Interprofessional nutrition management – implementation and evaluation of a course for medical and nursing students using research-based learning method.
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ABSTRACT:
SUBMITTER: Wesselborg B
PROVIDER: S-EPMC6905358 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
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Project description:Interprofessional collaboration is of great importance in clinical practice, particularly in the field of emergency medicine. The professions involved in providing emergency care must work hand in hand, and tasks and routines must be coordinated effectively. However, medical and nursing students have only few opportunities to experience interprofessional cooperation during their formal training. Addressing this situation, the Department of Anesthesiology and the Vocational School of Greifswald University Medical School initiated a project to increase patient safety by integrating interprofessional human factor training into the curriculum of both health professions. This manuscript addresses how an interprofessional course module focusing on clinical emergency medicine can be taught with an emphasis on competency and problem-solving. In addition, it was important to identify suitable instruments for systematic quality development and assurance of this teaching and learning format.The aim of the project, which took place from October 2013 to September 2015, was the development, implementation and evaluation of a simulation-based, interprofessional course module on clinical emergency medicine. Target groups were medical and nursing students. Modern pedagogical models and methods were applied to the design and teaching of the course content. The project was carried out in separate phases: definition, planning, practical implementation, evaluation and documentation. The project was accompanied by systematic quality development. Established guidelines for quality-centered school development were applied to quality development, assurance and evaluation.Over two years, a 16 credit-hour course module was developed and then taught and evaluated during the 2014 and 2015 summer semesters. A total of 120 medical students and 120 nursing students participated in the course module. Eighteen teachers from medicine and nursing were trained as instructors and assisted by 12 student tutors. Regular evaluations focused on different aspects of the project, using instruments for empirical educational research. Excellent ratings given to the course by the attendees indicate a high degree of satisfaction in both participating professions regarding course design and content, as well as the quality of teaching.In a position paper, the GMA committee on Interprofessional Education in Health Professions issued recommendations for interprofessional education. The recommendations given for teaching and quality assurance are drawn upon here, and relevant examples from the course concept presented.The design of the course corresponds to the recommendations of the GMA committee on Interprofessional Education in the Health Professions. Based on these, and considering the satisfactory evaluations, both continuation and further development of this interprofessional teaching format are justified.
| S-EPMC4895854 | biostudies-other
Project description:This study explores the extent to which a one-week nursing rotation for medical students changed the interprofessional attitudes of the participating nurses and students. Third-year medical students worked with nurses before starting clinical rotations. Pre- and post-experience surveys assessing perceptions of mutual respect, nurse-doctor roles, and interprofessional communication and teamwork were given to 55 nurses and 57 students. The surveys consisted of qualitative questions and a Likert scale questionnaire that was analyzed using qualitative and quantitative content analyses. The response rate was 51/57 (89%) students and 44/55 (80%) nurse preceptors. Nurses reported that students met nurses' expectations by displaying responsibility, respect, effective communication, and an understanding of nursing roles. Medical students' narratives demonstrated two significant changes. First, their views of nurses changed from that of physician helpers to that of collaborative patient-centred professionals. Second, they began defining nursing not by its tasks, but as a caring- and communication-centred profession. Responses to Likert-scaled questions showed significant differences corresponding to changes described in the narrative. A one-week immersive clinical nursing rotation for medical students was a transformative way of learning interprofessional competencies. Learning in an authentic workplace during a clinical rotation engendered mutual respect between nurses and future doctors. Students' view of the role of nurses changed from nurses working for doctors with patients, to working with doctors for patients.
| S-EPMC5967832 | biostudies-literature
Project description:IntroductionPatient safety education is required in medical, nursing, and pharmacy training, and interprofessional education offers an ideal format for teaching the core concepts of patient safety. This training activity was developed to fulfill interprofessional education core competencies for communication and teamwork and was nested within a required patient safety course taught at a medical school. However, the activity can easily be adapted as a stand-alone offering that can be included in a preclinical doctoring course, offered as an elective, or hosted at a college of nursing or pharmacy. Our goal was to prepare learners for the clinical environment by providing a context for patient safety, communication, and teamwork.MethodsStudents participate in a 1.5-hour large-group activity that explores a case from the perspectives of each discipline. Faculty from all three disciplines sequentially present and debrief the case using focused questions to guide students' reflections and interactions between team members.ResultsWe have presented this activity for 4 consecutive years. Students complete a questionnaire with retrospective pre-post ratings of their perspectives on the activity and its impact on their awareness of disciplinary roles and responsibilities, communication errors, and strategies for addressing interdisciplinary conflicts. Results show statistically significant increases in the items of interest.DiscussionThis interprofessional education offering is effective in terms of increasing awareness and knowledge among members of three health care disciplines, improving awareness of potential kinds of communication errors, and helping students consider the role of interdisciplinary interactions.
