Using interprofessional dementia learning opportunities to prepare the future healthcare workforce: Findings from a pilot study

Nearly 50 million people worldwide are living with dementia. Communication difficulties linked to this illness demand that all healthcare professionals are prepared to meet the needs of this group of service users. In response to this, the United Kingdom government is calling for professionals to acquire a basic (Tier 1) Dementia Awareness (DA) qualification. As healthcare students need to engage in interprofessional learning (IPL), this report describes the development, implementation and evaluation of an initiative to link the DA qualification to an existing IPL module delivered to first-year healthcare students (IPL1). A DA learning package was developed by a group of educators from a range of professions to ensure an interprofessional focus. It comprised of a set of practical exercises that students completed during and after IPL1. Sixty students evaluated the DA learning package by completing a post-intervention survey. 57 students rated it helpful or very helpful, in enhancing their knowledge of how to care for a person with dementia, while 3 students rated it as average. Two themes emerged from open-ended questions, which highlighted the importance of: i) learning to work together; and ii) blended learning. Students also suggested some changes for the full roll out, such as moving the Dementia Friends component into IPL1. This is an innovative approach that can be used to meet the challenges linked with the large-scale preparation of our future workforce and to ensure purposeful IPL

Activities by Hediste diversicolor under different light regimes: experimental quantification of particle reworking using time-resolved imaging

Particle reworking by the ragworm Hediste diversicolorwas assessed by quantifying the transport of fluorescent particles (luminophores) added to the surface sediment during a 10 day experiment. Plexiglass cores and thin glass aquaria with fauna and controls were exposed to either 12 hour light/dark cycles or constant darkness. Luminophore distributions were evaluated by side-view imaging of the aquaria together with destructive sectioning and quantification of tracer distributions in both types of microcosms at the end of experiments. Tracer distributions were evaluated by the gallery-diffusor model, from which the biodiffusion (Db) and the non-local transport (r) coefficients were determined. In addition, the maximum penetration depth (MPD) of luminophores, the 2-D redistribution coefficient, and the transport ratewere used as a suite of proxies to quantify particle reworking by fauna. All measured reworking proxies demonstrated a general decrease in transport of luminophores in darkness compared to light/dark cycles. The difference was significant for proxies determined from sectioning. Imaging of particle transport demonstrated that rates were ~30% higher during light/dark cycles, with ~constant amount of particles transported on a daily basis. The effect of light was consistent in the two microcosm types. However, there was a significant difference in Db, while r and MPD were not significantly different between the cores and aquaria. Overall, these results suggest a light-triggered surface feeding by H. diversicolor. Our study highlights the importance of experimental settings for quantification of particle transport by fauna, and that light conditions and types of experimental microcosms need to be carefully considered during investigations of bioturbation in illuminated environments

“From doing to knowing”: Medical students’ experiences of working as Healthcare Assistants

There is growing recognition that doctors need to deliver person-centred care. More evidence is needed on how to best equip students in an already busy curriculum. Providing medical students with the opportunity to work as Healthcare Assistants (HCAs) can help them develop the desired skills. This study examined medical students’ experiences of working as HCAs and perceived impact on their future practice. Adopting an Interpretative Phenomenological Analysis approach, we analysed narratives from two focus groups of 13 ‘Year 0’ and ‘Year 1’ medical students, who had completed an HCA project. This project allowed participants to experience a new dimension of patient care whereby learning by “doing” evolved to a deeper level of “knowing” patients, the HCA role and the wider team. Four major themes were identified: seeing the doctor: gaining new perspectives; building confidence: learning from and about patients; understanding the overall patient experience: providing personal care; finding ‘the person behind the patient’: exploring beyond the diagnosis. This study suggests that working as an HCA enables participants to develop sustainable skills that equip them for their future role as doctors able to deliver patient-centred care as part of an interprofessional team. Recommendations for inclusion of this type of intervention into the medical curriculum are discussed

Mentoring medical students as a means to increase healthcare assistant status: A qualitative study

