An evaluation of the psychometric properties of the Australian Collaborative Practice Assessment Tool.

OBJECTIVES: This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care. METHODS: The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022. RESULTS: The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted. CONCLUSION: The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties.

Psychometric evaluation of the culturally adapted interprofessional socialisation and valuing scale (ISVS)-19 for health practitioners and students in Indonesia.

We aimed to develop a culturally appropriate psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. Our study was organized in three phases (a) translation, (b) cross-cultural validation by evaluating the content validity and internal structure of the translated instrument (i.e. structural validity, internal consistency reliability, and measurement invariances), and (c) hypotheses testing for construct validity. A total of 266 health practitioners and 206 students from various professional backgrounds participated. The Indonesian ISVS-19 was confirmed unidimensional. Content validity evaluation confirmed the inclusion of relevant, understandable items and was comprehensive. Factor analysis supported removal of two items. Configural, metric, and scalar tests confirmed the invariance of the 1-Factor 19-Items model in practitioner and student cohorts. Age was a differentiating factor in both cohorts; length of work was only significant for practitioners, and educational background was significant for students (80% of assumptions were accepted, fulfilling COSMIN requirement for construct validity). The Indonesian ISVS-19 has good psychometric properties regarding content validity, internal structure, and construct validity and, therefore, is a psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia.

How do universities support communication skills for clinical placements with culturally and linguistically diverse students? A scoping review.

AIM: The aim of this scoping review was to examine and synthesise contemporary research on clinical communication interventions for tertiary students from a culturally and linguistically diverse background enrolled in a health professional qualification. BACKGROUND: Clinical communication competence is essential to high quality healthcare and thus is a critical component of all health professional education. The rise in tertiary students from non-English speaking backgrounds in Australia and many other countries has escalated concern over the communication skills required for success in clinical placements and future practice as a health professional. DESIGN: A scoping review was conducted using Arskey and O'Malley's methodological framework. METHODS: The search targeted journal articles published in English between 2010 and 2022 in the databases Medline, CINAHL, ProQuest, Scopus, and Google Scholar. A total of 105 full texts were independently reviewed by the team of researchers, and hand-searching of the references in these studies was conducted. Eighteen articles were eligible for inclusion. RESULTS: The majority of studies involved a small scale (<30 participants) intervention with nursing students in Australian universities. A small number of studies involved medical, physiotherapy and dentistry students. Most interventions were a voluntary face-to-face workshop(s) focused on experiential learning of either literacy-based skills (reading and writing) or communication skills for specific clinical procedures. Self-reported outcomes were the most commonly cited outcome measure. CONCLUSIONS: While a critical appraisal was not conducted, concerns over the quality of the research were highlighted, and most interventions were not replicable due to the lack of detail provided. Further research to address the gaps in current knowledge identified in this review is warranted.

Virtual nourishment: Paediatric feeding disorder management with telepractice amidst COVID-19: An allied health perspective.

PURPOSE: The rapid adoption of telepractice services by health professionals was necessary to maintain service continuity for children with paediatric feeding disorders during the COVID-19 pandemic, during periods where in-person therapy was restricted. The aim of this study was to explore clinical perspectives and reflections on the use of telepractice for managing paediatric feeding disorders during the pandemic. METHOD: A post-positivist qualitative approach using thematic analysis was adopted. This study seeks to understand participants' experiences and thoughts from allied health professionals from speech-language pathology, occupational therapy, and dietetics working with paediatric feeding in Western Australia. All participants delivered at least 10 telepractice sessions to children from birth to 12 years with a paediatric feeding disorder. Braun and Clarke's six-step thematic analysis process was used to analyse the data inductively. RESULT: Eleven allied health professionals representing eight clinical settings in Western Australia, including speech-language pathology, occupational therapy, and dietetics, working with paediatric feeding were recruited. The results revealed four themes: families becoming the catalyst of change, clinician comfort over confidence, insights into authentic mealtimes, and the paradox of choice. CONCLUSION: This study highlighted the need to build clinicians' confidence and competence, and the provision of service guidelines and training. Although many clinicians had positive experiences with telepractice, most returned to in-person delivery once COVID-19 restrictions were lifted, emphasising the importance of comfort in service delivery selection. We recognise that the findings of this study are constrained by the fact that it was conducted in a single geographical region and utilised a small qualitative sample. While telepractice was successful in managing paediatric feeding disorders, further development and implementation of telepractice guidelines are needed for telepractice to be a viable service delivery option for families and children with feeding disorders.

Early stages of learning in interprofessional education: stepping towards collective competence for healthcare teams.

