Changing the channel: the effect of an innovative video intervention on resident attitudes towards interprofessional collaboration on a Geriatric Medicine Unit

Krista Whitney; Vanessa Peck; Allen R Huang; Junghyun Park; Prudy Menard; Jason MacDonald; Edward Spilg; Lara Khoury

doi:10.36834/cmej.71529

Authors

Krista Whitney University of Ottawa
Vanessa Peck The Ottawa Hospital
Allen R Huang University of Ottawa https://orcid.org/0000-0003-2680-7657
Junghyun Park University of Ottawa
Prudy Menard University of Ottawa
Jason MacDonald University of Ottawa
Edward Spilg University of Ottawa https://orcid.org/0000-0002-6012-1571
Lara Khoury University of Ottawa https://orcid.org/0000-0002-0150-840X

DOI:

https://doi.org/10.36834/cmej.71529

Abstract

Background: Medical learners develop a more positive attitude toward Interprofessional Collaboration (IPC) following Interprofessional Education (IPE) programs. However, IPE is not standardized and the most effective teaching tool is unclear. The purpose of our study was to develop an IPE teaching tool for medical residents during an inpatient geriatric medicine rotation at an academic hospital, evaluate and explore the impact of the program on resident attitudes towards teamwork, and identify barriers and facilitators to interprofessional collaboration.

Methods: An innovative video was developed which simulated a common IPC scenario. Near the start of the rotation, learners watched the video then participated in a facilitated discussion around principles of IPE, using the Canadian Interprofessional Health Collaborative (CIHC) framework, which highlights interprofessional communication, patient-centered care, role clarification, team functioning, collaborative leadership, and interprofessional conflict resolution. At the end of their four-week rotation, focus groups were conducted to explore resident attitudes towards IPE. The Theoretical Domain Framework (TDF) was used for qualitative analysis.

Results: Data from 23 participants in five focus groups were analyzed using the TDF framework. Residents were able to identify barriers and facilitators to IPC in five TDF domains: environmental context and resources, social/professional role and identity, knowledge, social influences and skills. Their observations correlated with the CIHC framework.

Conclusion: The use of a scripted video and facilitated group discussion gave insights into residents’ attitudes, perceived barriers and facilitators towards IPC on a geriatric medicine unit. Future research could explore the use of this video intervention in other hospital services where team-based care is important

References

World Health Organization. Framework for action on interprofessional education and collaborative practice. 2010. https://apps.who.int/iris/handle/10665/70185

Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. 2017;6,CD000072. https://doi.org/10.1002/14651858.CD000072.pub3

CAIPE (2002) Interprofessional Education - Today, Yesterday and Tomorrow (Barr, H.) Higher education academy, learning & teaching support network for health sciences & practice, Occasional Paper 1. 2017, Dec 6. https://www.caipe.org/resources/publications/caipe-publications/caipe-2002-interprofessional-education-today-yesterday-tomorrow-barr-h [Accessed on Nov 23, 2020].

D’Eon, M. A blueprint for interprofessional learning. Med Teach. 2004;26:7, 604-609 https://doi.org10.1080/01421590400004924

Visser CLF, Ket JCF, Croiset G, Kusurkar RA. Perceptions of residents, medical and nursing students about Interprofessional education: a systematic review of the quantitative and qualitative literature. BMC Med Educ. 2017;17:77. https://doi.org/10.1186/s12909-017-0909-0

CAIPE. Interprofessional education guidelines. Barr H, Ford, J Gray R, et al. 2017, Aug 4. Available from https://www.caipe.org/resources/publications/caipe-publications/caipe-2017-interprofessional-education-guidelines-barr-h-ford-j-gray-r-helme-m-hutchings-m-low-h-machin-reeves-s [Accessed on Feb 26, 2022].

Vernon MM, Moore N, Mazzoli A, De Leo G. Respiratory therapy faculty perspectives on interprofessional education: Findings from a cross-sectional online survey. J Interprof Care. 2017;32:1–4. https://doi.org/10.1080/13561820.2017.1389865

Vernon MM, Moore NM, Cummins L-A, et al. Respiratory therapy faculty knowledge of and attitudes toward interprofessional education. Resp Care. 2017;62:873–881. https://doi.org/10.4187/respcare.05034

Tolle SL, Vernon MM, McCombs G, De Leo G. Interprofessional education in dental hygiene: Attitudes, barriers and practices of program faculty. J Dental Hygiene.2019;93:13–22.

