McGettigan Patricia, McKendree Jean
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
Hull York Medical School, Heslington, York, YO10 5DD, UK.
BMC Med Educ. 2015 Oct 26;15:185. doi: 10.1186/s12909-015-0436-9.
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.
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.
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.
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.
医院中存在的多种护理缺陷促使人们呼吁在医学教育中增加跨专业培训,以改善多学科团队合作。提供实用的跨专业培训面临诸多挑战,在英国医学院校中仍不常见。与以往大多数研究不同,此次对跨专业培训实习的评估采用了多方面的方法,不仅关注对学生的影响,还关注提供培训的临床工作人员以及患者的治疗结果。
我们采用混合方法,研究了三组医学、护理和治疗专业的最后一年学生在医疗康复病房进行的为期两周的跨专业培训实习的影响。我们确定了对工作人员、病房运作和参与实习的学生的影响。使用工作中的心理和社会因素问卷(QPSNordic)和焦点小组评估对工作人员的影响。从包括住院时间、投诉和不良事件在内的标准护理指标推断病房运作情况。使用跨专业学习准备度调查(RIPLS)对所有学生进行评估,并对医学生进行实习调查,以评估对学生的影响。
在2007年至2010年期间,362名医学生以及26名护理和治疗专业学生与病房工作人员一起完成了实习,为患者提供护理。工作人员指出了包括技能认可和专业知识共享在内的益处。病房运作保持稳定。学生在团队合作、职业认同和以患者为中心的护理等RIPLS指标上有显著改善。尽管其他专业的学生人数较少,但医学生对实习评价很高。学生人数增加和预算限制导致三年后该实习停止。
跨专业培训实习可以在临床环境中进行,而不会对护理造成不利影响,且对所有参与者都有益处。虽然财政支持是必要的,但似乎让多个专业的学生参与并非获得宝贵培训经验的关键因素;来自不同专业的工作人员和来自单一专业的学生可以成功合作。不同学生专业的时间表难以协调通常被认为是跨专业培训的障碍。我们的经验对此提出了挑战,应该鼓励提供真实的跨专业培训体验。