
  et al., 2006 Stone, 2006)

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• Benefits of interprofessional learning
  opportunities (Barr 2000 Barr et al., 2005
  Copperman and Newton, 2007 Robson and Kitson,
  2007).
• Reservations regarding the ability of medical and
  allied healthcare practitioners to collaborate
  (Freeth et al., 2002 Craddock and OHalloran,
  2004 Copperman and Newton, 2007)
• Stereotypical views of professions held prior to
  students commencing their undergraduate
  pre-registration programmes (Mandy, Milton and
  Mandy, 2004 Horsburgh et al., 2006)

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Pre-test Study

• AIM To investigate pre-registration students
  perceptions of inter-professional education.

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Methodology

• Quantitative cross-sectional survey design
• Ethical approval
• Pretest questionnaires were administered to
  pre-registration health and/ or social care year
  1 students in six Higher Education Institutions
  within the United Kingdom n1151.
• Inclusion criteria Year 1 students registered on
  a health or social care programme participating
  in an inter-professional education initiative
  that involved podiatry students.

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Questionnaire Pack

• Questionnaire pack- informed by (1) key informant
  interviews and (2) research evidence
• It incorporated a validated tool Readiness for
  Inter-professional Education Scale RIPLS and
  the Generic Role Perception questionnaire GRPQ.
  
• Face validity
• Content validity
• Pilot Study test (i) n67 test (ii) n62
• Test re-test reliability
• Internal consistency

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Results
Students Perceptions of Interprofessional
Education

• Inter-professional education had been introduced
  into the pre-registration curriculum to
• help health and/or social care professionals to
  be able to work more effectively together (1122
  97.5)
• enhance the quality of care given to patients
  (1098 95.4)
• Improve communication skills (1086 94.4)
• Increase confidence in professional roles (1005
  87.3)
• NOT weaken the power of the professions (952
  82.7)
• Increase cost effectiveness of patient care (601
  52.2)

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Students Perceptions of Interprofessional
Education

• Campus based inter-professional education
  opportunities were NOT perceived as being more
  meaningful than placement based learning
  opportunities 533 46.3
• Rivalries exist in placement locations that
  expose students to stereotypical views of
  professions (500 43.5)
• Motivational Factors -
• use of clinical scenarios in group-work
  activities 939 80.6
• inclusion of summative assessments
• 720 62.6

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Students Perceptions of Interprofessional
Education

• Statistically significant difference in
  reactions to statements a-c of students who have
  read information on IPE and students who have
  either not or are unsure whether they have read
  information on IPE.
• (a) the inclusion of summative assessments
  motivates students to learn from IPL
  opportunities
• (b) student feedback influences IPL module
  developments
• (c) the importance of IPE being integral to
  their programme is clear to students,
• Z-2.279, p0.023 Z-3.229, p0.001 Z-3.435,
  p0.001 respectively.

• Barriers linked to assessment or varying levels
  of ability in a programme can be overcome 881
  76.5.
• The importance of inter-professional education
  being integral to their programme was clear to
  students (731 63.5)

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Commitment to IPE

• Commitment was strongly influenced by
• facilitators attitudes towards
  inter-professional education (835 75.5)
• working practices of staff (833 72.4)
• Students induction to the inter-professional
  education initiative (716 62.2)

• Modal response of 6 - the majority of
  participants were only fairly committed (570
  49.5) to inter-professional learning.
• Positive correlation - age and level of
  commitment to inter-professional education
  (spearmans rho 0.243 respectively p0.000)

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Commitment to IPE cont

• Consistency of approach to IPE across programmes
  (698 60.6)
• The presence of a strong leader for IPE (670
  58.2)
• Scheduling of IPL sessions within the timetable
  (664 57.5)
• Assessment of student learning (596 51.8)
• Process of monitoring student attendance (523
  45.4)

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Commitment to IPE

• 756 (65.7) respondents had not read any
  information about inter-professional education.

• Primary information sources accessed by students
  who had read information about IPE
• websites (115)
• course materials (114)
• books (45)
• discussions in taught sessions (43)

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Reading Information about IPE

• Significant difference in commitment to IPE of
  students who had read information on IPE and
  students who either had not or were unsure as to
  whether they had read information on IPE
  Z-4.097 p 0.000 .

• Significant difference in the Readiness for
  Inter-professional Education Learning Scale
  (RIPLS) scores between students who had read
  information about inter-professional education
  versus students who either had not or were unsure
  Z -2.809 p.005.

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Readiness for Inter-professional Learning Scale

• Principle Component Analysis
• Kaiser-Meyer-Oklin value 0.932
• Bartletts Test of Sphericity (p0.000)
• Oblimin rotation with Kaiser Normalisation
• 3 component solution
• Comparisons with Parsell et al. (1998) Parsell
  and Bligh (1999) McFayden et al (2005) research

• Component 1
• Teamwork and collaboration
• Component 2
• Professional identity
• Component 3
• Roles and responsibilities

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RIPLS Subscale Comparisons
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Cronbach Alpha Measure of Internal Consistency of
Each Sub-scale
Inter-item correlations for Items 17-19 are in
the optimal range of between 0.2 and 0.4 (Briggs
and Cheek, 1986).
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Implications of Findings

• Multidisciplinary and interdisciplinary practice
  has the potential to reduce professional autonomy
  (Tryssenaar et al 1996)
• Occupations seek to maintain and improve their
  social standing
• professional project (Borthwick, 2001a)
• Rivalries and misconceptions about professional
  roles and responsibilities
• Challenge faced by curriculum developers

• Benefits of inter-professional learning were
  understood (Craddock et al., 2006 Robson and
  Kitchen 2007)
• Collaborative movement
• Generic movement
• Power of professions
• Professionalisation at undergraduate level
  (Richardson, 1999)

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Implications of Findings

• Student commitment to inter-professional
  learning.
• Key role of facilitators, the working practices
  of staff and the induction process.

• Fundamental consideration of
• Staff training
• Need to address academic staffs uncertainty
  regarding the effectiveness and impact of
  inter-professional education initiatives
  (McPherson et al., 2001 Mandy et al., 2004
  Stone, 2006).
• Current working practices
• Student induction to IPE

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Implications of Findings

• Value of placement based learning (Guest et al
  2002 Lumague et al., 2006 Robson and Kitsen,
  2007)
• Placement Based Learning not feasible?
• Stimulus materials in IPE initiatives linked to
  the practice setting.

• Reservations linked to
• practicability (Cook et al., 2001)
• Lack of clinical experience (Young et al., 2007)
• Existence of rivalries in practice (Robson
  and Kitchen, 2007)

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Implications of Findings

• RIPLS (Parsell and
• Bligh, 1999)
• Commitment
• Information
• on IPE
• gt age of students gt
• level of commitment

• Importance of reading
• Target course materials and incorporate links to
  related IPE websites
• Target engage younger students e.g. induction

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Further Research Possible

• To evaluate whether health and social care
  students perceptions of IPE change as a result
  of the completion of IPE units at undergraduate
  and/ or postgraduate level
• To explore and evaluate students post-test
  findings between institutions to determine which
  model of IPE has the greatest impact at
  influencing perceptions of IPE.