Team reflexivity and the shared mind in interprofessional learning

ABSTRACT. Occupational and physical therapy professionals are natural partners in neurorehabilitation especially in the acute stages of recovery. To enhance student-learning experiences from both disciplines, we have developed an interprofessional (IP) learning unit that was embedded in neurorehabilitation tracks of each respective program. The primary goal of this project was to examine interprofessional attitudes and perception toward interprofessional learning and practice. A total of 117 occupational therapy (53) and physical therapy (64) students completed an IP case-based learning module with the goal of developing an IP care plan typically seen in neurorehabilitation. Using a sequential explanatory mixed methods design, we collected data pre- and postintervention using the Readiness for Interprofessional Learning Survey (RIPLS). We also utilized a postintervention questionnaire and focus groups intended to solicit information regarding IP competencies. At pretest, students had high ratings on the RIPLS that led to minimal changes at posttest (p = .157). However, common threads from the questionnaire and focus groups showed positive effects on student learning and attitudes toward interprofessionalism. Students reported positive experiences with the IP module. An IP case-based educational module has the potential to facilitate professional development and readiness for future IP practice. Students from different disciplines appreciate the value of IP education (IPE) in reinforcing their professional identity and understanding the professional contributions of others. Our findings are consistent with literature on best practices for IPE.

FACULTY SEEKING TO CREATE LEARNING ACTIVITIES THAT FACILITATE EXPOSURE TO AND ENHANCE THE LEARNING OF INTERPROFESSIONAL (IP) HEALTH CARE TEAM BEHAVIORS WILL BENEFIT FROM AN UNDERSTANDING OF GROUP PROCESSES AS ADVOCATED BY SOCIAL SCIENTIST GORDON ALLPORT. In 1954, Allport postulated that prejudice or stereotyping within groups can interfere with the successful functioning of groups, and that just putting individuals together and expecting them to function is not enough (Pettigrew, 1998). Today's nursing students must be academically and experientially prepared to participate in the IP environment in order to assimilate the roles expected by employers and provide the highest quality patient care (Lindqvist & Reeves, 2007; Sullivan & Godfrey, 2012). However, while interprofessionalism is inherent in what nurses do every day in performing their job, there is often little focus on IP within nursing education. As the system of delivery of health care services changes to include the IP health care team process, the educational preparation of health care providers will have to evolve (Gillespie & McFetridge, 2006). This article provides a brief theoretical framework to support the development of team-oriented thinking and behavior through the use of faculty-guided learning experiences whereby nursing students can learn the skills necessary for working in IP health care teams. An example of a learning experience that can take place early in the student's nursing education, in a didactic setting, is provided. Barriers to Interprofessionalism The IP health care team is characterized as a group of health care professionals from various disciplines who share the responsibility of collaborative decision-making to achieve desired patient goals (McCallin & Bamford, 2007). A distinct focus on team-based health care delivery allows this group to address complex patient needs within a structure that also considers the full spectrum of care, including quality of service, its cost, and access to health care. The goal of the team partnership is joint decision-making to achieve patient-centered outcomes using collaborative knowledge, skills, and varied professional perspectives (Jansen, 2008; Johanson, 2008, Royeen, Jensen, & Harvan, 2009). Working under such complex conditions requires collaboration, team decision-making, and assertiveness and self-confidence, as well as a balance between one's profession and the team activities (Atwal & Caldwell, 2006; Kvarnstrom, 2008; Young, Baker, Waller, Hodgson, & Moor, 2007). However, researchers have identified barriers to the team approach, including varying perceptions of teamwork, differing ability levels in team members, stereotyping behaviors, and the potential for one profession, specifically medicine, to exert dominance over the others (Atwal & Caldwell; Gilbert, 2005; Royeen et al., 2009). McCallin and Bamford (2007) suggested that to change stereotypical perceptions attached to other professions, team members use communication techniques such as pluralistic dialoguing, which recognizes and respects the notion that alternative points of view have merit. Participants in this mode of communication are open to various perspectives and have a good understanding of the roles and skills of other practitioners. Interprofessional Education and AIIport's Intergroup Contact Hypothesis In an academic environment that seeks to promote IP education, simply creating a class roster of students from various professions and expecting the students to accept the perspectives of the individual professions represented in the class are not sufficient to create the attitudes necessary to function as an IP team in providing patient care (Lidskog, Lo, Mark, & Ahlstrom, 2007). Allport's intergroup contact hypothesis holds that prejudice can be reduced within and among groups and that there can be positive attitude changes in a group if certain elements exist. …