BACKGROUND: Interprofessional education (IPE) is a core element of many health professional education curricula. To date the focus of much research has been on student perceptions of, and attitudes towards, the learning experience. Little is known about the impact of early IPE experience on how students understand and learn about effective interprofessional teamwork. METHODS: This qualitative study involved first year university students enrolled in health professions degrees and investigated their descriptions of interprofessional teamwork through graphic elicitation and interviews. Participants were enrolled in a large-scale interprofessional unit (subject) in the university. RESULTS: The data were analysed through the lens of a tool that classifies dimensions of interprofessional activity. The findings indicated the majority of students had what was classified as a Stage 1 (or 'nascent') understanding of integration between work practices and a Stage 2 (or 'emerging') understanding of the dimensions of interprofessional teamwork which were commitment, identity, goals, roles and responsibilities, and interdependence. CONCLUSIONS: Based on the findings, the stages for a learning trajectory for interprofessional education are proposed and each stage is mapped to dimensions of interprofessional activity. A number of pedagogical strategies are suggested in order to move students through this two-stage model of learning and ensure their readiness for interprofessional teamwork as health professionals.

Exploring interprofessional identity development in healthcare graduates and its impact on practice.

Interprofessional identity development is an emerging area of research. Whilst there is a growing body of studies exploring interprofessional identity development and interprofessional education, little is known about interprofessional identity development in healthcare professionals and the impact of interprofessional identity on practice. This study explored interprofessional identity development in graduates during their first year of work as health professionals and the influence of this on practice. All graduates had prior interprofessional education as students. Fourteen interviews with eight graduates were conducted. Data was analysed cross-sectionally using inductive thematic analysis. Three inter-related themes were developed: 'growing confidence,' 'commitment to client-centred care,' and 'maintaining dual identification in different contexts.' These themes demonstrated that, first, interprofessional identity development occurred along a continuum influenced by the practice context and the individual's commitment to client-centred care. Second, confidence identifying and practising as a healthcare professional facilitates further interprofessional identity development. Third, maintaining identification as an interprofessional practitioner involves developing an increasingly sophisticated understanding of interprofessional practice by viewing interprofessional identity through increasingly complex meaning-making lenses consistent with the constructive developmental theory of self. Findings support the inclusion of pre-licensure interprofessional education and inform further interprofessional identity research in professionals beyond their first year of practice.

Facilitating interprofessional identity development in healthcare students through dedicated interprofessional placements.

There is a growing body of research evidencing the benefits of dedicated interprofessional placements in preparing healthcare students for interprofessional practice. However, little is known about if and how students develop their interprofessional identity during interprofessional placements. This study addresses this knowledge gap by exploring final-year students' interprofessional identity development during dedicated interprofessional placement(s). Thirty-eight students from five health professions were interviewed and data analyzed inductively to identify themes. Participants also drew images representing their perceptions of interprofessional identity and its relationship to professional identity as part of the data collection. The themes showed participants progressed from conceptualizing interprofessional identity as a requirement of the placement at the start of the placement, toward internalizing an interprofessional identity by the end of their placement. Context influences interprofessional identity salience. A commitment from healthcare professionals to model interprofessional practice, combined with explicitly facilitating interprofessional identity development, is recommended to facilitate continued interprofessional identity development in different contexts post placement.

High and low functioning team-based pre-licensure interprofessional learning: an observational evaluation.

Interprofessional education (IPE) is embedded in many health professional training programs, often with a focus on collaborative teamwork. Most studies into whether IPE delivers the desired collaborative teamwork capabilities has tended to rely on short term, self-assessed changes in learners' attitudes, knowledge and skills. This study adopted overt ethnographic observation to understand how a convenience sample of students behave in groups during interprofessional team-based clinical placements. Interprofessional student teams were observed by two independent observers on eight occasions (a total of 720 hours) across three sites. Thematic analysis of the observational data indicates that student teams fell into two categories: higher and lower functioning. Higher functioning teams were observed using humor to build rapport, reduce tension and express humility, and evidenced a greater emphasis on shared client goals. In contrast, lower functioning teams were more formal, with no evidence of humor and less interaction. The higher functioning teams, therefore, not only demonstrated greater interprofessional collaboration they also appeared to have higher levels of psychological safety. Participants in the higher functioning teams also demonstrated mutual trust and confidence and took more risks, often speaking up to provide suggestions, share knowledge and skills, and seek or offer feedback. The results suggest that further explicit training in, and assessment of, psychological safety in IPE needs to be undertaken.

