Association of Immersive Clinical Practice with Student Interprofessional Attitudes
Purpose/Hypothesis: Many healthcare systems across the world are continuing to struggle to manage the many unmet needs of each patient. Interprofessional practice has been identified as a mechanism to meet the needs of patients and populations, which can be achieved through purposeful interprofessional education of students in healthcare disciplines within clinical environments (IOM, 2015; WHO, 2010). Organizations such as the Interprofessional Education Collaborative have guided interprofessional practice through the creation of core competencies (IPEC, 2016) in hopes that interprofessional education can meet practice needs. In congruence, educators and researchers have been examining means of improving practice through the translation of IPEC competencies into the authentic clinically-immersive environments, where the classroom meets the patient population. The Interprofessional Attitudes Scale is a common instrument utilized to examine IPEC competencies as they relate to the interaction among disciplines as they relate in a clinical setting. The purpose of this study is to examine the relationship between the past participation of students in an interprofessional clinical environment with interprofessional attitudes of medical, pharmacy, social work, nursing, and physical therapy students at a large public university academic health science center. The researchers hypothesize that a greater level of experience in university-affiliated and overall outside experiences in interprofessional clinically-immersive environments will have a positive relationship with interprofessional attitudes. Number of Subjects: 170 Materials and Methods: All students who are in their clinical phase of training within medicine, social work, physical therapy, nursing, and pharmacy were invited to participate in a survey that included the IPAS scale to assess interprofessional attitudes (dependent variable), and the number of experiences each in interprofessional practice activities that were either university-sponsored or outside. Relationship between IP attitudes and IPP experiences were examined by a pearson correlation coefficient. In addition, group differences in IP attitudes were examined via an analysis of variance with pairwise comparisons via a post-hoc tukey test. Results: When considering the total sample involving all the disciplines, there was no significant correlation between total IPAS scores and amount of participation in interprofessional immersive clinical practices (p>.05). However, when separated by discipline, MD students had a statistically significant positive correlation between IPAS scores and total immersive activities (R=0.435, p=.013) while pharmacy students did have a significantly positive relationship (R=.434, p=.044) of attitudes with participation in a university sponsored activity. No other discipline had a statistically significant association in these total scores. However, the entire sample did have a positive relationship of attitudes with participation in the subdomain Interprofessional Bias (R=.178, p=.047). Student disciplines did have significant mean differences in IP attitudes as determined by the ANOVA (F=8.865, p=<0.001). These differences were mirrored by nearly every sub-domain of IPAS. The post-hoc tukey test revealed that medical students possessed significantly lowed IP attitudes than students from pharmacy, social work, and physical therapy (p<.001). No other pairwise differences were found between these groups. Conclusions: Our study indicates a direct relationship between interprofessional attitudes and participation in clinically-immersive interprofessional practice activities for various healthcare students. Clinical Relevance: Interprofessional education activities that are designed and implemented in an interprofessional practice environment may have a strong impact on student attitudes and subsequent practice.