Interprofessional (IP) experiences are increasing in frequency and scope in health professions education, though little is known about the role of the co-curricular environment in fostering students’ attitudes towards IP collaboration. We examined if participants in IP co-curricular activities of substantive duration held attitudes toward IP learning and collaboration differently than students who did not participate in such activities. We distributed a questionnaire composed of the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS) to the 2008, 2009, and 2010 graduates of an academic health center. Respondents indicated if they participated in any of the six substantive IP co-curricular activities offered by the institution. Respondents were grouped by participation in “one or more IP activity” or “no participation.” Independent sample T-tests were performed for each of the RIPLS and IEPS scales to assess differences between those groups. 997 (58.1%) of the graduates completed the survey; 52.9% of the respondents reporting participation in at least one IP activity. Of the seven scales from the two instruments, the mean scores of one scale were significantly different between the two groups: IEPS “perceived need for cooperation” (p Results indicate that students who have participated in a substantive IP co-curricular activity hold more positive attitudes toward the perceived need for cooperation. It is likely that as a result of their IP collaborative experiences, these students recognize the value and need for cooperation. It appears that important IP collaborative learning occurs within the IP co-curricular environment, and in turn, may translate into improved use of IP collaboration skills in practice.

How medical inter-professional (IP) education should be introduced to students is still a matter of research. We evaluated IP student attitudes before and after a busy “hands-on” clinical experience.During 3 separate trips, first/second year medical and physician assistant students and third/fourth year nursing students traveled to Central America to work together for 1 week in an underserved clinical setting. Student opinions on inter-professional education were obtained before and after Brigade-1 using the Readiness for Inter-professional Learning Scale validated questionnaire. From these results, a modified version of the survey was developed that included quantitative and qualitative responses. For brigades-2 and -3, students received this modified version of the survey pre and post brigade. Quantitative data was analyzed via paired student t test, and qualitative data was analyzed to identify emerging themes using constant comparative methodology by three separate investigators.No significant quantitative differences between IP student groups were observed in their evaluation of the importance of inter-professional education either before or after the brigades. Qualitative data noted pre-brigade expectations of positive IP, experiential and patient-centered cultural learning. Pre- and post-brigade student perspectives maintained a strong belief that high functioning IP care benefited the patient. Post-brigade perspectives revealed a shift in attitude from purely positive expectations to more practical aspects of teamwork, respect, and interpersonal relationships.Students believe that patient care benefits from IP collaboration. After a busy clinical experience requiring collaboration, students realized that functional teams require appropriate skills, roles, and respectful interpersonal relationships.

This study explored exposure to, and attitudes toward, interprofessional (IP) teams between third-year longitudinal integrated clerkship (LIC) and traditional rotation-based clerkship (RBC) students at the University of Calgary medical school. Students completed a survey pre-post 32-week LIC or 6-week rural, regional or urban RBC family medicine rotations. Pre and post rotation surveys were completed by 213 (48%) students (LIC = 33/34; rural = 76/152; regional = 24/46; urban = 80/208). More LIC students (76%) reported participating on six or more IP teams than RBC students (rural = 38%; regional = 25%; urban = 21%). At pre rotation, the mean attitude to IP teams score of LIC and rural RBC students was high and did not differ. At post rotation, the mean attitude score of LIC students was significantly greater than the mean reported by rural RBC students. Only LIC students reported a significant pre-post rotation increase in attitude. Exposure to IP teams, possibly facilitated by a longer duration of rotation, appears to be an important factor in affecting attitude to IP teams.

