Prior experience of interprofessional learning enhances undergraduate nursing and healthcare students' professional identity and attitudes to teamwork

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Abstract

Background

How willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? There is a lack of evidence of students' views by discipline despite this being a priority task for higher education sectors. This study explored the views of nursing, midwifery, nursing-emergency health (paramedic), medical, physiotherapy and nutrition–dietetics students.

Methods

Senior undergraduate students from six disciplines at one university completed the Readiness for Interprofessional Learning Scale prior to participating in interprofessional clinical learning modules.

Results

For 741 students, the highest ranked response was agreement about a need for teamwork (mean 4.42 of 5 points). Nursing students held significantly more positive attitudes towards Teamwork/Collaboration, and were more positive about Professional Identity than medical students (p < .001). Midwifery and nursing-emergency-health students rejected uncertainty about Roles/Responsibilities compared with medical students (p < .001). One-third of all students who had prior experience of interprofessional learning held more positive attitudes in each of four attitude domains (p < .05).

Conclusion

Overall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. Early introduction of IPL is recommended. Further studies should explore the trajectory of students' attitudes throughout the university degree.

Introduction

How willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? Competent health professionals are required to work together in complex and dynamic healthcare environments and to collaborate in teams. The higher education sector is thus bound to produce a health workforce that is adaptable, can collaborate and work across professional boundaries (L-TIPP 2009). Recent education reforms have aimed to address this by increasing undergraduate interprofessional learning opportunities in the health care professions, including in nursing (Australian Nursing and Midwifery Accreditation Council (ANMAC) 2011). This follows the lead of international recommendations regarding a need for improvement in health professional education to ultimately improve patient-centred care (Pollard et al., 2004, Thistlethwaite and Moran, 2010, World Health Organization and Health Professions Network Nursing and Midwifery Office, 2010). These skills are ideally learned during the undergraduate years when students undertake shared, or interprofessional learning (Hylin et al., 2011).

Interprofessional learning (IPL) occurs when there is active learning ‘with’ and ‘from’ other disciplines: i.e., when two or more students learn with, from and about each other with the aim of improving collaboration and the quality of professional practice (Centre for Advancement of Interprofessional Education (CAIPE) 2002). For example, nursing students may learn clinical skills from a curriculum that is common to nursing, medical and physiotherapy students, with all three disciplines focussing on their contributory roles whilst learning together. Learning via working with other students provides an opportunity for students to position themselves within the healthcare team and to ‘fine-tune’ a professional persona, described by Ibarra (1999) as ‘trying on a provisional self’. Rather than weaken the acquisition of professional identity, its development was enhanced by learning alongside other healthcare students (Wilhelmsson et al., 2009).

While IPL has been introduced in some university programmes via multi-professional undergraduate healthcare studies (Hamilton et al., 2008, Jacobsen et al., 2009, Mann et al., 2009), this is not implemented universally. Studies have reported various barriers to conduct of IPL ranging from resource issues and administrative differences between departments to the logistics of parallel timetabling (Tourse et al., 2008). In addition, there are differences among students in various professional disciplines in relation to attitudes and willingness to engage in learning together (Rose et al., 2009, Wilhemsson et al., 2011). All students enter university with an already established set of attitudes influenced by their personal, cultural, social and philosophical belief systems that shape a person's conscious or unconscious mind (Eiser, 1997) Attitudes are changed as a result of favourable or unfavourable evaluation of a person, or object, or thing- and thus alter with experience (Eagly and Chaiken, 2007). Furthermore, the literature suggests that health professional students have traditionally experienced very little contact with each other (Gilbert, 2005) with few opportunities to learn about interprofessional collaboration. Furthermore, few studies report whether individual student disciplines are willing to undertake interprofessional learning as, to date, small student samples have prevented this analysis.

The purpose of this paper is to examine the attitudes of undergraduate health professional students towards interprofessional learning within a large multidisciplinary undergraduate cohort. We include a focus on nursing, midwifery and nursing-emergency health, among others, to explore the willingness of these groups to participate in shared learning. The present report forms part of a longitudinal study conducted by researchers from Monash University and Southern Health (Victoria, Australia) that developed an interprofessional clinical learning programme for pre-registration healthcare students (Leech et al., 2013). This paper reports discipline attitudes and explores differences between-disciplines. The students' views were examined prior to their engaging in interprofessional clinical learning experiences that were offered while the students were on clinical placement in the health service.

