Gillespie Colleen, Adams Jennifer, Hanley Kathleen, Wagner Ellen, Shaker-Brown Amara, Naidu Mrudula, Kalet Adina, Zabar Sondra
Institute for Innovations in Medical Education, New York University School of Medicine, New York, NY, USA.
Division of General Internal Medicine and Clinical Innovations, New York University School of Medicine, New York, New York, USA.
BMJ Simul Technol Enhanc Learn. 2015 Aug 25;1(2):54-60. doi: 10.1136/bmjstel-2014-000014. eCollection 2015.
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.
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.
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.
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.
所有执业医疗专业人员都必须能够就患者护理问题与同事进行有效沟通。医疗专业人员之间更好的沟通不仅能改善患者的治疗效果，还能减少昂贵且不必要的检查或医疗服务。在纽约大学（NYU），我们通过将一系列跨专业客观结构化临床考试（OSCE）案例纳入基于表现的评估计划，来满足跨专业教育（IPE）的需求，以扩展跨专业协作（IPC）实践、评估和反馈的教育工具。
我们确定并实施了IPC能力，以创建一个用于IPC临床案例的评估工具，划定核心领域，然后确定代表更广泛能力的可观察行为。IPC案例（用于OSCE）的设计要求医学生和住院医师与来自另一学科的医疗专业人员（标准化注册护士（RN））有效协作，以便为（标准化）患者提供优质护理。对标准化RN和参与者的反馈进行了内容分析，并描述了我们自己的实施经验。
该方法表明，IPC实践可以有效地纳入本科和研究生阶段的医学教育培训和评估中。我们发现每个核心IPC能力领域内的项目之间具有高度的内部一致性（克朗巴哈α系数为0.80 - 0.85）。基于标准化RN和教师的反馈，这些案例在区分本科医学教育（UME）和研究生医学教育（GME）水平内及跨水平的学习者，以及在学习者内部识别个人优势和劣势方面是有效的。学习者认为这些案例真实、具有挑战性且能激发兴趣。
基于OSCE的IPC培训是一种可行且有用的方法。最终，IPC OSCE案例是培训工具，为学习者提供一个安全的环境来进行实践、接受反馈并培养我们不断发展的医疗系统所需的关键技能。下一步是扩大IPE案例的范围，纳入更多团队成员，并且团队工作还要纳入教师发展，以确保我们的教师和榜样能够有效地提供关于IPC实践的反馈。
