Catalysts for and detractors from interprofessional learning during physical therapy internships.
Purpose
The workplace environment is rich in qualities of engagement and inclusion as it relates to the learner’s future workplace. Despite historically being referred to as informal, evidence has occurred validating the learning can be as robust in outcomes in the workplace, as the didactic learning in academic institutions.1 Workplace learning, referred to as clinical education in physical therapy, is highly valued and a significant component in all physical therapist professional education programs. Despite a consensus to place a greater importance on clinical education within the doctor of physical therapy (DPT) degree, as demonstrated by increasing requirements for time spent in terminal clinical internships, there is ambiguity as to what skills are advanced and to what level as a result of this increased time. Specifically, the outcomes in interprofessional education (IPE) are poorly understood, during the clinical education portion of the pre-licensure degree.
The volume of research in IPE is significant.2-4 Systematic reviews demonstrate the abundance of research produced in IPE. One gap in the research is objective measurement of transferring collaborative and other interprofessional behaviors to practice.5-6
A mixed method, sequential pre-experimental study that explores more about interprofessional learning in the clinical portion of the physical therapy pre-licensure degree may help focus the clinical teaching this valuable skill.
The purpose of this educational session is to discuss this study, followed by the results, leading to a discussion about the strengths of and the challenges to interprofessional learning in the clinical portion of the DPT degree. Through engaging discussions with other fellow PT educators in the field who are passionate about interprofessional education, teaching interprofessional skills can be further clarified.
Methods and/or Description of Project
Quantitative assessment of physical therapy students’ interprofessional competencies during terminal clinical internships occurred six weeks prior to completion of the internship via an online version of the Interprofessional Collaboration Assessment Rubric (ICAR). Interviews with clinical instructors and students then augmented quantitative data through open-ended discussions of interprofessional learning in the clinic regarding factors that enhanced and detract from interprofessional learning.
Results/Outcomes
While sample size limited quantitative correlation analysis, qualitative data clarified characteristics of instructor, student and organization that influence interprofessional learning. The mentoring relationships between the clinical instructor and student were valuable in setting expectations for interprofessional learning. Specifically, communication focused on growth for the student, modeling of positive interprofessional interactions, establishing informal relationships between professionals and displaying a patient centered practice were the leading strategies that positively influenced interprofessional skill obtainment in the field. Detractors to learning were protecting the student from interacting with other professionals in exchange for focusing on profession specific skills. The outside influence of the organization’s culture influenced engagement with the student between professionals outside the student’s discipline.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
This educational session is targeted toward strengthening interprofessional skills during internships. In order to be successful, a student must manage concurrently the relationship between the clinical instructor and the relationships in the organization. These multiple layers add to the complexity of interprofessional practice and the preceeding interprofessional education. Transferring interprofessional education to the practice environment is valuable for the student to navigate this overlap when obtaining the skills necessary for interprofessional practice. The findings from this study and this two part educational session, aim to add to the conversation about strengthening interprofessional skills during internships by exploring strategies in clinical internships to advance teaching interprofessional skills.
References
1. Billet, S. Learning in the workplace: Strategies for effective practice. Crows Nest, Australia: Allen & Unwin, 2001.
2. Hammick, M, Freeth, D, Koppel, I, et al. A best evidence systematic review of interprofessional education: BEME guide no. 9. Med Teachr, 2007;29(8), 735-751. doi: 10.1080/01421590801682576
3. Reeves, S, Zwarenstein, M, Goldman, J, et al. The effectiveness of interprofessional education: Key findings from a new systematic review. J Interprof. Care, 2010;24(3), 230-241.
4 Lapkin, S, Levett-Jones, T, Gilligan, C. The effectiveness of interprofessional education in university based health professional programs: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 2011;9(46), 1917-1970. doi:10.1016/j.nedt.2011.1.006
5. Cooper, H, Carlisle, C, Gibbs, T, et al. Developing an evidence base for interdisciplinary learning: a systematic review. J Adv Nursing, 2001;35(2), 228-237.
6. Zwarenstein, M, Reeves, S, Perrier, L. Effectiveness of pre-licensure interprofessional education and post-licensure collaborative interventions. J Interprof. Care, 2005;19, 148-165. doi.org/10.1080/13561820500082800.
Course Objectives
1. Recognize evidence of the previously started conversation of interprofessional education in physical therapy thus far through a research review.
2. Differentiate between the didactic and clinic portions of the CAPTE criteria for interprofessional education.
3. Critique components of the study including use of the Interprofessional Collaboration Assessment Rubric (ICAR).
4. Engage in discussion over the results of the study including strengths and barriers to learning interprofessional skills.
5. Develop strategies to leverage catalysts over barriers to obtain interprofessional competencies, in the clinical portion of the DPT degree.
Instructional Methods
Educational Session
Tentative Outline/Schedule
Objectives:
Instructional Methods: Educational session
Time line:
10 min:
Introduction on workplace learning theory and research
20 min:
Expand the workplace learning conversation to physical therapy education, specifically the clinical portion of the degree and how this relates to obtainment of interprofessional skills.
10 min:
Review of CAPTE requirements that are attributed toward interprofessional education, specifically the clinical portion
20 min:
Presentation of study design, methods, results
15 min:
Further presentation on results including attributes that enhances and those that detracted
15min:
Open up to discussion about these catalysts and detractors in clinical education regarding interprofessional skill obtainment
15 min:
Brain storm ways to leverage these discoveries.
15 min:
Conclusion and wrap up