the readiness of iium nursing and medical students ...

THE READINESS OF IIUM NURSING AND MEDICAL STUDENTS TOWARDS INTERPROFESSIONAL EDUCATION AYU FARAH HANA MOHAMED, UNDERGRADUATE STUDENT

NURUL’AIN AHAYALIMUDIN KULLIYYAH OF NURSING INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA [email protected] 10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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BACKGROUND  A number of factors, such as an ageing population and the shift of the burden of illness from acute to chronic care, require a number of different health and social care professions to be involved in the delivery of care (Reeves et al., 2005).  Patient reported higher levels of satisfaction, better acceptance of care and improved health outcomes following treatment by a collaborative team (World Health Organization, 2010).

 WHO (2010) found evidence to indicate that interprofessional education enables effective collaborative practice which in turn optimizes health-services, strengthens health systems and improves health outcomes.

10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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OBJECTIVES 1.

To identify the readiness of IIUM nursing and medical student towards interprofessional education.

2.

To determine the potential barriers of nursing and medical student towards interprofessional education.

3.

To determine the relationship between demographic data and the readiness of nursing and medical student towards interprofessional education


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LITERATURE REVIEW  Interprofessional teams are being used in more situations across the health care spectrum and as a result more interprofessional educational efforts are needed (Giordano, 2010).  There is a pressing need to redesign health professions education and integrate an interprofessional and systems approach into training (Abu-Rishie et al., 2012).  Students felt that interprofessional teaching could even act as a ‘change mechanism’ in respect of existing medical hierarchical dominance in healthcare teams (MacFarlane, 2006).  Many medical, nursing, and allied health care programs have implemented interprofessional health care courses to improve communication between future 1team members (Haskin, 2008). 0TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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METHODOLOGY STUDY SETTING

Kulliyyah of Nursing and Kulliyyah of Medicine (IIUM)

TYPE OF STUDY

Cross-Sectional Study

POPULATION SAMPLE

N=538 • Nursing=168 • Medicine=370

SAMPLE SIZE

After calculate using RAOSOFT (Sample Size Calculator): 228 • Nursing: 85 • Medicine: 143

SAMPLING METHOD

Multistage sampling • Stratified random sampling • Simple random sampling 10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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INSTRUMENT/ TOOLS  Questionnaire RIPLS developed by Parsell & Bligh (1998) and quoted from Thannhauser, Mayhew and Scott (2010).  The questionnaires divided into 3 different parts:Part 1: Socio-demographic data

Part 2: Readiness for Interprofessional Learning Scale (RIPLS) Questionnaire

Part 3: Potential Barrier for IPE 10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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REALIBILITY & VALIDITY  The RIPLS (Parsell & Bligh, 1998).  Questionnaire of potential barrier for interprofessional education:  developed from WHO(2010), “Examples of influences that affect interprofessional education and collaborative practice at the system level”.  Pilot study had been carried out (Cronbach alpha: 0.82).


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DATA COLLECTION & ETHICAL CONSIDERATIONS DATA COLLECTION  Collected on April 2013.  Self-administered questionnaires. ETHICAL CONSIDERATIONS  Ethical Approval letter from the Ethics Committee of the university, Kulliyyah of Nursing and Kulliyyah of Medicine.  Verbal and written consent applied.


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RESULTS AND DISCUSSION Variable

Mean

Age: 21-27

23.59

Frequency (%)

Gender: Male Female

73 (32.0) 155(68.0)

Course: Nursing Medicine

85 (37.3) 143 (62.7)

Year of Study: 2 3 4 5 Weeks of Clinical Skills: 8 -130 Previous Experience of IPE No Yes

25(11.0) 78(34.2) 77(33.8) 48 (21.1) 50.41 53 (23.2) 175 (76.8) NURSING AND MIDWIFERY

10TH INTERNATIONAL CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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RESULTS AND DISCUSSION Strongly agree n(%)

Agree

Undecided

Disagree

n(%)

n(%)

n(%)

Strongly disagree n(%)

Learning with other students will make me a more effective member of a health and social care team

102 (44.7)

117 (51.3)

3 (1.3)

0

0

Patients would ultimately benefit if health and social care students worked together

122 (53.5)

95 (41.7)

6 (2.6)

4 (1.8)

1 (0.4)

Shared learning with other health and social care students will increase my ability to understand clinical problems

111 (48.7)

107 (46.9)

8 (3.5)

2 (0.9)

0

Communications skills should be learned with other health and social care students.