| S-EPMC6338184 | biostudies-literature
Project description:Introduction: Despite its frequency, malnutrition is underestimated in its importance for morbidity and mortality. Interprofessional nutrition management can improve patient safety and clinical outcomes. An interprofessional education is considered as the basis for good team cooperation. So far, little data is available on the effects of interprofessional education on measurable outcomes for patients. The objective is to determine to what extent student feedback leads to a change of in-patient nutritional management for a selected internal medical ward. Methodology: In a teaching project based on the method of research oriented learning, medical and nursing students conducted an analysis of the nutritional situation of patients and developed individual treatment plans. The students orally reported their findings to the care teams as well as via a poster presentation to decision-makers of the clinic. A prospective cohort intervention study was conducted to assess the nutritional status of patients before and after student interventions using established screening tools. Differences were tested using t-test and Fisher's exact test. Institutional consequences for nutrition management were recorded descriptively. The teaching unit was evaluated by the students before and after. Results: Malnutrition was found in 59% of patients. Inspired by student feedback, institutional consequences followed: a) routine inpatient screening using Nutritional Risk Screening; and b) the use of pie charts to estimate food intake. Conclusion: The feedback from the results of student interprofessional cooperation led to a sensitization of decision-makers and enabled new measures to improve nutritional management. These can increase patient safety.
| S-EPMC6446465 | biostudies-literature
Project description:IntroductionMany physicians do not feel competent providing nutritional counseling to patients. A minimum of 25 hours dedicated to nutrition is recommended in preclinical years, but only 40% of U.S. medical schools achieve this goal. Nutrition counseling is best done when physicians work collaboratively with registered dietitians (RDs). We sought to introduce this interprofessional approach in our preclinical curriculum.MethodsIn our first-year doctoring course, students viewed a nutrition lecture from a physician and RD. Teams of two to three medical students and one dietetics student were formed. The medical students took a history and performed nutrition counseling on the dietetics student role-playing a patient. The RD student provided feedback and reviewed clinical questions pertaining to the nutrition case. Medical students presented answers to their assigned case to the whole group. Medical students completed pre-/postsurveys assessing satisfaction and perceived confidence with nutrition counseling and were formally assessed using a standardized patient. The scores were compared to students from the year before who received the lecture but not the RD student activity.ResultsEighty-one medical students participated. After the activity, there was an increase in confidence with nutrition counseling (p < .001), and 74% found working with dietetics students to be helpful or extremely helpful. The nutrition counseling mean score increased from 68% (historical control, n = 76) to 84% (n = 75; p < .001) on the standardized patient assessment.DiscussionThis format is an effective method of teaching nutrition counseling and promoting interprofessional behavior among rising physicians and RDs.
| S-EPMC6342344 | biostudies-literature
Project description:The aim of the course "interprofessional communication and nursing" is to reflect medical students' experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration.The design of the course includes an assessment of a change in the students' perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students' perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students' knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students' research papers.The assessment of the students' perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team.Interprofessional education is an important part of medical education and should be a topic from the beginning. The assessment of the course shows that it is possible and important to integrate the topic early in the curriculum.
| S-EPMC4895841 | biostudies-other
Project description:BackgroundTeamwork and communication are essential tools for doctors, nurses and other team members in the management of critically ill patients. Early interprofessional education during study, using acute care simulation, may improve teamwork and communication between interprofessional team members on the long run.MethodsA comparative sequential quantitative-qualitative study was used to understand interprofessional learning outcomes in nursing and medical students after simulation of acute care. Students were assigned to a uni- or interprofessional training. Questionnaires were used to measure short and long term differences in interprofessional collaboration and communication between the intervention and control group for nursing and medical students respectively. Semi-structured focus groups were conducted to gain a better understanding of IPE in acute simulation.ResultsOne hundred and ninety-one students participated in this study (131 medical, 60 nursing students). No differences were found between the intervention and control group in overall ICCAS scores for both medical and nursing students (p = 0.181 and p = 0.441). There were no differences in ICS scores between the intervention and control group. Focus groups revealed growing competence in interprofessional communication and collaboration for both medical and nursing students.ConclusionsInterprofessional simulation training did show measurable growth of interprofessional competencies, but so did uniprofessional training. Both medical and nursing students reported increased awareness of perspective and expertise of own and other profession. Furthermore, they reported growing competence in interprofessional communication and collaboration in transfer to their workplace.
