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J Educ Eval Health Prof > Volume 16; 2019 > Article
Dyess, Brown, Brown, Flautt, Barnes, and Huh: Impact of interprofessional education on students of the health professions: a systematic review

Abstract

Purpose

Interprofessional education (IPE) is a concept that allows students from different health professions to learn with and from each other as they gain knowledge about their chosen professions and the professions of their colleagues. The purpose of this systematic review was to determine the effectiveness of IPE in the academic preparation of students of the health professions.

Methods

A search was conducted of the PubMed and CINAHL databases using the following eligibility criteria: IPE including students from 3 or more healthcare professions, IPE exposure within academic coursework, measurement of attitudes and/or perceptions as outcomes, and quantitative reporting of results. Articles were screened by title, abstract, and full text, and data were extracted.

Results

The search yielded 870 total articles. After screening, 7 articles remained for review. All studies reported a positive impact of IPE on the education of students of the health professions.

Conclusion

Evidence showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration within interdisciplinary teams.

Introduction

Rationale

The World Health Organization has cited interprofessional education (IPE) activities as a powerful learning tool in efforts to improve healthcare delivery [1]. Effective interprofessional collaborations have resulted in decreased medical errors, increased patient satisfaction, and improved patient care [2,3]. Data collected from IPE studies may be beneficial for improving academic health professional programs, preparing students for their chosen profession outside of the classroom, and refining patient-centered care [3].
Due to the complex nature of the health issues that many patients face, there is an increasing need for interprofessional collaboration among healthcare practitioners. Interprofessional practice contributes to knowledge of effective communication, the importance of distinguishing team roles, and efficient solutions for resolving conflict [4]. Healthcare faculty members across the United States have recognized the importance and benefits of implementing IPE in the academic curriculum [1].
IPE is a concept that allows students from different health professions to learn with and from each other as they gain knowledge about their chosen professions, as well as the professions of their future colleagues [3,5]. Various IPE activities should occur in an environment that supports collaborative learning to better facilitate interprofessional practice in the clinical care of patients [3,5].

Objectives

The objective of this systematic review was to determine the effectiveness of IPE among students of the health professions.

Methods

Ethics statement

This report examined previously published work. Therefore, it did not require approval from an institutional review board.

Study design

The preparation of this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, which outline specific criteria to be included in written format. The PRISMA tool consists of 27 items that have been created to ensure that essential information is expressed [6].

Eligibility criteria

Articles that were included in this review required participation in IPE activities by students from 3 or more healthcare professions, and the IPE exposure must have been included within academic coursework. Additionally, the studies must have reported quantitative measures of student attitudes and/or perceptions about their IPE experiences as outcomes.

Information sources/search

A search of the literature was performed in October 2018 using the PubMed and CINAHL databases. The search included terms related to healthcare, healthcare professionals, students, and IPE. Searches were limited to articles in the English language published within the last 10 years.

Study selection

Duplicate articles in both databases were eliminated from one set of the search results. Titles were screened by 4 of the authors divided into 2 groups. If title screening resulted in a tie, it was presented to the opposite group for a final decision. This process was followed by a screening of the abstracts utilizing the same methodology. After the abstracts were screened, the full text of the remaining articles was screened by all authors in order to determine which articles would be included in the review.

Data collection process and data items

The articles chosen from the screening process were analyzed by the authors for data extraction, and the findings were discussed with the group. The data extracted from the articles included the number of participants and the specific type of health profession training program in which they were enrolled, the type of interprofessional learning activity that was included, the specific outcome measures used, and the authors’ findings.

Risk of bias assessment

The quality assessment tool for before-after (pre-post) studies with no control group was used to assess the quality of the articles included [7]. This is a 12-question tool developed to allow reviewers to systematically assess the internal validity of a study. Each question was answered with yes, no, or not reported, and the total number of affirmative responses was recorded.

Results

Study selection

The article search yielded 870 articles, of which 24 were eliminated due to duplication. The titles of the resultant 846 articles were screened; through this process, 632 articles were eliminated, resulting in 214 articles for the abstract screening. Screening of the individual abstracts yielded 14 articles that underwent full-text screening. Following the complete screening process, 7 articles were selected to be included in the review (Fig. 1).