Quality of contact counts: The development of interprofessional identity in first year students.

BACKGROUND: Little is known about how nursing and other healthcare students develop professional and interprofessional identities. OBJECTIVES: This study a) measures changes in students' professional and interprofessional identities between the start and end of a faculty-wide interprofessional first year programme, and b) identifies factors influencing interprofessional identity strength at the end of the programme. PARTICIPANTS: One hundred and eight first year nursing, medicine and allied health students. METHODS: A single-group pre-post-test design was used. Students completed an online survey at the start and end of the year-long programme. The survey comprised measures of professional and interprofessional identity, stereotypes, contact and demographics. The same survey was used twice. RESULTS: There was a small decline in professional identity and a large decline in interprofessional identity across the year. Nursing students, the only group involved in clinical practicums, were exempt from the large fall in interprofessional identity. Quality of contact with students from other professions and autostereotypes about own profession were predictors of interprofessional identity strength at the end of the programme, consistent with intergroup contact theory. CONCLUSIONS: Introductory interprofessional education programmes should include opportunities for quality contact with students from other professions, and for students to develop a clear understanding of their own profession.

Teamwork, collaboration and networking: self-reported behavioural change following pre-licensure interprofessional clinical learning.

The majority of studies exploring the impact of interprofessional education (IPE) for pre-licensure health professionals have focused on IPE experiences in the classroom, online or through simulation. Research into IPE in clinical settings has been carried out, however, to date most studies have focused on short-term outcomes related to learner reaction, attitudes and perceptions, and knowledge and skills. This study adds to the literature investigating IPE in clinical settings for pre-licensure health professionals by investigating the experiences of learners who, following their IPE clinical placement, had moved into other clinical (workplace) environments. To understand what, if any, influence the clinical IPE experience had on their subsequent professional practice, 13 participants (students and graduates) from five professions were interviewed. Inductive thematic analysis identified that, following their IPE placement, participants engaged in interprofessional practice by seeking and sharing information, embedding other professional goals into patient sessions and conducting joint sessions. Several factors influenced the ability and capacity to collaborate at the individual and organisation level. Findings from this study suggest that the dedicated IPE placements enhanced both student and graduate openness and ability to collaborate with other professions in subsequent clinical workplace settings.

What do we know about student resilience in health professional education? A scoping review of the literature.

OBJECTIVES: Resilience has been identified as a key capability to thrive in the complex changing work environment of the 21st century. Therefore, the aim of this scoping review was to investigate how resilience is understood in the context of pre-qualifying health education, if there is a need to build student resilience, and what approaches to enhancing student resilience are described in the literature. DESIGN AND DATA SOURCES: Arksey and O'Malley's (2005) literature scoping review design was adopted as it enables researchers to review, summarise and analyse the literature on a given topic. The databases searched were Cumulative Index of Nursing and Allied Health Literature, Scopus, Proquest, Medline, Science Direct, and Education Resources Information Centre. REVIEW METHOD: Four research questions informed the literature review: (1) how is resilience conceptualised in the literature?, (2) what evidence exists for the need for resilience enhancement?, (3) what resilience factors should inform resilience enhancement?, and (4) what resilience enhancement programs are described in the literature? RESULTS: A total of 36 papers were reviewed in detail. Whilst the need for a focus on resilience across the health professions was evident an array of definitions and conceptualisations of resilience were described. A small number of approaches to enhancing resilience were identified. CONCLUSION: Whilst widespread recognition of the importance of resilience in the health professions exists the area remains under theorised with limited conceptual models and robust interventions published to date.

Interprofessional team-based placements: The importance of space, place, and facilitation.

Interprofessional education in practice settings typically requires greater resource investment than in the classroom or online. Increased interest in return on investment means research on the outcomes of practice-based interprofessional education is needed. In this article, we report findings from a qualitative study involving a series of focus groups with health sciences' students during their interprofessional placements in three community health settings in Western Australia. An exploratory case study approach was adopted to determine students' perceptions of the placement and their learning. The presage-process-product (3P) model of learning and teaching was employed to illuminate to the nature of this interprofessional education experience. Verbatim transcripts were analysed by two researchers using an inductive approach to derive key themes. Findings illuminate a number of factors that strongly influenced student perceptions of their learning in interprofessional practice-based placements including a dedicated space to collaborate and learn; exposure to a wide range of professions in practice settings; the approach of the facilitators; and students' previous clinical experience, year level and the timing of the placement. Students reported that the placement enhanced their knowledge, professional communication, leadership, understanding of other health professions and collaboration. This study provides contemporary insight into key factors that influence student learning during practice-based interprofessional placements.

