Global Interprofessional Study Abroad Impact on Nurse Practitioners' and Medical Students' Perceptions About Role Definition

Thursday, 27 July 2017: 3:50 PM

Debra A. Kosko, DNP
School of Nursing, Department of Graduate Nursing Science, DNP Program, East Carolina University, Greenville, NC, USA
Deborah Chapa, PhD
Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
Melvin S. Swanson, PhD
College of Nursing, PhD Program, East Carolina University, Greenville, NC, USA

Purpose: Healthcare delivered by well-functioning teams results in improved clinical outcomes and lower costs. However, health professions students are typically educated in silos, seldom communicating across disciplines (Cox & Naylor, 2013). Once students graduate, the professional silos persist, resulting in fragmented care that increases cost and decreases quality. Therefore, educating health professions students about team-based care and how to work with other health professionals, known as Interprofessional Education (IPE), provides them the necessary skills to improve the healthcare delivery system and the lives of their patients upon graduation. The purpose of this project was to evaluate the impact of a 2 week interprofessional study abroad program on health professions student’s readiness for interprofessional education (IPE).

Methods: This outcome-based summative program evaluation had a convenience sample of four family nurse practitioner (FNP) students and seven medical students. The education model was a two week immersion study abroad in Nicaragua where students provided patient care in FNP/medical student teams within a variety of clinical settings. The students attended debrief sessions throughout the experience that included discussions about IPE. All students and faculty stayed at the same hotel, shared meals and shared free time. Immediately before departing the US and immediately upon returning from the US, students received a web-based anonymous questionnaire via Qualtrics. An open-ended question was asked about the role of FNP’s and physicians in healthcare. Several additional open-ended questions were added to the post-experience questionnaire. These questions inquired about the impact of the study abroad on future clinical practice and their impression about learning with students from another health profession.

Results: The phenomenological analysis compared medical student’s responses to FNP student’s responses. Both groups responded similarly when asked about learning with each other. Common themes included great experience, enhanced learning and well working teams. One NP student stated the experience highlighted a lack of knowledge as compared to medical students, while one medical student stated greater learning occurred because of working with FNP students who were experienced nurses. When asked about applying the study abroad experience to clinical practice, none of the FNP students identified learning with medical students as impactful while one medical student stated learning with FNP students provided needed preparation for future clinical practice. A dichotomy was found with responses about the role of each other’s profession in healthcare delivery. There were no pre-travel responses from medical students while 4 of the 5 medical students provided post-travel responses. The theme of the responses was hierarchy. The medical students identified FNP students as physician extenders; that they are supervised by physicians and are below a physician. One FNP student responded pre-travel and one responded post-travel; both responses were also hierarchical such that the physician serves as a reference and was the health professional that guided patient care.

Conclusion: This study abroad provided students at our university a unique educational experience that enabled collaborative practice in a variety of clinical settings. Although the students worked in FNP/medical student teams and IPE core competency content was provided, an understanding of collaborative practice was not reflected in the qualitative data. Rather, the medical students and a FNP student used hierarchical terms to describe the relationship between the professions. An immersion experience abroad provides the opportunity for IPE, however, more research is needed in developing educational interventions that promote IPE and develop tools to measure IPE knowledge. This project will promote further development of interprofessional education models that can transform clinical practice. Study abroad models of IPE can also serve to promote interprofessional clinical practice globally.