Charting a Key Competency Domain: Understanding Resident Physician Interprofessional Collaboration (IPC) Skills.

BACKGROUND: Interprofessional collaboration (IPC) is essential for quality care. Understanding residents' level of competence is a critical first step to designing targeted curricula and workplace learning activities. In this needs assessment, we measured residents' IPC competence using specifically designed Objective Structured Clinical Exam (OSCE) cases and surveyed residents regarding training needs. METHODS: We developed three cases to capture IPC competence in the context of physician-nurse collaboration. A trained actor played the role of the nurse (Standardized Nurse - SN). The Interprofessional Education Collaborative (IPEC) framework was used to create a ten-item behaviorally anchored IPC performance checklist (scored on a three-point scale: done, partially done, well done) measuring four generic domains: values/ethics; roles/responsibilities; interprofessional communication; and teamwork. Specific skills required for each scenario were also assessed, including teamwork communication (SBAR and CUS) and patient-care-focused tasks. In addition to evaluating IPC skills, the SN assessed communication, history-taking and physical exam skills. IPC scores were computed as percent of items rated well done in each domain (Cronbach's alpha > 0.77). Analyses include item frequencies, comparison of mean domain scores, correlation between IPC and other skills, and content analysis of SN comments and resident training needs. RESULTS: One hundred and seventy-eight residents (of 199 total) completed an IPC case and results are reported for the 162 who participated in our medical education research registry. IPC domain scores were: Roles/responsibilities mean = 37 % well done (SD 37 %); Values/ethics mean = 49 % (SD 40 %); Interprofessional communication mean = 27 % (SD 36 %); Teamwork mean = 47 % (SD 29 %). IPC was not significantly correlated with other core clinical skills. SNs' comments focused on respect and IPC as a distinct skill set. Residents described needs for greater clarification of roles and more workplace-based opportunities structured to support interprofessional education/learning. CONCLUSIONS: The IPC cases and competence checklist are a practical method for conducting needs assessments and evaluating IPC training/curriculum that provides rich and actionable data at both the individual and program levels.

'We might as well be speaking different languages': an innovative interprofessional education tool to teach and assess communication skills critical to patient safety.

Introduction: All practicing health professionals must be able to communicate effectively with their colleagues around the care of patients. Better communication between health professionals not only improves patient outcomes, but also cuts down on costly and unnecessary tests or healthcare services. At New York University (NYU), we have addressed the need for interprofessional education (IPE) by incorporating a set of interprofessional objective structured clinical examinations (OSCEs) cases into our performance-based assessment programme to expand the educational tools for interprofessional collaborative (IPC) practice, assessment and feedback. Methods: We identified and operationalised IPC competencies to create an assessment tool for use in IPC clinical cases, delineating core domains and then identifying observable behaviours that represented the broader competencies. IPC cases (for use in OSCEs) were designed in a way that required medical students and residents to collaborate effectively with a health professional from another discipline (standardised registered nurse (RN)) in order to provide quality care to a (standardised) patient. Feedback from the standardised RN and the participants was content analysed and our own experience in implementing was described. Results: This method demonstrates that IPC practice can effectively be incorporated into medical education training and assessment, at the undergraduate and graduate level. We found high internal consistency among items within each of the core IPC competency domains (Cronbach's α 0.80-0.85). Based on both standardised RN and faculty feedback, the cases were effective in discriminating among learners within and across undergraduate medical education (UME) and graduate medical education (GME) levels, and within learners, in identifying individual strengths and weaknesses. Learners found these cases to be realistic, challenging and stimulating. Conclusions: OSCE-based IPC training is a feasible and useful methodology. Ultimately, IPC OSCE cases are training tools that provide learners with a safe environment to practice, receive feedback and develop the critical skills needed for our evolving healthcare system. The next steps are to expand the scope of IPE cases to include more team members, and team work to also incorporate faculty development to ensure that our teachers and role models are effective in providing feedback on IPC practice.