Aim: To offer a practical way in which the status of healthcare assistants (HCAs) can be increased by drawing on their experience, knowledge and skillset, whilst mentoring medical students during an HCA project. Design: Qualitative, reflexive thematic analysis. Methods: One-to-one semi-structured interviews were conducted between April and June 2019, with 13 participants. Participants included five healthcare assistants; three practice development nurses, two of whom were former HCAs; one registered general nurse and four clinical educators. Results: Two themes were identified: HCAs as silent, invisible caregivers (theme 1) and the formation of an HCA identity through mentoring (theme 2). HCAs are often silent performers of complex patient care with limited opportunity to engage in the interprofessional team dialogue. Social perceptions of HCAs describe them as a marginalised, poorly understood, ‘unqualified’ group with ‘lowly status’. Mentoring medical students allows HCAs to draw on their experience, knowledge and skillset by actively contributing to the learning and development of future doctors. Conclusion: The mentoring of medical students gave HCAs an active voice within the interprofessional team, instilling their confidence and self-worth. Mentoring allowed HCAs to move from a homogenous, group-based social identity to a role-based one that enabled HCAs to reveal the true extent of their work whilst negotiating their place and identity within the interprofessional team. Impact Leaders in healthcare will see that a re-evaluation of HCAs as performers of basic, hands-on patient care is needed to breakdown ingrained beliefs, eliminating a ‘us and them’ mentality. Involving HCAs in the mentoring of medical students will impact on the personal development of both HCAs and medical students in the cultivation of a future, person-centred, inclusive and collaborative workforce. Reporting Method COREQ guidelines to enhance methodological rigour were strictly adhered to. Patient and Public Involvement There is no patient or public involvement

University teachers’ views of interprofessional learning and their role in achieving outcomes - a qualitative study

Over the past decade, there has been a rapid increase in higher education institutions offering opportunities for interprofessional learning (IPL) to their students. The literature presents a number of factors that contribute to effective IPL, including having trained facilitators that help optimise the learning process. Many of these IPL facilitators are university teachers and the literature provides us with some insight into their views of IPL. However, little is known about university teachers’ views about IPL and their role in supporting students in achieving outcomes linked to IPL during their own teaching; this paper explores these areas. University teachers, working with students in Norway and England who contribute to patients’ care pathway were purposively invited to join focus groups. Data collected from the teachers’ conversations during these focus groups were analysed to elicit the main themes. Findings show that university teachers have a wide range of views about IPL, its potential to enhance collaborative practice and care, and their role in helping students achieve outcomes linked to IPL. A key challenge appears to be whether IPL is “worth the struggle,” which emphasises the need for strong leadership in order to align pedagogical approaches in education and practice that strive to achieve agreed outcomes

Training students as interprofessional learning facilitators: An exploratory study highlighting the need to build confidence

Interprofessional learning (IPL) aims to equip students for future interprofessional and collaborative practice. Involving students as IPL facilitators is becoming increasingly commonplace as an attempt to catalyse the necessary transformation of our workforce needed to deliver truly integrated and person-centred care. Evidence in the literature highlights the key role of trained facilitators in reaching successful IPL outcomes. Some guidelines are available as to how we train staff facilitators, but little evidence is available that describes how to appropriately prepare student IPL facilitators. The aim of this exploratory study was to investigate whether student IPL facilitators felt that they were sufficiently prepared for their role. Data in the form of open-ended text-based responses from student facilitators (n = 9) were collated after an intervention where student facilitators had been given the role of supporting IPL. Data were analysed using principles of thematic analysis. Three main themes emerged: i) building confidence; ii) purpose of IPL; iii) learning moments. Student IPL facilitators who took part in this study felt that they were adequately prepared for their role. Findings show that preparing students for IPL facilitation has similar, yet unique, components compared to the training staff. In particular, this study highlighted a need for student facilitators to receive further preparation to help build their confidence. Involving students as IPL facilitators has great potential in staff and students joining forces to equip students for future interprofessional and collaborative practice that can deliver high-quality care