109 (47.8)

114 (50.0)

5 (2.2)

0

0

Team-working skills are vital for all health and social care students to learn

126 (55.3)

96 (42.1)

6 (2.6)

0

0

Shared learning will help me to understand my own professional limitations

89 (39.0)

120 (52.6)

16 (7.0)

3 (3.1)

0

Learning between health and social care students before qualification and for professionals after qualification would improve working relationships after qualification / collaborative practice

89 (39.0)

125 (54.8)

12 (5.3)

1 (0.4)

0

Questions

Shared learning will help me think positively about other health and social care professionals

104 115 7 2 0 (45.6) (50.5) (3.1) (0.9) 10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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RESULTS AND DISCUSSION Strongly agree n(%)

Agree

Undecided

Disagree

n(%)

n(%)

n(%)

Strongly disagree n(%)

For small-group learning to work, students need to respect and trust each other

126 (55.3)

98 (43.0)

4 (1.8)

0

0

I don't want to waste time learning with other health and social care students

2 (0.9)

10 (4.4)

25 (11.0)

118 (51.8)

2 (0.9)

It is not necessary for undergraduate / postgraduate health and social care students to learn together

10 (4.4)

16 (7.0)

20 (8.8)

114 (50.0)

68 (29.8)

Clinical problem solving can only be learnt effectively with students from my own school / organization

11 (4.8)

32 (14.0)

47 (20.6)

11 (4.8)

46 (20.2)

Shared learning with other health and social care professionals will help me to communicate better with patients and other professionals

91 (39.9)

122 (53.5)

11 (4.8)

3 (1.3)

1 (0.4)

I would welcome the opportunity to work on small group projects with other health and social care students

75 (32.9)

144 (63.2)

9 (3.9)

0

0

I would welcome the opportunity to share some generic lectures, tutorials or workshops with other health and social care students

81 (35.5)

132 (57.9)

14 (6.1)

1 (0.4)

0

Shared learning and practice will help me clarify the nature of patients' or clients' problems

89 (39.0)

129 (56.6)

8 (3.5)

1 (0.4)

1 (0.4)

Questions

I have to acquire much more knowledge and skill than other students / professionals in my own faculty / organisation

14 37 39 97 41 (6.1) (16.2) (17.1) (42.5) (18.0) 10TH INTERNATIONAL NURSING AND MIDWIFERY CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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RESULTS AND DISCUSSION VARIABLE

YES Frequency (%)

NO Frequency (%)

Academic Requirement

138 (60.5)

90 (39.5)

Duration of Study

196 (86.0)

32 (14.0)

Academic Calendar

188 (82.5)

40 (17.5)

Accommodation

119 (52.2)

109 (47.8)

Financial Assistance

162 (71.1)

66 (28.5)

Kulliyyah building

103 (45.2)

125 (54.8)


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RESULTS AND DISCUSSION  The argument that was mentioned most often by medical students against interprofessional classes was the fact that the differences in students’ curriculum were too big, there was too much theory to learn and they had different roles and responsibilities in their future work (Jaworska and Kolarzyk, 2012).  Brainbridge (2010) found that barriers to IPE are many and are common across all health professions. With respect to education, these include a lack of flexibility in the scheduling of curricular activities; the challenges of finding space to bring groups of students together; the costs required for team teaching; the complexity of assessing students’ performance in team-based settings; and a lack of interprofessional placements in the community.


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RESULTS AND DISCUSSION Variables

Readiness towards IPE

Test value

P-value

Test

Age

0.03

0.959

Spearman correlation

Gender

-0.59

0.552

Student Ttest

Course

-0.94

0.349

Student Ttest

Year of study

0.154

0.927

ANOVA

Weeks of clinical posting

-0.017

0.916

Spearman correlation

0.377

Student Ttest

Previous coefficient 0.88 a= Spearman correlation (r) experience b= p value


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RESULTS AND DISCUSSION VARIABLES

AUTHOR

Students’ ages and Hertweck, Hawkins, the RIPLS total Bednarek, Goreczny, score Schreiber and Sterrett (2012) Student’s readiness for IPE and their gender

RESULTS Significant negative relationship (r = -.168; p = .036)

William, Boyle, Did not appear to be Brightwell, McCall, significant McMullen, Munro, O’Meara, & Webb, (2012). Hertweck, Hawkins, Bednarek, Goreczny, Schreiber and Sterrett (2012)

Significant relationship with RIPLS total score

Coster, Normana, females were more Murrells, Kitchen, positive about IPE Meerabeau, Sooboodoo & than males 10TH INTERNATIONAL NURSING AND MIDWIFERY D’Avray, (2008)C O N F E R E N C E , B R U N E I 2 6 T H - 2 7 T H J U N E 2 0 1 4

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RESULTS AND DISCUSSION VARIABLES

AUTHOR

RESULTS

Course

Wilhelmsson et al., (2011)

nursing students scored significantly higher on RIPLS score than medical students

Year of study

Olenick, (2013).

Significant different found

Curran et al (2008)

senior undergraduate students reported significantly more positive attitudes

Previous experience in IPE

Curran et al., (2008)

Students reported significantly more positive attitude towards IPE prior experience INTERNATIONAL NURSING AND MIDWIFERY

10TH CONFERENCE, BRUNEI 26TH-27TH JUNE 2014

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LIMITATION  The study design can be carried out using qualitative or cohort study design.  Unable to generalised as it was conducted in IIUM only.


