Journal of Interprofessional Care, June 2006; 20(3): 314 – 316
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Effectiveness of a Faculty Development Program on Interprofessional Education: A randomized controlled trial
DEBBIE KWAN, KEEGAN K. BARKER, ZUBIN AUSTIN, CAROLE CHATALALSINGH, VALERIE GRDISA, SYLVIA LANGLOIS, JAMES MEUSER, AZADEH MOAVENI, ROXANNE POWER, SANDY RENNIE, DENYSE RICHARDSON, LYNNE SINCLAIR, SUSAN J. WAGNER, & IVY OANDASAN University of Toronto, Ontario, Canada
Introduction Evidence of the effectiveness of interprofessional education (IPE) is largely untested. In particular, assessing the best model for educating clinical faculty about IPE and whether it impacts their teaching remains a challenge. The IPE literature recognizes that skilled, knowledgeable, interprofessional faculty facilitators are integral for the successful implementation of IPE interventions. For collaborative practice (CP), however, there are gaps in our educational knowledge base. First, the literature falls short in outlining how faculty should learn how to teach interprofessional collaborative practice. Second, the literature offers little in the way of empirical accounts of the effectiveness of these sparse descriptions for faculty development. Goals and objectives The goal of this study is to assess the effectiveness of education in IPE for clinical faculty who teach and practice in clinical settings. The primary objective is to measure the effectiveness of a Faculty Development Program on Interprofessional Education (FDP-IPE) on the faculty’s knowledge, skills, attitudes (KSA) related to teaching IPE for collaborative practice. Our
Correspondence: Debbie Kwan, BSc Phm, MSc, Assistant Professor, Leslie Dan Faculty of Pharmacy and, Department of Family and Community Medicine, Universtiy of Toronto, Toronto Western Hospital, Family Health Centre, 399 Bathurst Street, Toronto, ON M5T 2S8. E-mail:
[email protected] ISSN 1356-1820 print/ISSN 1469-9567 online Ó 2006 Taylor & Francis DOI: 10.1080/13561820500518712
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secondary objective is to create interprofessional clinical placement opportunities for medical trainees and other health professional learners at the University of Toronto. Project outline A randomized controlled trial using an interprofessional sample of 40 clinical faculty staff from various practice settings will be implemented where half of the clinical faculty will be randomly assigned to receive the FDP-IPE, while the other half will be controls. The FDP-IPE was developed and implemented through a grant from the Royal College of Physicians and Surgeons of Canada. It is a five-day (40-hour) faculty development program that utilizes didactic/experiential learning, video vignettes, case discussion, and standardized learners to advance participants’ understanding and ability to teach others about interprofessional collaboration. The current project will build on this program by refining it based on the initial qualitative evaluation and feedback from participants (many of whom are co-investigators on the current project). The program will be shortened to 3 modules in order to make the program more feasible for participants. The modules will cover the topics of: (1) Knowledge: (a) frameworks for: (i) planning IPE, (ii) CP; (b) role understanding as required for collaboration; (c) seven essential elements for CP (Way, Busing, & Jones, 2000); (2) Skills: (a) understanding challenges/benefits of IPE and CP; (b) group process and group facilitation; (c) the reflective practitioner; (d) feedback in IPE; (3) Attitudes: appreciate the importance of interprofessional CP and teamwork in today’s health system. Lastly, participants will receive written instructions on how to implement a case-based discussion with an interprofessional group of learners. After each module, participants will reflect upon how their learning affects this educational intervention. The control group will only receive written instructions on how to implement the case-based discussions. Clinical faculty will be recruited from a number of hospital and ambulatory-based practice sites that routinely provide clinical placements for pre-licensure students from various health professions (e.g., medicine, nursing, occupational therapy, pharmacy, physiotherapy, social work, speech-language pathology). The University and these potential sites have identified a common 4-week time period during which at least three health care professions are completing clinical placements concurrently. The clinical faculty will facilitate weekly casebased discussions with the interprofessional student groups on-site. The FDP-IPE will be completed prior to the students’ clinical placement. Expected outcomes (1) An understanding of the impact of a faculty development program for clinical faculty and how it affects their KSA related to teaching IPE, specifically: (a) Clinical faculty’s knowledge and attitudes related to teaching IPE will be improved in those faculty who received the FDP-IPE; (b) Students’ evaluation of the facilitation skills of faculty who received the FDP-IPE will be superior compared to faculty who did not; (2) The number of interprofessional teaching sites available to the Faculty of Medicine will increase.
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Evaluation process and procedures The planned evaluations fall under the 2nd level of the Modified Kirkpatrick’s Model of Educational Outcomes for IPE (Freeth, Hammick, Koppel, Reeves, & Barr, 2002): modification of attitudes/perceptions and acquisition of knowledge/skills. To measure change in knowledge related to teaching IPE, a content-based questionnaire will be developed that will cover professional roles, scopes of practice and the essential elements of collaborative practice (Way et al., 2000). To measure facilitation skills of clinical faculty staff, the students with whom they implement the case-based discussion, will complete a shortened Team Integration Measure (TIM; Lichtenstein, Alexander, Jinnett, & Ullman, 1997), Team Collaboration Index (TCI; Aram, Morgan, & Esbeck, 1971) and, a modified Collaboration Satisfaction About Care Decisions (CSACD; Baggs, 1994). Change in attitude towards teaching IPE will be measured using the Attitude Toward Healthcare Teams (Heinemann, Schmitt, Farrell, & Brallier, 1999). All tools will be administered either in person or electronically and informed consent obtained. Faculty staff from both the intervention and control groups will complete measures in knowledge and attitudes of teaching IPE at two points: 3 weeks prior to the FDP-IPE and within 1 week after completion of the students’ clinical placement. Their students will complete measures on the faculty’s skills in this area after they complete their clinical placement. Lastly, as future research, we intend to explore the feasibility of using trained behavioral observers and team OSCEs (Objective Structured Clinical Examination) to measure changes in student KSA related to interprofessional practice. Acknowledgements The authors would like to thank the University of Toronto Dean’s Excellence Fund, Toronto Western Hospital Family Health Centre, University of Toronto Department of Family and Community Medicine, University of Toronto Faculty of Pharmacy (International Pharmacy Graduate Program), University of Toronto Faculty of Social Work, and University Health Network Allied Health for their funding support. References Aram, D., Morgan, C. P., & Esbeck, E. S. (1971). Relation of collaborative interpersonal relationships to individual satisfaction and organizational performance. Administrative Science Quarterly, 16, 289 – 296. Baggs, J. G. (1994). Development of an instrument to measure collaboration and satisfaction about care decisions. Journal of Advanced Nursing, 20, 176 – 182. Freeth, D., Hammick, M., Koppel, I., Reeves, S., & Barr, H. (2002). A critical review of evaluations of interprofessional education. London: LTSN. Heinemann, G. D., Schmitt, M. H., Farrell, M. P., & Brallier, S. A. (1999). Development of an Attitudes Toward Health Care Teams Scale. Evaluation & the Health Professions, 22, 123 – 142. Lichtenstein, R., Alexander, J. A., Jinnett, K., & Ullman, E. (1997). Embedded intergroup relations in interdisciplinary teams: Effects on perceptions of level of team integration. The Journal of Applied Behavioral Science, 33, 413 – 435. Way, D. O., Busing, N., & Jones, L. (2000). Implementation strategies: ‘‘Collaboration in primary care-family doctors & nurse practitioners delivering shared care’’. Ontario: The Ontario College of Family Physicians.