PurposeThe purpose of this study is to examine the effect of leader humility on team reflexivity. This study also investigates the mediating role of relation-oriented shared leadership and the moderating role of leader trust.Design/methodology/approachThis study collected data from the information technology (IT) service provider of a large telecommunications company in South Korea. A total of 311 employees (individual response rate of 31.2%) in 59 teams (team response rate of 83.01%) were included in the final analysis. Several hierarchical regression analyses and PROCESS macro were used.FindingsThe results indicate that leaders’ humble behaviour is positively associated with team reflexivity and facilitates relation-oriented shared leadership among team members, particularly when they have a higher level of affect-based trust in leaders.Practical implicationsThis study may help researchers and practitioners better understand the conditions influencing the impact of leader humility on team members’ behaviour.Originality/valueThe main value of this study is to add to the knowledge on team reflexivity by identifying leader humility as a critical factor affecting team reflexivity. Furthermore, this study provides a deeper understanding of why leader humility influences team reflexivity.

Importance of interprofessional collaboration in teaching diabetic foot self-management: Perceptions of health care professionals

Effective interprofessional (IP) collaboration is essential for managing complex patient cases. Collaborative clinical reasoning (CCR) is an approach where IP teams collectively analyze and address complex clinical cases, facilitating a shared understanding of patient management. While simulation and case-based learning are established methods for fostering IP collaboration, the process by which students develop a shared mental model for patient management after a simulated home visit and how this approach promotes the development of IP competencies is unknown. Understanding this process is critical for advancing IP competences that are fundamental to case management practice. The purpose of this study was to explore students' perceptions of the CCR processes used to develop an integrated care plan following a simulated home visit. Home care and community-based practice settings. A qualitative descriptive approach was employed to explore PT and nursing student teams' perceptions of the CCR processes used to develop an integrated care plan following a simulated home visit. Written responses to five reflection questions were analyzed using conventional content analysis among n =87 physical therapy and nursing students. There were three overarching themes: clarifying roles; developing a mutual approach; embracing shared values. Students' perceptions reflected skills needed to develop IP competencies including CCR. More research is needed to explore how student teams resolve disputes and use interdisciplinary knowledge in the process of CCR. Findings highlight the importance of IP collaboration in clinical case management, emphasizing the need for case managers to facilitate clear role clarification, mutual approaches, and shared values among IP teams to enhance integrated care planning and improve patient outcomes. These insights can inform training and development programs for case managers on IP teams, promoting the adoption of CCR in practice.

Many studies examine the impact of interprofessional (IP) interventions on various health practice and education outcomes. One significant gap is the lack of research on the effects of IP interventions on health human resource (HHR) outcomes. This project synthesized the literature on the impact of IP interventions at the pre- and post-licensure levels on quality workplace, staff satisfaction, recruitment, retention, turnover, choice of employment and cost effectiveness. Forty-one peer-reviewed articles and five IECPCP project reports were included in the review. We found that IP interventions at the post-licensure level improved provider satisfaction and workplace quality. Including IP learning opportunities into practice education in rural communities or in less popular healthcare specialties attracted a higher number of students and therefore may increase employment rates. This area requires more high quality studies to firmly establish the effectiveness of IP interventions in recruiting and retaining future healthcare professionals. There is strong evidence that IP interventions at the post-licensure level reduced patient care costs. The knowledge synthesis has enhanced our understanding of the relationships between IP interventions, IP collaboration and HHR outcomes. Gaps remain in the knowledge of staff retention and determination of staffing costs associated with IP interventions vis-à-vis patient care costs. None of the studies reported long-term data on graduate employment choice, which is essential to fully establish the effectiveness of IP interventions as a HHR recruitment strategy.

The purposes of this exploratory study were to investigate the attitudes of radiation oncology professionals regarding interprofessional (IP) teaching and interprofessional education (IPE), to identify the challenges faced by radiation oncologists who teach within an IP context, and to discover new strategies to aid professionals teaching IP students. A questionnaire was developed through the review of existing literature on IPE using Medline. The proposed group of questions was selected by educators from different professions actively involved in IPE. The final revised questionnaire consisted of three main domains assessing the understanding of IP concepts, attitudes toward IP teaching and learning environments, and attitudes toward health-care teams. An open-ended comment section was included. The questionnaire was administered to health-care professionals (physicists, radiation oncologists, and radiation therapists) nationally through SurveyMonkey® (electronic survey). A total of 220 respondents provided demographic information. Half of these respondents indicated that they previously received education relating to IPE. A high level of agreement was received for nearly all the questions. There were no significant statistical differences among the three different professional respondent groups for any question. Overall, most of the respondents demonstrated a good knowledge and understanding of IP concepts and advocated IP training and collaboration.

