Interprofessional objective structured clinical examination with physician assistant and pharmacy students - A qualitative and quantitative study.

BACKGROUND: To assess the impact of an interprofessional objective structured clinical examination (iOSCE) on attitudes/perceptions regarding interprofessional practice (IPP) and to determine if patient (simulated) outcomes improved with interprofessional collaboration (pharmacy and physician assistant (PA) students). INTERPROFESSIONAL EDUCATION ACTIVITY: A team of interprofessional faculty designed an iOSCE case and grading checklist containing key interventions. Students individually reviewed the case and were asked to document potential changes to the admission orders. Then they were given the opportunity to collaborate in an interprofessional team to discuss the case and orders. Finally, the team presented their recommendations to an interprofessional faculty panel. Individual and team scores were compared to determine the impact of interprofessional collaboration. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered pre- and post-iOSCE to assess changes in opinions about interprofessional learning. DISCUSSION: Individual and team iOSCE scores for 187 students were evaluated (86 PA and 101 pharmacy). A 21% absolute increase in the number of key interventions was found when comparing average individual scores to average team scores (2.11/5 vs. 3.18/5, p < 0.001). While in aggregate the students had a positive attitude towards IPE pre-iOSCE, RIPLS responses were strengthened post-iOSCE. IMPLICATIONS: Through iOSCEs, it appears students can learn from and with one another to improve patient care and gain perspective on the roles/skills of interprofessional colleagues.

The use of intramuscular benzodiazepines and antipsychotic agents in the treatment of acute agitation or violence in the emergency department.

The management of an agitated, abusive or violent patient is a common and challenging problem in Emergency Medicine. Priorities include measures to ensure the safety of the patient and the emergency staff, including provision of physical restraint of the patient and evaluation for correctable medical causes of such behavior. Medications used in the treatment of such patients include benzodiazepines and antipsychotic agents. The newer atypical antipsychotic agents seem to provide a safe and effective treatment for such patients. The atypical antipsychotic agents may have fewer short-term side effects than older typical antipsychotic agents, such as haloperidol and droperidol. Currently available atypical antipsychotic medications for the treatment of acute agitation include ziprasidone and olanzapine, which can be administered in an intramuscular formulation, and risperidone, which is available in a rapidly dissolvable tablet and liquid formulation.