Interprofessional Education and Practice Guide No. 8: Team-based interprofessional practice placements.

Whilst interest in interprofessional learning (IPL) in practice contexts has grown in recent years, the complexities involved have led many universities to rely on IPL in the classroom, online, and/or simulated contexts. Curtin University's Faculty of Health Sciences has successfully implemented a multi-award winning, large-scale Interprofessional Practice Programme. This programme, which began with five small pilots in 2009, provides team-based interprofessional practice placements for over 550 students from nine professions per annum. Drawing on both the literature and Curtin University's experience, this Interprofessional Education and Practice Guide aims to assist university and practice-based educators to "weigh the case" for introducing team-based interprofessional placements. The key lessons learned at Curtin University are identified to offer guidance to others towards establishing a similar programme for students during their prequalifying courses in health, social care, and related fields.

Exploring the potential of a capability framework as a vision and "sensemaking" tool for leaders of interprofessional education.

Creating a vision (visioning) and sensemaking have been described as key leadership practices in the leadership literature. A vision provides clarity, motivation, and direction for staff, and is essential particularly in times of significant change. Closely related to visioning is sensemaking (the organisation of stimuli into a framework allowing people to understand, explain, attribute, extrapolate, and predict). The application of these strategies to leadership within the interprofessional field is yet to be scrutinised. This study examines an interprofessional capability framework as a visioning and sensemaking tool for use by leaders within a university health science curriculum. Interviews with 11 faculty members revealed that the framework had been embedded across multiple years and contexts within the curriculum. Furthermore, a range of responses to the framework were evoked in relation to its use to make sense of interprofessional practice and to provide a vision, guide, and focus for faculty. Overall the findings indicate that the framework can function as both a visioning and sensemaking tool.

A scoping review to understand "leadership" in interprofessional education and practice.

This scoping study examined how "leadership" is referred to and used in interprofessional education and practice. A total of 114 refereed articles were reviewed to determine how leadership is defined, conceptualised, and theorised. The review also examined what capabilities were identified for effective interprofessional leadership. The majority of papers were empirical studies undertaken by researchers based in North America. The majority of articles did not refer to a specific leadership approach, nor did they define, describe, or theorise leadership. Moreover, "leadership" capabilities were rarely identified. Articles generally focused on health practitioners and educators or students as leaders with little exploration of leadership at higher levels (e.g. executive, accrediting bodies, government). This review indicates the need for a more critical examination of interprofessional leadership and the capabilities required to lead the changes required in both education and practice settings. The goal of this article is to stimulate discussion and more sophisticated, shared understandings of interprofessional leadership for the professions. Recommendations for future research are required in both education and practice settings.

An Australian hospital-based student training ward delivering safe, client-centred care while developing students' interprofessional practice capabilities.

Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process. An interprofessional practice program was established with six beds within a general medical ward. This provided the setting for 2- to 3-week clinical placements for students from medicine, nursing, physiotherapy, occupational therapy, social work, pharmacy, dietetics and medical imaging. Following an initial trial, the training ward began with 79 students completing a placement. An interprofessional capability framework focused on the delivery of high quality client care and effective teamwork underpins this learning experience. Quantitative outcome data showed not only an improvement in students' attitudes towards interprofessional collaboration but also acquisition of a high level of interprofessional practice capabilities. Qualitative outcome data from students and clients was overwhelmingly positive. Suggestions for improvement were identified. This innovative learning environment facilitated the development of the students' knowledge, skills and attitudes required for interprofessional, client centred collaborative practice. Staff reported a high level of compliance with clinical safety and quality.

An interprofessional practice capability framework focusing on safe, high-quality, client-centred health service.

This paper describes an interprofessional capability framework which builds on the existing interprofessional competency and capability frameworks from the United Kingdom, Canada, and the United States of America. Existing published frameworks generally make reference to being client-centred and to the safety and quality of care, and locate interprofessional collaborative practice as the central theme or objective. In contrast, this framework interlinks all three elements: client-centred services, safety and quality of services, and interprofessional collaborative practice. The framework is clear and succinct with an accompanying visual representation that highlights all key features. The framework has informed curriculum which incorporates a common first-year, case-based educational workshops and practice placements within a large complex health sciences faculty of approximately 10,000 students from 22 disciplines. The articulation of these key elements of health practice has facilitated students, academic staff, and community health professionals to develop a shared understanding of interprofessional education and practice. The design, implementation, and evaluation of learning outcomes, learning experiences, and assessments have been transformed with the introduction of this framework, which is highly applicable to other contexts.