Exploring interprofessional clinical placements to understand perceptions and outcomes for pre-registration healthcare students

Background There is an ongoing need for preregistration healthcare students to acquire skills that equip them to collaborate with others for patient-centred care and outcomes. Traditional models of university learning and clinical placement seldom offer students the opportunities to experience interprofessional learning or to ‘test the waters’ of collaborative practice. Aims A range of interprofessional learning opportunities were offered to preregistration healthcare students while on clinical placement in a large metropolitan health service. This research evaluated interprofessional learning opportunities for preregistration healthcare students as preparation for collaborative practice. It also explored the perceived value for student learning of these activities and examined the challenges and opportunities accompanying the design and implementation of the student-led beds model. Methods A mixed methods approach was undertaken. In particular, there was a focus on the experiences of students in an immersive two-week interprofessional placement in which interprofessional student teams worked together to lead the care of inpatients in a variety of clinical settings. This experience enabled students to experience authentic collaborative practice in a real clinical setting. The Theory of Planned Behaviour was used to retrospectively evaluate the findings presented in the published papers. Outcomes This research reflects a journey of student experience of clinical interprofessional learning (IPL), from understanding attitudes to IPL to perceptions of clinical workshops and culminating in the experience of an immersive clinical placement. Outcomes included positive learning experiences and a sense of clarity of professional and interprofessional identity. The model of placement was informed by the international literature, most notably the ‘student-led bed’ model pioneered at Karolinska Institute in Sweden. Despite solid evidence of the usefulness and efficacy of this model, it is yet to be embedded in clinical environments across the world. This research demonstrated that the model can be successfully implemented in a metropolitan health service and may contribute to real behavioural change of our future health professionalsDoctor of Philosoph

Statistical review of Hydroxychloroquine in patients with COVID-19 : an open-label, randomized, controlled trial

Publisher PD

Evaluation of interprofessional student teams in the emergency department : opportunities and challenges

Background: Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning. Methods: An interprofessional clinical placement program was implemented with the aim to enhance students’ capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students’ perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences. Results: The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging. Conclusions: Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students’ clinical supervision are proposed for the placement model. © 2022, The Author(s)

Parents' and clinicians' views of an interactive booklet about respiratory tract infections in children: a qualitative process evaluation of the EQUIP randomised controlled trial

Background: ‘When should I worry?’ is an interactive booklet for parents of children presenting with respiratory tract infections (RTIs) in primary care and associated training for clinicians. A randomised controlled trial (the EQUIP study) demonstrated that this intervention reduced antibiotic prescribing and future consulting intentions. The aims of this qualitative process evaluation were to understand how acceptable the intervention was to clinicians and parents, how it was implemented, the mechanisms for any observed effects, and contextual factors that could have influenced its effects.<p></p> Methods: Semi-structured interviews were conducted with 20 parents and 13 clinicians who participated in the trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using a framework approach, which involved five stages; familiarisation, development of a thematic framework, indexing, charting, and interpretation.<p></p> Results: Most parents and clinicians reported that the ‘When should I worry’ interactive booklet (and online training for clinicians) was easy to use and valuable. Information on recognising signs of serious illness and the usual duration of illness were most valued. The interactive use of the booklet during consultations was considered to be important, but this did not always happen. Clinicians reported lack of time, lack of familiarity with using the booklet, and difficulty in modifying their treatment plan/style of consultation as barriers to use. Increased knowledge and confidence amongst clinicians and patients were seen as key components that contributed to the reductions in antibiotic prescribing and intention to consult seen in the trial. This was particularly pertinent in a context where decisions about the safe and appropriate management of childhood RTIs were viewed as complex and parents reported frequently receiving inconsistent messages. Conclusions: The ‘When should I worry’ booklet, which is effective in reducing antibiotic prescribing, has high acceptability for clinicians and parents, helps address gaps in knowledge, increases confidence, and provides a consistent message. However, it is not always implemented as intended. Plans for wider implementation of the intervention in health care settings would need to address clinician-related barriers to implementation

Statistical review of Remdesivir in adults with severe COVID-19 : a randomised, double-blind, placebo-controlled, multicentre trial

Publisher PD

Understanding students' and clinicians' experiences of informal interprofessional workplace learning: An Australian qualitative study

Objectives While postgraduate studies have begun to shed light on informal interprofessional workplace learning, studies with preregistration learners have typically focused on formal and structured work-based learning. The current study investigated preregistration students' informal interprofessional workplace learning by exploring students' and clinicians' experiences of interprofessional student-clinician (IPSC) interactions. Design A qualitative interview study using narrative techniques was conducted. Setting Student placements across multiple clinical sites in Victoria, Australia. Participants Through maximum variation sampling, 61 participants (38 students and 23 clinicians) were recruited from six professions (medicine, midwifery, nursing, occupational therapy, paramedicine and physiotherapy). Methods We conducted 12 group and 10 individual semistructured interviews. Themes were identified through framework analysis, and the similarities and differences in subthemes by participant group were interrogated. Results Six themes relating to four research questions were identified: (1) conceptualisations of IPSC interactions; (2) context for interaction experiences; (3) the nature of interaction experiences; (4) factors contributing to positive or negative interactions; (5) positive or negative consequences of interactions and (6) suggested improvements for IPSC interactions. Seven noteworthy differences in subthemes between students and clinicians and across the professions were identified. Conclusions Despite the results largely supporting previous postgraduate research, the findings illustrate greater breadth and depth of understandings, experiences and suggestions for preregistration education. Educators and students are encouraged to seek opportunities for informal interprofessional learning afforded by the workplace. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Kerry Hood” is provided in this record*

Effectiveness of active support for adults with intellectual disability in residential settings : systematic review and meta-analysis

Background The review examined the effectiveness of Active Support (RQ1) and stakeholders’ experiences of the model (RQ2). Method Data were meta-analysed (RQ1; Studies=14) and synthesised narratively (RQ2; Studies=10). Results By follow-up (six-months post-training), effect sizes (RQ1) for resident total activity engagement were significant and ranged from small (d=0.33, 95% CIs: 0.10, 0.50) to large (Tau-U=0.95, 95% CIs: 0.64, 1.25) depending on study design. Follow-up changes in staff assistance were moderate (d=0.56, 95% CIs: 0.23, 0.89; Tau-U 0.63, 95% CIs: 0.32 to 0.93) and large for quality of support (d=1.03, 95% CIs: 0.61, 1.44). Other outcomes did not change. Conclusions Active Support was more effective following complete staff training, in larger settings, at lower staff-to-resident ratios, and with less experienced staff. Active Support training and outcomes were valued by staff and residents (RQ2), and staff experienced increased job satisfaction. Lower staff turnover and organisational readiness appear crucial for maintaining implementation