Interprofessional training for final year healthcare students: a mixed methods evaluation of the impact on ward staff and students of a two-week placement and of factors affecting sustainability

BACKGROUND: Multiple care failings in hospitals have led to calls for increased interprofessional training in medical education to improve multi-disciplinary teamwork. Providing practical interprofessional training has many challenges and remains uncommon in medical schools in the UK. Unlike most previous research, this evaluation of an interprofessional training placement takes a multi-faceted approach focusing not only on the impact on students, but also on clinical staff delivering the training and on outcomes for patients. METHODS: We used mixed methods to examine the impact of a two-week interprofessional training placement undertaken on a medical rehabilitation ward by three cohorts of final year medical, nursing and therapy students. We determined the effects on staff, ward functioning and participating students. Impact on staff was evaluated using the Questionnaire for Psychological and Social factors at work (QPSNordic) and focus groups. Ward functioning was inferred from standard measures of care including length of stay, complaints, and adverse events. Impact on students was evaluated using the Readiness for Interprofessional Learning Survey (RIPLS) among all students plus a placement survey among medical students. RESULTS: Between 2007 and 2010, 362 medical students and 26 nursing and therapy students completed placements working alongside the ward staff to deliver patient care. Staff identified benefits including skills recognition and expertise sharing. Ward functioning was stable. Students showed significant improvements in the RIPLS measures of Teamwork, Professional Identity and Patient-Centred Care. Despite small numbers of students from other professions, medical students’ rated the placement highly. Increasing student numbers and budgetary constraints led to the cessation of the placement after three years. CONCLUSIONS: Interprofessional training placements can be delivered in a clinical setting without detriment to care and with benefits for all participants. While financial support is a necessity, it appears that having students from multiple professions is not critical for a valuable training experience; staff from different professions and students from a single profession can work successfully together. Difficulty in aligning the schedules of different student professions is commonly cited as a barrier to interprofessional training. Our experience challenges this and should encourage provision of authentic interprofessional training experience

Autistic people’s perspectives on stereotypes: An interpretative phenomenological analysis

Autism stereotypes can often portray autistic people in a negative way. However, few studies have looked at how autistic people think they are perceived by others, and none have specifically asked autistic people what they think the autistic stereotypes are. Semi-structured interviews with twelve autistic adults (aged between 20-63 years) were conducted. Using Interpretative Phenomenological Analysis, three main themes emerged from the data. These were: (1) primary stereotype is that autistic people are ‘weird’; (2) autistic stereotypes have negative effects and consequences; (3) autistic people are heterogeneous. This study makes an important and novel contribution to understanding the experience of being autistic in several ways by exploring how autistic people feel they are perceived by others and identifying some of the ways in which negative stereotypes are believed to have negative consequences for autistic people

Variation in snowshoe hare density near Churchill, Manitoba estimated using pellet counts

Snowshoe hares (Lepus americanus) are a keystone species in the Boreal Forest of Canada and their well-characterized population cycles can strongly influence the abundance of their predators. We examined annual variation in snowshoe hare density near Churchill, Manitoba, using counts of hare fecal pellets from 2012 to 2015. We used a regression formula to estimate the density of snowshoe hares based on fecal pellet density. Our estimates of snowshoe hare densities were highest in the first year of study, which may reflect a bias due to pellets accumulating from previous years, and we found no difference in hare density estimates in the subsequent three years. These results suggest the forest-tundra ecozone may be marginal habitat for snowshoe hares, precluding rapid increases in hare density, so population densities of snowshoe hares in Churchill may not cycle in their historic 10-year intervals. However, the northward advancement of the tree line with climate warming may improve habitat conditions for snowshoe hares, and thus the predator populations they typically support

Electrophysiological Evidence of Atypical Spatial Attention in Those with a High Level of Self-reported Autistic Traits

Selective attention is atypical in individuals with autism spectrum conditions. Evidence suggests this is also the case for those with high levels of autistic traits. Here we investigated the neural basis of spatial attention in those with high and low levels of self-reported autistic traits via analysis of ERP deflections associated with covert attention, target selection and distractor suppression (the N2pc, NT and PD). Larger N2pc and smaller PD amplitude was observed in those with high levels of autistic traits. These data provide neural evidence for differences in spatial attention, specifically, reduced distractor suppression in those with high levels of autistic traits, and may provide insight into the experience of perceptual overload often reported by individuals on the autism spectrum

From treetops to tabletops:A preliminary investigation of how plants are represented in popular modern board games