Study characteristics

The 7 studies consisted of participants from a wide variety of health professions who took part in IPE activities within their academic coursework. The number of health professions included within each study ranged from 3 to 11, and the number of participants ranged from 30 to 291 (Table 1).

Risk of bias

The results from the quality assessment tool for before-after (pre-post) studies with no control group are shown in Table 2. The quality scores ranged from 7 to 10 out of 12, with a mean of 8.7.

Discussion

Summary of evidence

The evidence from this review showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration with other members of interdisciplinary healthcare teams. All 7 studies yielded significant results in regard to IPE among students of the health professions and its positive impact on students’ attitudes related to interprofessional teamwork [3,5,8-12]. Positive results were found among several healthcare professions, supporting the incorporation of IPE in the academic preparation of future healthcare providers across disciplines. Although varied outcome measures were utilized across the studies, each showed some impact on attitudes and self-perceptions of interprofessional teamwork in the delivery of healthcare services.
The works by Ruebling et al. [11] in 2014 and Leithead et al. [8] in 2018 each incorporated outcome measures that included items addressing interpersonal communication and problem-solving, which demonstrated significant changes after IPE activities. Effective communication and collaborative efforts to find solutions to clinical issues across healthcare professions is essential for achieving the best outcomes for patients and establishing a positive work environment. These findings are supported by the works by Paige et al. [9] in 2014 and Cino et al. [5] in 2018, who also found significant improvements in constructs related to communication among the healthcare team, while Paige et al. [9] in 2014 and Stubbs et al. [12] in 2017 suggested that IPE may be beneficial for improvements in shared problem-solving. In addition to benefits in teamwork, communication, and shared problem-solving, the studies by Renschler et al. [3] in 2016 and Cino et al. [5] in 2018 each suggested that IPE activities may improve knowledge and skills among students of the health professions, which may ultimately benefit the consumers of healthcare services.

Limitation

Publications within this review were limited to the English language; therefore, important work published in other languages may not have been represented. Additionally, studies that consisted of participants from only 2 healthcare professions were excluded, which may also have led to the omission of important works.

Conclusion

The information gleaned from these studies supports the incorporation of IPE in the educational preparation of healthcare professionals. Important aspects of healthcare delivery, such as working within a team environment, the ability to work together in a way that promotes shared decision-making to find positive solutions, effective interpersonal communication, and excellent knowledge and skills, may be positively influenced by the utilization of IPE activities across health professions within academic programs.

Notes

Authors’ contributions

Conceptualization: LB. Data curation: AD, JB, NB, KF. Formal analysis: AD, JB, NB, KF, LB. Funding acquisition: not applicable. Methodology: AD, JB, NB, KF. Project administration: LB. Visualization: AD. Writing-original draft: LB. Writing-review and editing: AD, JB, NB, KF, LB.

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Funding

None.

Data availability

None.

Acknowledgments

The authors would like to acknowledge and express appreciation to Dr. Jennifer Reneker and Tamara Nelson, MLIS, EdS for their help and support for this work.

Supplementary materials

Data files are available from https://doi.org/10.7910/DVN/K3BKTG
Supplement 1. Audio recording of the abstract.
jeehp-16-33-abstract-recording.avi