Section snippets

Methods

The study design was a cross-sectional survey utilizing a valid questionnaire: the Readiness for Interprofessional Learning Scale (RIPLS) together with a demographic question set. This asked about participants' age, year of birth, course and year of university course, and whether they had previously experienced IPL.

The 19-item RIPLS scale (Parsell and Bligh, 1999) was developed through a survey of 120 s-year undergraduate healthcare students including medicine, nursing and six other health and

Results

As shown in Table 2, a total of 741 students from six healthcare degree courses comprised the final dataset. The response rate was approximately 46% of all students scheduled for clinical placement during the period. The student groups were: (in decreasing order) medicine, nursing, midwifery, physiotherapy, nursing-emergency health (paramedic), and nutrition–dietetics. The demographic profile of the students is given in Table 1. There were 23 nursing students in a graduate entry programme who

Discussion

Overall, the study identified positive attitudes to, and strong support for, interprofessional learning from all the disciplines: nursing, midwifery, nursing-emergency health, medicine, physiotherapy and nutrition–dietetics students. Mean attitude ratings were 72% (68.5 of a possible 95). This result concurs with a number of other studies of health and social care students that have reported positive attitudes towards IPL. Rose et al. (2009), who explored the attitudes of North American first

Conclusion

The main finding of this study is that overall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. This bodes well for future work readiness in the healthcare professions. Attitudes towards interprofessional learning are shaped by course culture and experience, with results showing differences by discipline. This study's findings imply that other factors contribute to readiness for interprofessional

Acknowledgements

The study was part of an Increased Clinical Training Capacity (ICTC) Project for pre-registration healthcare students at Southern Clinical School, Monash University, Melbourne, Victoria. The ICTC Project was funded by the Australian Government: Department of Health and Ageing, Canberra, Australia.

References (34)

  • Australian Nursing and Midwifery Accreditation Council (ANMAC)

    National Accreditation Framework

    (2011)
  • S.K. Baxter

    Perspectives and practice: speech and language therapy student views of an interprofessional learning experience

    Learning in Health and Social Care

    (2004)
  • J. Carpenter

    Interprofessional education for medical and nursing students: evaluation of a program

    Medical Education

    (1995)
  • Centre for Advancement of Interprofessional Education (CAIPE)

    Centre for Advancement of Interprofessional Education (CAIPE): Defining IPE

    (2002)
  • L. Dalton et al.

    Report of the Investigation of Undergraduate Health Science Student Attitudes toward Interprofessional Education

    (2007)
  • A.H. Eagly et al.

    The advantages of an inclusive definition of attitude

    Social Cognition

    (2007)
  • J. Eiser

    Attitudes and beliefs

  • J.H.V. Gilbert

    Interprofessional learning and higher education structural barriers

    Journal of Interprofessional Care

    (2005)
  • P. Hall

    Interprofessional teamwork: professional cultures as barriers

    Journal of Interprofessional Care

    (2005)
  • S.S. Hamilton et al.

    Interprofessional education in gross anatomy: experience with first-year medical and physical therapy students at Mayo Clinic

    Anatomical Sciences Education

    (2008)
  • S. Hean et al.

    Theoretical insights into interprofessional education: AMEE Guide No. 62

    Medical Teacher

    (2012)
  • A. Henderson et al.

    Developing a Model for Interprofessional Education during Clinical Placements for Medical and Nursing Undergraduate Students

    (2010)
  • U. Hylin et al.

    Students' approaches to learning in clinical interprofessional context

    Medical Teacher

    (2011)
  • H. Ibarra

    Provisional selves: experimenting with image and identity in professional adaptation

    Administrative Science Quarterly

    (1999)
  • F. Jacobsen et al.

    Interprofessional undergraduate clinical learning: results from a three year project in a Danish Interprofessional Training Unit

    Journal of Interprofessional Care

    (2009)
  • S. Lapkin et al.

    A cross-sectional survey examining the extent to which interprofessional education is used to teach nursing, pharmacy and medical students in Australian and New Zealand universities

    Journal of Interprofessional Care

    (2012)
  • M. Leech et al.

    Creating Interprofessional Learning Opportunities for Preregistration Healthcare Students to Enrich Clinical Placement: the Increased Clinical Training Capacity (ICTC) Program

    (2013)
  • Cited by (0)

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