The impact of an interprofessional practice experience on student behaviors related to interprofessional communication and teamwork

Few interprofessional (IP) learning opportunities are designed specifically for advanced health learners who are early in their training yet have already had some clinical experience. This group of learners requires activities that are didactic based but extend beyond the introductory IP curricula typically geared towards prelicensure students. This highly interactive curriculum aims to fill that gap in the literature. An interprofessional case-writing team created two unfolding video cases-a mother-infant dyad seeking care and an elderly non-English-speaking man experiencing disjointed care-for a large IP event with doctors of nursing practice (DNPs), pharmacy practice, and dental science, masters in social work, and physician assistant (PA) trainees, individualized to learner interest. The team also developed a highly detailed faculty guide, including specific talking points, to assist IP teams of faculty facilitators. Learners were evaluated using a Likert-scale postsession survey and open-ended questions. Qualitative data were analyzed for themes related to the objectives. Survey results indicated that learning objectives were met and students were highly satisfied with the overall curriculum. Mean scores for organization, utility, and facilitation effectiveness were all above 4.6 (range: 1-5), with the DNP, pharmacy, and PA students indicating higher levels of satisfaction compared to the other professions. Faculty feedback was very positive, particularly with respect to the faculty guide. Challenges were concentrated around implementation of the curriculum rather than the curriculum itself. This curriculum can be used with a variety of learners with minimal adaptation of discussion questions.

ABSTRACTResearch has identified the importance of knowledge coordination in high-performing teams. However, little is known on the processes through which these cognitive structures are developed, more specifically on the learning occurring as teams communicate and interact to build new team knowledge. In a multiple-measures experiment, 33 teams with no prior experience in flight simulations were assigned to newly formed dyads to complete 4 successive performance episodes of a flight simulation task, modeling a complex, fast-paced, and high workload task context. The study showed how team learning processes (i.e., team learning behaviors and team reflexivity), driven by task cohesion, and group potency supported coordination development, which in turn predicted team performance.

Date Presented 04/04/19 A convergent parallel mixed-methods study examined the relationship between reflective journaling (RJ) and self-regulated learning (SRL) in a collaborative online interprofessional (IP) course. Thirty students’ reflective texts indicated effective learning for IP practice through online collaborative instruction. Pearson correlation indicated: 1) moderate relationship between SRL and grade point average, 2) not a significant relationship of SRL and RJ, and 3) connection with self-determination theory. Primary Author and Speaker: Joan Tunningley

This paper describes the development and implementation of an interprofessional (IP) module for pre-qualification medical, nursing and physiotherapy students. The module focuses on clinical care in the acute care setting, and is called Interprofessional Working in Acute Care (IWAC). The authors are acute-care practitioners and educators familiar with an environment where good interprofessional collaboration and communication are prerequisite for, and linked to, good patient outcomes. We believe that explicit opportunities to learn the skills of collaborative IP working are required. We developed a blended-learning 15-credit module that was vertically integrated into the existing curricula of the three programmes. It used several different types of learning: self-directed learning; in-practice teaching; clinical observation; simulation-based teaching (SBT); and collaborative peer-group working and student presentations. The contact teaching time had to be limited because of the constraints of three divergent timetables, and was dominated by SBT that featured four acute care scenarios. The scenarios were formulated so that they could not be managed without interprofessional collaboration. Each student was assigned to an IP group (comprising at least one student from each discipline) for the whole module. A common assessment included a collaborative presentation by each IP group where members were expected to discuss and reflect upon the role of a different professional within their group. This narrative account exhibits our development of teaching praxis in the story of teaching innovation, and highlights some of the challenges and opportunities within IP learning in undergraduate education.