References

1. Smith BS, Anderson K. Attitudes toward interprofessional education: Comparing physical therapist and other health care professions’ students. J Phys Ther Educ 2018;32:183-190. https://doi.org/10.1097/jte.0000000000000039
crossref
2. Acquavita SP, Lewis MA, Aparicio E, Pecukonis E. Student perspectives on interprofessional education and experiences. J Allied Health 2014;43:e31-e36.
pmid
3. Renschler L, Rhodes D, Cox C. Effect of interprofessional clinical education programme length on students’ attitudes towards teamwork. J Interprof Care 2016;30:338-346. https://doi.org/10.3109/13561820.2016.1144582
crossref pmid
4. Darlow B, Coleman K, McKinlay E, Donovan S, Beckingsale L, Gray B, Neser H, Perry M, Stanley J, Pullon S. The positive impact of interprofessional education: a controlled trial to evaluate a programme for health professional students. BMC Med Educ 2015;15:98. https://doi: 10.1186/s12909-015-0385-3
crossref pmid pmc
5. Cino K, Austin R, Casa C, Nebocat C, Spencer A. Interprofessional ethics education seminar for undergraduate health science students: a pilot study. J Interprof Care 2018;32:239-241. https://doi.org/10.1080/13561820.2017.1387771
crossref pmid
6. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264-269. https://doi.org/10.1371/journal.pmed.1000097
crossref pmid
7. U.S. Department of Health and Human Services. Study quality assessment tools: quality assessment tool for before-after (pre-post) studies with no control group [Internet]. Bethesda (MD): National Institute of Health; [cited 2019 Sep 26]. Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.

8. Leithead J 3rd, Garbee DD, Yu Q, Rusnak VV, Kiselov VJ, Zhu L, Paige JT. Examining interprofessional learning perceptions among students in a simulation-based operating room team training experience. J Interprof Care 2018 Sep 19 [Epub]. https://doi.org/10.1080/13561820.2018.1513464
crossref
9. Paige JT, Garbee DD, Kozmenko V, Yu Q, Kozmenko L, Yang T, Bonanno L, Swartz W. Getting a head start: high-fidelity, simulation-based operating room team training of interprofessional students. J Am Coll Surg 2014;218:140-149. https://doi.org/10.1016/j.jamcollsurg.2013.09.006
crossref pmid
10. Pinto C, Possanza A, Karpa K. Examining student perceptions of an inter-institutional interprofessional stroke simulation activity. J Interprof Care 2018;32:391-394. https://doi.org/10.1080/13561820.2017.1405921
crossref pmid
11. Ruebling I, Pole D, Breitbach AP, Frager A, Kettenbach G, Westhus N, Kienstra K, Carlson J. A comparison of student attitudes and perceptions before and after an introductory interprofessional education experience. J Interprof Care 2014;28:23-27. https://doi.org/10.3109/13561820.2013.829421
crossref pmid
12. Stubbs C, Schorn MN, Leavell JP, Espiritu EW, Davis G, Gentry CK, Friedman E, Patton T, Graham A, Crowder R, Wilkins CH. Implementing and evaluating a community-based, inter-institutional, interprofessional education pilot programme. J Interprof Care 2017;31:652-655. https://doi.org/10.1080/13561820.2017.1343808
crossref pmid

