Methods: We developed a training curriculum with learning objectives reflective of geriatric team-based care and IPC core competencies (Interprofessional Education Collaborative, 2016). Our education model begins with one hour of didactic presentations concentrated on geriatric topics including medications, geriatric syndromes, elder law, emotional intelligence, and TeamSTEPPSâ. We designed the next step of training to build on the didactic topics, with a one hour interactive tabletop simulation of a geriatric case study augmented with a standardized patient (SP) playing the role of patient or caregiver. The goal of the simulation is for interprofessional teams to develop an interprofessional plan of care while using effective communication strategies and tools with team members and the SP. Facilitator-guided debriefing follows the simulation in the small group, and with the overall large group in attendance. We collected demographic details, education evaluation data, and measured progression in IPC competencies with the 20-item Interprofessional Collaborative Competencies Attainment Survey (ICCAS) pre and post education (Archibald, Trumpower & MacDonald, 2014).
Results: A total of 362 professionals from eight different disciplines attended the trainings over three years including nursing, medicine, pharmacy, social work, EMS, counseling, speech/language pathology and chaplaincy. We found that overall professionals rated their interprofessional collaborative competencies highly prior to the training. There was a non-significant decrease in the overall ICCAS scores following the training (pre x̄=122.4, post x̄=115.5, p=0.19). However, we saw increases that were not statistically significant on both the conflict management/resolution and team functioning subscales (p=0.29, p=0.08, respectively). Participants provided positive quantitative and qualitative feedback regarding evaluation of the education design, such as 94% agreed that the training was a valuable learning experience.
Discussion: There have been other studies that examined the correlation between interprofessional team training and job satisfaction, team commitment, retention and turnover rates (Baik & Zierler, 2018; Galletta, Portoghese, Carta, D'Aloja, & Campagna, 2016; Kaiser, Patras, & Martinussen, 2018; Twigg & McCullough, 2014). Each provide evidence that interprofessional collaboration is a component of a healthy work environment, validating the importance of research for methods to strengthening it. While our results did not find statistically significant quantitative changes in interprofessional collaborative competencies, the education evaluation results were promising. It is possible that the high pre-education ICCAS scores of our participants limited the potential for increase post-education. Another explanation may be related to the limitations in sampling from a relatively small geographical area that appears to already have strong interprofessional practice environments. We suggest replicating this study with other professional cohorts where there is less evidence of interprofessional collaboration as well as other geographical regions to broaden generalizability. Finally, it is also possible that the education itself as a one-time delivery was not a strong enough influence to change interprofessional collaborative competencies in professionals, unlike our results with similar education provided for pre-licensure students. Designing continuing education over a longer delivery, or as a series of programs using a similar format, is another suggestion for future research.
Based on evaluation feedback on the education format and content, participants confirmed that an active learning pedagogy such as simulation is valuable. By offering these training sessions to active care providers, we can impact current work environments by creating a healthy team approach that has been identified as valuable in the literature (Kaiser et. al, 2017). Although our curriculum focused on care of the geriatric population, we feel it could easily be adapted to other patient and client populations, and care settings; we suggest this as a topic of future research.
Other: This project is funded by HRSA under GWEP cooperative agreement (#U1QHP28707).