| S-EPMC9921059 | biostudies-literature
Project description:IntroductionErrors that harm patients often have many contributing factors and ideally should be disclosed by a team rather than an individual provider. However, most health professions students learn about errors and error disclosure in a single-profession class.MethodsWe developed a 2-hour small-group session in which our students practice discussing and disclosing a medical error that involves several professions, following a communication map. As they practice, students gain an understanding of the roles, skills, and perspectives of the other professions represented in the group.ResultsOver the last 5 years, student evaluations have been very positive. In 2016, our students strongly agreed that "The small group skills practice was a useful and interesting learning opportunity," "Learning with other professional students was valuable," and "Thinking about error disclosure from a team perspective was helpful." Student comments consistently indicated that they learned both about disclosing medical errors as well as other professionals' roles and perspectives.DiscussionThis activity has met both of our major goals. The first was to bring health professions students together to learn with, from, and about each other. The second was to practice a critical and challenging communication skill. This activity has been successfully implemented at other institutions, and can be adapted to fit other groups of students.
| S-EPMC6338166 | biostudies-literature
Project description:Objectives: Interprofessional collaboration is becoming increasingly important in health care for various reasons. Interprofessional Education (IPE) can provide a basis for this. The aim of our study was to find out how medical (MS) and nursing students (NS) think about their own and other professions, what they know about each other, how strong their willingness to embrace IPE is, and what forms of IPE they deem useful. Methodology: Seven IPE experts rated the two measuring instruments, Readiness for Interprofessional Learning Scale RIPLS, and Interdisciplinary Education Perception Scale IEPS in terms of relevance of the items, and the quality of translation into German. Nine RIPLS items and 13 IEPS items were considered content-valid. All MS of the University of Bern and NS of the two Bernese educational institutions for nursing were invited to the online survey in the fall of 2014 by email. Results: 498 (254 MS, 244 NS) of the 2374 invited students completely filled in the questionnaire (21%). The results of the reduced RIPLS allowed no conclusive statements. When assessing their own occupational group in the IEPS, the MS attributed "competence and autonomy" to themselves significantly more frequently, while to the NS, the same was true for the item, "actual cooperation". MS know significantly less about the training of other health professionals. NS show a significantly higher willingness to embrace IPE. Teaching ethics, communication, team training, and clinical skills are deemed suitable for IPE by both groups. From the comments it appears that in both groups a majority welcomes IPE; however, the various arguments had different prevalence in both groups. Both groups fear that IPE leads to heightened stress during the study. A subgroup of MS fears a lowering of academic level. Conclusion: The results of this survey of Bernese MS and NS concerning IPE provide important information for the planning and implementation of IPE. Important steps in the introduction of IPE will be a clear justification and the definition of its objectives. These must be explicitly communicated to all students.
| S-EPMC5135421 | biostudies-literature
Project description:Introduction:Dietary factors are recognized as a major contributor to the global burden of disease, and the obesity epidemic continues to be a major public health problem. Patients rely on doctors for dietary advice and to serve as role models for health behaviors. However, nutrition content is significantly underrepresented in medical school curricula. Methods:We created an interactive session to address this gap during the ambulatory medicine rotation for senior medical students and delivered it as a 90- to 120-minute interactive monthly didactic session. We focused on reviewing evidence-based diet patterns for weight loss and hypertension and on use of practical tools for diet assessment and counseling. Immediately and 1 month after delivery, we administered a knowledge and confidence assessment survey to evaluate the session impact. Results:We incorporated the session into the regular didactic time of the clerkship. Sixty-six students attended over an 8-month period, of whom 42 completed the survey. Immediately and 1 month after delivery, participants reported statistically significant improvements (p < .001) in their confidence in the domains measured. Participants' knowledge scores increased immediately and 1 month after the session compared to before participation. Discussion:We delivered a single recurring seminar on diet patterns and practical tips that was well received by fourth-year medical students during the ambulatory medicine clerkship. The seminar was a practical and interactive way of delivering important nutrition content to the medical school curriculum, and we demonstrated retention of confidence and knowledge of the delivered content.
| S-EPMC7012311 | biostudies-literature