Fig. 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram.
jeehp-16-33f1.jpg
Table 1.
Data summary
References Student type (no. of participants) Intervention Outcome measures Results
Cino et al. [5] (2018) Dental hygiene (10); nursing (37); medical laboratory technician (28) Students participated in a questionnaire determining self-efficacy for IPE before and after participation in an interprofessional ethics activity. Self-efficacy for interprofessional learning Six questions yielded significant improvements in self-efficacy for IPE learning
Teamwork (P=0.023)
Multiple professions roles  (P=0.031)
Patient benefits of team care (P=0.043)
Objectives of interprofessional learning (P=0.019)
Quality of interprofessional team work (P=0.008)
Interprofessional learning goal achievement (P=0.012)
Leithead et al. [8] (2018) Medical (70 IPT/43 RIPLS); undergraduate nursing (40 IPT/27 RIPLS); nurse anesthesia (42 IPT/29 RIPLS) Students participated in IPE involving a high-fidelity simulation of the operating room over the course of 3 years. IPT Significant improvement overall was reported on IPT following the intervention (P<0.001)
RIPLS Significant improvement overall was reported on RIPLS following the intervention (P<0.001)
Paige et al. [9] (2014) Nursing (18); certified registered nurse anesthetist (20); medical (28) Students participated in IPE involving a high-fidelity simulation of the operating room. Likert-type items measuring self-efficacy and team performance Eleven out of the 15 items showed significant improvement following the intervention including items related to individual task responsibilities, communication, and teamwork (P<0.001)
Pinto et al. [10] (2018] Medical (70); occupational therapy (34); physical therapy (28); physician assistant (12); nursing (44) Students completed a stroke simulation activity along with pre- and post-test questionnaires regarding the IPE. IPE collaborative competency self-assessment tool Following the intervention, overall results indicated significant improvement in interprofessional values and interprofessional interactions
Values domain (P<0.0001)
Interactions domain (P=0.0003)
Renschler et al. [3] (2016) Osteopathic medicine (1st 19/2nd 21); nursing (1st 30/2nd 41); health science (1st 7/2nd 6); speech-language (1st 18/2nd 17); athletic training (1st 4/2nd 0); exercise sciences (1st 3/2nd 0) Student participation in an interprofessional geriatric home visit program for a 1-sem versus a 2-sem IPE activity. Attitudes Towards Health Care Teams Scale 1st sem: led to significant improvements following the intervention (P=0.00)
2nd sem: showed no significant improvements
Team Skills Scale 1st sem: showed significant improvement in team skills (P=0.00)
2nd sem: reported significant improvements (P=0.01)
- Between-group comparisons showed more significant improvements in the 1-sem program than in the 2-sem program (P<0.05)
Ruebling et al. [11] (2014) Athletic training (15); clinical laboratory (9); cytotechnology (2); health information management (2); investigative medical sciences (15); nuclear medicine (4); nursing (115); nutrition and dietetics (18); occupational therapy (20); physical therapy (83); Radiation therapy (8) Questionnaire completed by students who participated in a sem-long IPE course in interdisciplinary teams. RIPLS Significant improvements after the introductory IPE course (P=0.05)
Significant improvements after the IPE course (P<0.001)
University of West England Interprofessional Questionnaire Improvements were noted after the IPE course (P=0.01)
Significant improvements after the IPE course (P<0.001)
Stubbs et al. [12] (2017) Dentistry; dietetics; divinity; medicine; nursing; occupational therapy; pharmacy; public health; social work; speech and hearing science (30) Students completed a questionnaire before the IPE program, after IPE training and upon completion of the IPE consisting of didactic and community service work. ISVS The ISVS contained 3 sub-scales: SPA, CWO, VWO
SPA: After completion significant improvements were reported (P=0.005)
CWO: After completion significant improvements were reported (P<0.0001)
VWO: After completion significant improvements were reported (P=0.001)

IPE, interprofessional education; IPT, Interprofessional Teamwork Scale; RIPLS, Readiness for Interprofessional Learning Scale; Sem, semester; ISVS, Interprofessional Socialization & Valuing Scale. SPA, self-perceived ability to work with others; CWO, comfort working with others; VWO, value of working with others.

Table 2.
Risk of bias
Quality assessment tool 1 2 3 4 5 6 7 8 9 10 11 12 Total
Cino et al. [5] Yes No NR NR Yes Yes Yes No Yes Yes No Yes 7
Leithead et al. [8] Yes Yes Yes No Yes No Yes No Yes Yes Yes Yes 9
Paige et al. [9] Yes No Yes No No Yes Yes No Yes Yes Yes Yes 8
Pinto et al. [10] Yes Yes Yes Yes Yes No Yes No Yes Yes No Yes 9
Renschler et al. [3] Yes Yes Yes Yes Yes Yes Yes Yes NR Yes No Yes 10
Ruebling et al. [11] Yes Yes Yes Yes Yes Yes Yes No No Yes No Yes 9
Stubbs et al. [12] Yes No Yes Yes No Yes Yes No Yes Yes Yes Yes 9

Criteria: 1: study question; 2: eligibility criteria and study population; 3: study participants representative of clinical populations of interest; 4: all eligible participants enrolled; 5: sample size; 6: intervention clearly described; 7: outcome measures clearly described, valid, and reliable; 8: blinding of outcome assessors; 9: follow-up rate; 10: statistical analysis; 11: multiple outcome measures; 12: group-level interventions and individual-level outcome efforts.

NR, not reported.

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