Physical Therapy and Occupational Therapy Students Benefit from Interprofessional Pediatric Screenings
Purpose/Hypothesis:
Limited studies have investigated the impact of interprofessional collaboration on student physical therapists (SPT’s) and occupational therapy students (OTS’s) performing pediatric, developmental screenings with children in their natural environments. The current study aimed to fill the gap in the pediatric interprofessional education literature by investigating how interprofessional collaboration during pediatric developmental screening impacts perceptions of interprofessional practice (PIP) and self-assessment of competency (SAC) among SPT’s and OTS’s. Research questions included: 1. Do SPT’s and OTS’s perception of interprofessional practice change following community-based interprofessional developmental screenings? 2. Do SPT’s and OTS’s self-assessment of competency change following community-based interprofessional developmental screenings? The authors hypothesized students PIP would increase and SAC would improve following these interprofessional learning activities.
Number of Subjects:
Ninety-six students were recruited to participate; 83 provided informed consent. Of those who provided consent, 72 students completed both pre and post PIP and SAC surveys (n = 30 PT students and 42 OT students). Of the 72 students who completed all surveys, 52 were paired with partners of the other discipline and 20 students were partnered with students of the same discipline
Materials and Methods:
The research project included individual discipline specific coursework for SPT”s and OTS’s during scheduled classes, along with group training for PT and OT students during time outside of scheduled classes. Students were assigned to work with a partner to complete the screenings at a range of local preschools. Prior to the pediatric screenings, all students met as a large group with supervising faculty to discuss the on-site pediatric screening logistics and to discuss the specific pediatric screening with their student partner. After all screenings were completed, PT and OT students met again as a large group to participate in a debriefing session related to the pediatric screenings. A pre-post design was used to evaluate the change in perceptions of interprofessional practice (PIP) and self-assessment of competency (SAC) after performing the developmental screenings. A descriptive comparative design was employed to determine if there was a difference in PIP and SAC scores between PT and OT students as well as students who were paired with a partner from a different discipline (DD) versus a partner from the same discipline (SD). The independent variable included time with two levels, pre and post pediatric developmental screenings. Dependent variables investigated were mean total scores from the perceptions of interprofessional practice (PIP) and self-assessment of competency (SAC) surveys.
Two surveys were used to assess the change in student Perception of Interprofessional Practice (PIP) as well as to assess Student Assessment of Competency (SAC). Instruments to assess student PIP and SAC. The PIP survey was developed from the “Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education” instrument or SPICE survey normed on the physician-pharmacist interaction. The objective of the survey was to assess student perceptions of collaborative clinical education with the other professional (Fike, Zorek, MacLaughlin, Samiuddrin, Young, & MacLaughlin, 2013). The tool demonstrated adequate evidence of construct validity based on the examination of convergent and discriminant validity. Internal consistency reliability of the tool established with the Cronbach alpha calculated at alpha=.837. For this study, the specific reference to physicians and pharmacists in the original instrument was modified to refer to occupational and physical therapists, otherwise survey items were comparable to those listed in the SPICE instrument.
The SAC survey was developed by the primary investigators (PI’s) to assess the student’s perception of their competency specific to pediatric screening skills both before and after performing the developmental screenings. The primary investigators identified competencies to assess related to communication, interaction with the child and with other students and staff, accuracy in administration and scoring, as well as accurate interpretation of the screening tool. Students completed surveys via a electronic format through a secure, web-based program.
After written parental consent and completed questionnaire was obtained, children enrolled in area preschools were screened by PT and OT students using The Ages and Stages Questionnaire, third edition, (ASQ-3). All students were supervised by onsite licensed PT and OT faculty during each screening event. The Ages and Stages Questionnaire, third edition, (ASQ-3) Kit and Forms (Squires, Twombly, Bricker, Potter, 2009) was utilized to assess the developmental skills of the preschool-aged children. The ASQ-3, is a criterion-referenced, parent-report developmental screening assessment used for children birth to five years of age.
Results:
The scores for the PIP survey revealed that post-screening PIP total scores (mean = 46.57, SD= 5.5) were statistically significantly higher than pre-screening PIP total scores (mean= 45.46, SD = 3.89), Z = -3.091, p = .002 per the Wilcoxon signed ranks test. Findings indicate perceptions of interprofessional practice improved after participation in the developmental screenings.
Interestingly, a Mann Whitney U test indicated that pre-screening PIP scores were statistically significantly different between SPT's and OTS's. OT students had statistically significantly higher average PIP total score, pre-screening (mean= 46.79, SD= 3.53) compared to PT students (mean =43.6, SD =3.65), U = 323.5, p <.001. However, post screening surveys showed no statistically significant difference in PIP survey scores between OT and PT students. Following the screenings, both groups of students reported similar perceptions related to interprofessional practice. Additional Wilcoxon signed ranks tests were performed to determine if there was a change from pre to post for each PIP survey question. Of the ten survey questions, three questions were found to have to have statistically significantly changed from pre-screening to post screening. These items included: • My role within the interdisciplinary team is clearly defined.
• I understand the roles of others in a disciplinary team.
• During their education programs OT and PT students should be involved in teamwork to better understand their respective roles
Data was analyzed to determine if there was a difference in PIP total scores between those students partnered with students of a different discipline (DD) versus students partnered with those from the same discipline (SD) for pre-screening and post screening. No statistically significant differences in total PIP scores were found between the students in the DD and SD groups at either time frame.
Self-Assessment of Competency Results using Wilcoxon signed rank tests revealed post-screening SAC survey scores were statistically significantly higher (mean = 25.88, SD = 2.85) than pre-screening SAC survey scores (mean = 20.02, SD = 4.74), Z = -7.41, p <.001. Wilcoxon signed rank tests were performed for each survey question, and each of the six questions showed statistically significantly improvements from pre- to post-screening at or below the p <.001 level. Self-assessment competency ratings indicated students perceived an increased level of competence across all individual survey items. A Mann Whitney U test revealed that there were no statistically significant differences in total mean scores per SAC item between SPT’s and OTS's at pre-screening (U = 775.5, p = .557) nor at post-screening (U = 771.5, p = .530). Likewise, there were no statistically significant differences noted between students partnered with students of different disciplines (DD) than those partnered with students of the same discipline (SD) at pre-screening, U = 581, p = .406 nor at post-screening, U = 639.5, p = .829.
Conclusions:
This study sought to determine how perception of interprofessional practice and competency changes in SPT’s and OTS’s following community-based collaborative pediatric screenings. The study revealed performing developmental screenings in pediatric community settings resulted in statistically significantly improved overall perception of interprofessional practice from pre to post screenings as well as improved self-assessment of competency.
Clinical Relevance:
The study suggests implementing learning experiences which allow SPT’s and OTS’s to collaborate while working with children in their natural environment may benefit students. Planning and implementing interprofessional education (IPE) activities for SPT’s and students of other disciplines, within a community setting, should be considered as a component of all entry-level physical therapy programs