Interprofessional Teamwork Through Remote Collaboration: A Mixed-Methods Approach

Introduction: Quality health care relies on effective, patient-centered teamwork. Interprofessional education and learning is one of the foundations of health education. These principles were challenged during the COVID-19 pandemic. We sought to determine whether a collaborative, online learning activity would be experienced as interprofessional by learners from eight health professions. Methods: A mixed-methods, cross-sectional cohort study with retrospective analysis of survey data was utilized. Two custom-designed exit surveys to assess team behaviors: one from the learners’, the second from the faculty observers’ perspective. A thematic analysis of two open-ended questions was completed. Results: Nursing was the largest discipline (45 %) participating. Most participants (79 %) reported previous face-to-face interprofessional learning experiences. Correlational analysis showed no association between prior participation in face-to-face IPE and perception that the remote activity was interprofessional. Qualitative analysis revealed recurrent themes of “teamwork and professional collaboration”. A positive correlation between student engagement and learning on an electronic platform was detected. Discussion: Remote learning activities are experienced as “interprofessional” by learners even if those learners have previously experienced in-person collaborative activities. The results align with existing knowledge that student engagement is an important factor in the success of online learning

Pharmacological Properties and Functional Role of Kslow Current in Mouse Pancreatic β-Cells: SK Channels Contribute to Kslow Tail Current and Modulate Insulin Secretion

The pharmacological properties of slow Ca2+-activated K+ current (Kslow) were investigated in mouse pancreatic β-cells and islets to understand how Kslow contributes to the control of islet bursting, [Ca2+]i oscillations, and insulin secretion. Kslow was insensitive to apamin or the KATP channel inhibitor tolbutamide, but UCL 1684, a potent and selective nonpeptide SK channel blocker reduced the amplitude of Kslow tail current in voltage-clamped mouse β-cells. Kslow was also selectively and reversibly inhibited by the class III antiarrythmic agent azimilide (AZ). In isolated β-cells or islets, pharmacologic inhibition of Kslow by UCL 1684 or AZ depolarized β-cell silent phase potential, increased action potential firing, raised [Ca2+]i, and enhanced glucose-dependent insulin secretion. AZ inhibition of Kslow also supported mediation by SK, rather than cardiac-like slow delayed rectifier channels since bath application of AZ to HEK 293 cells expressing SK3 cDNA reduced SK current. Further, AZ-sensitive Kslow current was extant in β-cells from KCNQ1 or KCNE1 null mice lacking cardiac slow delayed rectifier currents. These results strongly support a functional role for SK channel-mediated Kslow current in β-cells, and suggest that drugs that target SK channels may represent a new approach for increasing glucose-dependent insulin secretion. The apamin insensitivity of β-cell SK current suggests that β-cells express a unique SK splice variant or a novel heteromultimer consisting of different SK subunits

Evaluating Interprofessional Competencies and Knowledge of and Confidence in Addressing Social Determinants of Health

Promoting health requires coordinated, team-based interventions responsive to multiple determinants of health. This study aimed to determine if interprofessional competencies and knowledge of and confidence in addressing the social determinants of health improved following an interprofessional learning event. A two-group randomized controlled trial was used to determine study outcomes among 408 health science students from 14 health profession programs in the Midwest. Formed groups were randomly assigned to the customary medical-based (control) or social determinants of health focused (experimental) case study. In small groups students engaged in a case study simulation and offered recommendations for intervention. Small improvements in knowledge of the social determinants of health were found among participants in both groups. Interprofessional competencies largely showed no significant differences between using the case study which emphasized social determinants of health compared to a medically based case study. The suggestions for interventions resulted in more frequent recommendations related to socioeconomic status and access to health care among students in the experimental group versus the recommendation of medically based health services among students in the control group. Additional qualitative research is recommended to learn more about how groups collaborated to form these recommendations

Development of Learning Materials to Address Social and Medical Factors Impacting a Minoritized Population

Health outcomes are multi-factorial. Health professionals must weigh all factors when making recommendations and providing intervention, however, limited learning materials which describe the health of minoritized populations exist for students in health science educational programs, necessitating the development of content for interprofessional learning that address the health factors experienced by underserved populations. This study used a descriptive design. Eleven expert content reviewers from eight health science and medical professions were recruited and provided feedback on the quality and content of a developed case study that described the lifestyle and health status of an individual from an ethnic minoritized population. Participants strongly agreed that the content strengthened the case study’s usefulness as a tool for interdisciplinary education. Most reviewers strongly agreed that social factors were a key component of the case and that it was suitable for use in interdisciplinary education. Incorporating social determinants into a case was viewed favorably by case reviewers who indicated that the components of the case were high quality and important as a tool for interprofessional education

The COVID Pandemic Prompts Interprofessional Learning in an Online Format

Interprofessional education is generally defined as “when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes”. IPE is most effective when interaction occurs between students and when learning methods reflect the real world practice experiences of students. This principle was challenged during the recent Covid-19 pandemic. Due to the sudden move to increased online learning, institutions of higher learning have had to improvise and adapt their established interprofessional learning environments to an online format. This presented many hurdles because little was known about how team function translates to an online environment. At the USD School of Health Sciences (SHS), the annual IHEC Activities Day planned for March 24, 2020 had to be adapted to an online format on short notice. The Student Learning Objectives were to: 1. Work as a healthcare team that interacts remotely to complete an assignment. 2. Function as a member of an interprofessional team, accepting input from and valuing contributions by team members of all professional levels and disciplines. 3. Demonstrate, through remote interactions with other health care professionals, professional attitudes and share knowledge. 4. Consider a complex, real-time, emergent situation and propose solutions that are based on science and research. The purpose of this study was to determine whether students working in physical isolation but through a remote Zoom platform, and working on a group assignment, would experience the activity as interprofessional. The results show that students perceive working as remote teams as “interprofessional”

A calcium sensor in the sodium channel modulates cardiac excitability

Sodium channels are principal molecular determinants responsible for myocardial conduction and maintenance of the cardiac rhythm. Calcium ions (Ca2+) have a fundamental role in the coupling of cardiac myocyte excitation and contraction, yet mechanisms whereby intracellular Ca2+ may directly modulate Na channel function have yet to be identified. Here we show that calmodulin (CaM), a ubiquitous Ca2+-sensing protein, binds to the carboxy-terminal 'IQ' domain(1) of the human cardiac Na channel (hH1) in a Ca2+-dependent manner. This binding interaction significantly enhances slow inactivation-a channel-gating process linked to life-threatening idiopathic ventricular arrhythmias(2,3). Mutations targeted to the IQ domain disrupted CaM binding and eliminated Ca2+/CaM-dependent slow inactivation, whereas the gating effects of Ca2+/CaM were restored by intracellular application of a peptide modelled after the IQ domain. A naturally occurring mutation (A1924T) in the IQ domain altered hH1 function in a manner characteristic of the Brugada arrhythmia syndrome(4,5), but at the same time inhibited slow inactivation induced by Ca2+/CaM, yielding a clinically benign (arrhythmia free) phenotyp