Assessment of Interprofessional Education for Undergraduate health-care students: a systematic review and intervention study

Abstract

Introduction: Interprofessional education (IPE) provides health care students and practitioners with the training necessary to be ready to collaborate, and to work effectively in interprofessional teams. It is widely believed that interprofessional working improves the healthcare system and reduces medical errors, thus improving patient safety. Furthermore, it has been suggested that interprofessional training for undergraduates is a useful strategy to improve staff wellbeing and patient care in the future. Aim: The overall aim of this thesis was to design, and test an IPE educational intervention and improve IPE assessment for undergraduate students. Method: A systematic review was conducted to critically appraise IPE assessment tools used for undergraduate IPE. From this review, an IPE Assessment Decision Aid was then developed to help educators select the appropriate IPE assessment tool. The next phase involved the development of a robust, authentic intervention and an evidence based assessment approach based on the systematic review findings. Final year medical students and final and third year pharmacy students were recruited via email to participate in this intervention. Medical and pharmacy students were assigned in pairs to work together online to undertake a hospital discharge process. The IPE intervention was repeated three times using three different patient scenarios. A multi-modality approach to assessment of students was taken to gain a better understanding of student learning and improvement. Quantitative and qualitative data were collected from different sources. Data collected included: a validated scale completed by an interprofessional assessment team, discharge letters completed by students, written feedback provided by the assessment team, student reflections on their performance, and focus groups conducted with the students and the assessment team. Results: Eighteen students (nine from each professional programme) completed the study and a total of 27 IPE sessions were conducted. The assessment team completed 54 Interprofessional Professionalism Assessments (IPA) of the students’ performance, evaluated 27 discharge letters and 31 student reflections, which were received from the eighteen students who participated. Additionally, nine focus groups were conducted with students, and one focus group was conducted with the assessment team. The third IPE iteration showed a statistically significant improvement in students’ interprofessional behaviour. The discharge letter, used as a proxy for patient outcome, also improved over the IPE iterations. Students found the educational sessions useful and relevant. Conclusion: The selection of an appropriate assessment tool is a decision to be taken alongside the conception and design of the IPE intervention. No single IPE tool is suited to all IPE interventions. This PhD project provides educators with a decision aid about which tools might be most appropriate for the purpose of their planned IPE intervention. The developed and implemented intervention and assessment approach illustrated the benefits of repeating the same IPE intervention for students to develop skills and assess improvement. In the assessment, having the opportunity to provide qualitative feedback is important to provide a more global assessment of student performance. This IPE study was distinguished from other IPE studies in its ability to capture the impact of interdependence, as students worked with different partners across each iteration.