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RECOMMENDATION  Further study need to be done to discover the actual barriers towards IPE among nursing and medical student.  IPE workshop must be developed by faculty to expose student with IPE thus provide awareness on the important of IPE and should experience some kind of interprofessional training as part of their education in order to facilitate working relationship.  Winterbottom and Seoane (2012) supported that students in health profession programs are traditionally educated in silos throughout their program of study. Therefore, it requires collaboration between faculty or program


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CONCLUSION  Both group of students are willing to be educated interprofessionally. However, there are few factors that have been identified hindering the process.  Interprofessional will be better understand through practice, thus there is a need to include IPE into curriculum.  Special attention should be given to early integration of IPE among undergraduate as these experience may positively influence the readiness for engagement in IPE and practice.


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REFERENCES Abu-Rish, E., Kim, S., Choe, L., Varpio, L., Malik, E., White, A. A., Craddick, K., Blondon, K., Robbins, L., Nagasawa, P., Thigpen, A., Chen. L. L., Rich, J., & Zierler, B. (2012). Current trends in interprofessional education of health sciences students: A literature review. Journal of Interprofessional Care, Early Online: 1–8. Doi: 10.3109/13561820.2012.715604. Brainbridge, L. (2010). Interprofessional Education for Interprofessional Practice: Will Future Health Care Providers Embrace Collaboration as One Answer to Improved Quality of Care? University of British Columbia Medical Journal, 2: 9-10 Coster, S., Normana, I., Murrells, T., Kitchen, S., Meerabeau, E., Sooboodoo, E., & D’Avray, L. (2008). Interprofessional Attitudes amongst Undergraduate Students in the Health Professions: A Longitudinal Questionnaire Survey. International Journal of Nursing Studies, 45: 1667–1681 Curran, R. V., Sharpe, D., Forristall, J., & Flynn, K. (2008). Attitudes of Health Sciences Students towards Interprofessional Teamwork and Education. Learning in Health and Social Care, 7(3): 146–156. Giordano, C. (2010). Interprofessional Collaboration in Health Education: A Mixed Methods Evaluation of The Jefferson Health Mentors Program. Retrieved from Proquest online database. Haskins, A. M. (2008). An Exploration of Satisfaction, Psychological Stress, and Readiness for Interprofessional Learning in Medical, Nursing, Allied Health, and Social Work Students in An Interprofessional Health Care Course. Communication in Medicine. Retrieved Oct 23, 2012, from Proquest Online Database. Hertweck, M. L., Hawkins, S. R., Bednarek, M. L., Goreczny, A. J., Schreiber, J. L., & Sterrett, S. E. (2012). Attitudes toward Interprofessional Education: Comparing Physician Assistant and Other Health Care Professions Students. The Journal of Physician Assistant Education, 23(2): 8-15 Jaworska, J., & Kolarzyk, E. (2012). Evaluation of Medical Students’ Attitudes Towards Interprofessional Education. Hygeia Public Health, 47(4): 448-452

MacFarlane, A. (2006). Undergraduate Interprofessional Education Faculty of Medicine and Health Sciences Nui, Galway: An Action Research Development Project. Development Report, 5: 1-43 Olenick, M., & Allen. L. R. (2013). Faculty Intent to Engage in Interprofessional Education. Journal of Multidisciplinary Healthcare, 6: 149–161 Parsell, G., & Bligh, J. (1998). Interprofessional Learning. The Fellowship of Postgraduate Medicine, 74: 89-95. Reeves, S., Zwarenstein, M., Goldman, J., Barr, H., Freeth, D., Hammick, M., & Koppel, I. (2005). Interprofessional education: effects on professional practice and health care outcomes. Thannhauser, J., Mayhew, S. R., & Scott, C. (2010). Measures of interprofessional education and collaboration. Journal of Interprofessional Care, 24(4): 336–349. Doi: 10.3109/13561820903442903.

Wilhelmsson, M., Ponzer, S., Lars-Ove, D., Toomas Timpka, T., & Tomas, F. (2011). Are Female Students in General and Nursing Students More Ready for Teamwork and Interprofessional Collaboration in Healthcare? BMC Medical Education, 11(15). William, B., Boyle, M., Brightwell, R., McCall, M., McMullen, P., Munro, G., O’Meara, P., & Webb, V. (2012). A Cross-sectional Study of Paramedics' Readiness for Interprofessional Learning and Cooperation: Results from Five Universities. Nurse Education Today. Doi:10.1016/j.nedt.2012.06.021

0 T Hthe IBridge. N T E The R NOchsner A T I O Journal, N A L 12: N U389–393. RSING Winterbottom, F., & Seoane, L. (2012). Crossing the Quality Chasm: It Takes a Team to1Build

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World Health Organization. (2010). Framework for Action on Interprofessional Education & Collaborative Practice.

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