Patton Z, Vernon M, Haymond K, Anglin J, Heboyan V, De Leo G. Evaluation of interprofessional education implementation among nutrition program directors in the United States. TIN. 2018;33:196–204. https://doi.org/10.1097/TIN.0000000000000143

Kent F, Glass S, Courtney J, Thorpe J, Nisbet G. Sustainable interprofessional learning on clinical placements: The value of observing others at work. J Interprof Care. 2020:1–7. https://doi.org/10.1080/13561820.2019.1702932

Armstrong KJ, Walker SE, Feld SD, Weidner TG. Athletic training students’ engagement in interprofessional education in the classroom and during clinical education. J Interprof Care. 2019:1–6. https://doi.org/10.1080/13561820.2019.1707173

Zechariah S, Ansa BE, Johnson S, Gates A, De Leo G. Interprofessional education and collaboration in healthcare: An exploratory study of the perspectives of medical students in the United States. Healthcare. 2019;7(117). https://doi.org/10.3390/healthcare7040117

Barker KK, Oandasan I. Interprofessional care review with medical residents: Lessons learned, tensions aired - a pilot study. J Interprof Care. 2005;19(3), 207–214. https://doi.org/10.1080/13561820500138693

Fox L, Onders R, Hermansen-Kobulnicky CJ, et al. Teaching interprofessional teamwork skills to health professional students: a scoping review. J Interprof Care. 2018;32(2), 127–135. https://doi.org/10.1080/13561820.2017.1399868

Faulk CE, Lee TJ, Musick D. Implementing a multidimensional geriatric curriculum in a physical medicine and rehabilitation residency program. Amer J Phys Med Rehab 2012;91(10), 883–889. https://doi.org/10.1097/PHM.0b013e318264408f

Menard P, Varpio L. Selecting an interprofessional education model for a tertiary health care setting. J Interprof Care. 2014;28(4), 311–316. https://doi.org/10.3109/13561820.2014.893419

Keijsers CJPW, Dreher R, Tanner S, Forde-Johnston C, Thompson S. Interprofessional education in geriatric medicine. J Euro Ger Med. 2016;7(4), 306–314. https://doi.org/10.1016/j.eurger.2016.01.011

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.

Bandura A. Social foundations of thought and action: a social cognitive theory. Prentice-Hall, Inc: Englewood Cliffs, NJ, US; 1986.

Atkins L, Francis J, Islam R, et al. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci. 2017;12(1):77. https://doi.org/10.1186/s13012-017-0605-9

Debono D, Taylor N, Lipworth W, et al. Applying the theoretical domains framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitals. Implement Sci. 2017;12(1):42. https://doi.org/10.1186/s13012-017-0572-1

Lawton R, Heyhoe J, Louch G, et al. Using the theoretical domains framework (TDF) to understand adherence to multiple evidence-based indicators in primary care: a qualitative study. Implement Sci. 2015;11(1):113. https://doi.org/10.1186/s13012-016-0479-2

Murphy K, O’Connor DA, Browning CJ, et al. Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study using the theoretical domains framework. Implement Sci. 2014;9(1):31. https://doi.org/10.1186/1748-5908-9-31

Peck V, Valiani S, Tanuseputro P, et al. Advance care planning after hospital discharge: qualitative analysis of facilitators and barriers from patient interviews. BMC Palliative Care. 2018;17:127. https://doi.org/10.1186/s12904-018-0379-0

Heinemann GD, Schmitt MH, Farrell MP, Brallier SA. Development of an attitudes toward health care teams scale. Eval Health Profess. 1999;22(1), 123-142. https://doi.org/10.1177/01632789922034202

Taylor N, Lawton R, Moore S, et al. Collaborating with front-line healthcare professionals: the clinical and cost effectiveness of a theory based approach to the implementation of a national guideline. BMC Health Services Research. 2014;14(1):648. https://doi.org/10.1186/s12913-014-0648-4

Mirbaha F, Shalviri G, Yazdizadeh B, Gholami K, Majdzadeh R. Perceived barriers to reporting adverse drug events in hospitals: a qualitative study using theoretical domains framework approach. Implementation Science. 2015;10(1):110. https://doi.org/10.1186/s13012-015-0302-5

Duncan EM, Francis JJ, Johnston M, et al. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors. Implementation Science. 2012;7(1):1. https://doi.org/10.1186/1748-5908-7-86

McCluskey A, Vratsistas-Curto A, Schurr K. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study. BMC Health Services Research. 2013;13(1):323. https://doi.org/10.1186/1472-6963-13-323

Khoury, L. Interprofessional education in geriatrics. [Video]. 2020. Available from: https://www.youtube.com/watch?v=BICr31O-NzA

Canadian Interprofessional Health Collaborative. A national interprofessional competency framework. 2010. https://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf [Accessed Aug 1, 2019].

Terry G, Hayfield N, Clarke V, Braun V. Thematic analysis. In: The Sage handbook of qualitative research in psychology. Los Angeles: Sage; Jun 30, 2017:17-37.

Frank JR, Snell L, Sherbino J. (Eds.). CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada. 2015.