Plant blindness is the inability to appreciate plants in one's own environment, in the biosphere as a whole and their relationship to human affairs. Here, we discuss a community of interests in which we suggest that an appreciation of plants is vital for success: namely the world of modern board gaming. We present a classification system for the presentation of plants in the 500 most popular modern board games, where games are categorised based on their complexity, and representation and portrayal of plants. This initial mapping exercise defines a potential scope for the future analysis of how modern board games may offer a novel and interactive entertainment mechanism to challenge plant blindness and a framework for future analysis work in this area

The making of the interprofessional arena in the United Kingdom: a social and political history

This article offers a critical sociological rendering of the making of the interprofessional arena in the United Kingdom. It offers an interpretation of the conditions that led to the formation, expansion and development of the interprofessional arena using a social worlds/arenas lens of secondary data. I propose that the making of the interprofessional arena has been achieved in three historiographical phases. First, the "recognition of the professionalisation conundrum" that led to the intuitive assumption that interprofessional education (IPE) could lead to improved collaboration in practice and improved outcomes. Second, the "legitimisation" of the interprofessional assumption through the development of networks, building consensus, nurturing an evidence base and negotiating with policymakers. Third, "Talking up and acting up" the interprofessional agenda by developing global communities of practice, pandering to a neoliberal agenda, disseminating exemplars of good practice and encouraging practical changes within diverse settings. Articulating these historical "moments" may allow us insights into the conditions that have created the contemporary interprofessional arena and offer us ways of considering how present conditions may re-shape the discourses that constitute the interprofessional arena of the future

Interprofessional Education: An evaluation of a joint learning workshop for podiatry and pharmacy students

"Interprofessional Education occurs when two or more professionals learn with, from and about each other to improve collaboration and the quality of care" (CAIPE 2002). Interprofessional education forms part of the Standards for the Initial Education and Training of Pharmacists. Working with and understanding the role of another profession has been shown to positively impact on the quality of care of the patient. Following positive pharmacy student feedback from visits to podiatry clinics an interprofessional learning workshop with case - based scenarios was developed. These were based on patients with high risk medical conditions that would impact on the work of both professions. Data from the feedback forms was evaluated and analysed to determine whether the workshop increased knowledge of the British National Formulary (BNF), the prescribing process and gave an insight in to the role of other healthcare professionals. We discuss how the student’s learning has been enhanced by the contribution of another professional group. The workshop was positively received. Students were observed working together discussing the patients’ conditions and issues relating to their care. This initially revolved around the students’ area of knowledge; however, as the session progressed it became apparent that the students were learning with, from and about each other for the benefit of patient care

‘I was exhausted trying to figure it out’: the experiences of females receiving an autism diagnosis in middle to late adulthood

Females often receive autism spectrum condition diagnoses later than males, leaving needs misunderstood. This study aimed to explore the lived experiences of female adults diagnosed with an autism spectrum condition in middle to late adulthood. Eleven autistic females diagnosed over the age of 40 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Four superordinate themes emerged: A hidden condition (pretending to be normal and fitting in; mental health and mislabelling), The process of acceptance (initial reactions and search for understanding; re-living life through a new lens), The impact of others post-diagnosis (initial reactions; stereotyped assumptions), and A new identity on the autism spectrum (negotiating relationships, connections and community; changing well-being and views of the self; the meaning of diagnosis). Findings highlight several factors not previously identified that affect late diagnosis in females, including widespread limited understandings of others. Diagnosis was experienced by several participants as facilitating transition from being self-critical to self-compassionate, coupled with an increased sense of agency. Participants experienced a change in identity that enabled greater acceptance and understanding of the self. However, this was painful to adjust to at such a late stage

Scanpath analysis of expertise and culture in teacher gaze in real-world classrooms

Humans are born to learn by understanding where adults look. This is likely to extend into the classroom, making teacher gaze an important topic for study. Expert teacher gaze has mainly been investigated in the laboratory, and has focused mostly on one cognitive process: teacher attentional (i.e., information-seeking) gaze. No known research has made direct cultural comparisons of teacher gaze or successfully found expert–novice differences outside Western settings. Accordingly, we conducted a real-world study of expert teacher gaze across two cultural settings, exploring communicative (i.e., information-giving) as well as attentional gaze. Forty secondary school teachers wore eye-tracking glasses, with 20 teachers (10 expert; 10 novice) from the UK and 20 teachers (10 expert; 10 novice) from Hong Kong. We used a novel eye-tracking scanpath analysis to ascertain the importance of expertise and culture, individually and as a combination. Attentional teacher scanpaths were significantly more similar within than across expertise and expertise + culture sub-groups; communicative scanpaths were significantly more similar within than across expertise and culture. Detailed analysis suggests that (1) expert teachers refer back to students constantly through focused gaze during both attentional and communicative gaze and that (2) expert teachers in Hong Kong scan students more than experts do in the UK