A multimodal interprofessional education program including case-based problem solving focused on pain management increases student's knowledge and interprofessional skills.

Interprofessional education (IPE) activities are recommended to reflect current and future practice. The opioid epidemic is one of the most significant current health challenges; recently declared a United States public health crisis. Thus, an IPE program centered on interprofessional roles in pain management during the opioid crisis was developed at the Eugene Applebaum College of Pharmacy and Health Sciences. Professional students from pharmacy, physical therapy, occupational therapy, physician assistant, and nurse anesthesia programs were included. The program included a lecture about each profession, small group case-based problem-solving sessions (group activity), and a panel discussion led by representative pain management experts from each profession. We conducted a retrospective review of data from 251 professional students attending the IPE program, and assessed students' knowledge of each profession and their respective roles in pain management. We evaluated interprofessional skills using the Interprofessional Collaborative Competency Attainment Survey and gathered qualitative student feedback. Participants gained knowledge about other professions. Each represented profession had improvements in five constructs related to interprofessional skills. Students found the most value from the group activity, which encouraged interaction among professions. Overall, the program design was effective in enhancing student knowledge and attitudes regarding collaborative interprofessional team skills.

Quality of Rehabilitation Clinical Practice Guidelines: An Overview Study of AGREE II Appraisals.

OBJECTIVE: To evaluate the quality of rehabilitation Clinical Practice Guidelines (CPG), specifically with respect to their applicability. DATA SOURCES: The Medline, Embase, Web of Science, CINAHL, PsycINFO, and Cochrane Library databases were searched for papers published between 2017 and 2019 that applied the Appraisal of Guidelines for Research & Evaluation II (AGREE II) CPG quality assessment tool to rehabilitation CPGs. STUDY SELECTION: Deduplicated abstracts (N=449) were independently screened by 2 authors, resulting in 47 articles. Independent screening of 47 full texts by 2 authors resulted in a final selection of 40 papers appraising 544 CPGs. DATA EXTRACTION: Data were extracted by 1 author using a pretested Excel form and were checked by a second author. Key data on the review papers included: purpose, methods used for finding and appraising CPGs, and observations and conclusions on CPG quality, specifically applicability. Key data on each CPG included the 6 AGREE II domain scores or 23 item scores, as well as 2 global evaluations. DATA SYNTHESIS: The mean AGREE II domain scores for the 544 CPGs (all on a 0-100 scale) were: scope and purpose (72), stakeholder involvement (53), rigor of development (56), clarity of presentation (71), applicability (34), and editorial independence (50). Only 36% of CPGs were recommended without modification. The 40 review authors generally stated that all or most of the CPGs they appraised were poor or mediocre, especially with respect to applicability. They only infrequently pointed out what information, going beyond that specified in AGREE II, would enhance applicability. CONCLUSIONS: CPGs in principle are an ideal means to move knowledge obtained from clinical research into practice. Our review of reviews of rehabilitation CPGs shows that they commonly have deficits, especially in terms of applicability. Much work needs to be done by guideline developers to make it easier for the average rehabilitation organization and clinician to implement CPGs in daily practice.

Resident sign-out and patient hand-offs: opportunities for improvement.

BACKGROUND: Inpatient care is characterized by multiple transitions of patient care responsibilities. In most residency programs trainees manage transitions via verbal, written, or combined methods of communication termed "sign-out." Often sign-out occurs without standardization or supervision. PURPOSE: The purpose was to assess daily sign-out with a goal of identifying aspects of this process most in need of improvement. METHODS: This was a prospective, observational cohort study of interns' sign-out conducted by industrial engineering students. Daily sign-out was analyzed for inclusion of multiple criteria and scored on organization (on a scale of 0-4) based on how effectively written information was conveyed. RESULTS: We observed 124 unique verbal and written sign-outs. We found that 99% of sign-outs included a general hospital course. Sign-outs were well organized with a mean of 3.1, though substantial variation was noted (SD = 0.8). Directions for anticipated patient events were included in only 42% of sign-outs. Do Not Resuscitate (DNR) or advanced directive discussions were reported in only 11% of sign-outs. Only 50% of successive daily sign-outs were updated. CONCLUSIONS: We found variability in the content and organization of interns' sign-out, possibly reflecting a lack of instruction and supervision. Standardization of sign-out content, and education on good sign-out skills are increasingly important as patient hand-offs become more frequent.