Objective: the purpose of this presentation is to describe the design and analysis plan outlined to evaluate the implementation effect of a practice-based clinical education project focused on improving students’ IP healthcare competencies and patients’ health outcomes. The final study result is expected to (1) investigate the overall implementation effect of this project, (2) explore factors or patient characteristics that potentially influence the implementation effect, and (3) provide suggestions regarding research design and statistical analysis for future clinically-based interprofessional education projects involving students in healthcare fields.
Methods: Student participants voluntarily joined either the study group (IP teams) or comparison group (students from the same cohort of the study group participants). Both study and comparison group students completed identical survey instruments before and after each clinical session. To examine the educational effectiveness of this project, pre- and post- assessment results will be compared for study and comparison groups respectively using paired t-test. To exclude the effect of pre-existing differences between the study and comparison groups and to adjust for potential confounding (Skelly, Dettori, & Brodt, 2012) and/or effect modification (Knol & VanderWeele, 2012), the propensity score matching and propensity score weighting (Karpen, 2017) will be used to assess study and comparison group post survey score differences, adjusting for pre survey scores, sociodemographic characteristics, specialty and previous clinical experience. Measurements and data collection on patient physical and mental health outcomes are conducted at every patient visit. To evaluate the IP teams’ intervention impact on patient health outcomes, the Joinpoint Trend Analysis (Brown, Prince, Minami, & Abrantes, 2016) will be used to assess the trend of physical and mental health indexes change over time. In order to identify factors that potentially influence the intervention effect, the trend analysis will be conducted among different patient subpopulations defined by patient sociodemographic characteristics and/or disease diagnoses.
Results: Data collection began in January 2017 when the first teams were assigned to clinics and is expected to proceed until June 2020. Participants thus far include 46 students in the study group, 72 students in the comparison group and 69 patients. Eighteen student interprofessional healthcare teams have collaborated interprofessionally at five different clinical sites. Descriptive statistical results will be reported based on data collected up to the point of the conference presentation.
Conclusions: By describing the design and analysis plan prior to completion of data collection, this presentation provides a sample framework about study design and statistical analysis for similar practice-based clinical education projects. The presentation also emphasizes the importance of considering potential confounding and modification effects at both study design and statistical analysis phases.
Acknowledgements: This project was approved by the Institutional Review Board for the Use of Human Subjects in Research, and informed consent was obtained by students and patients prior to any participation. All results were confidential and compiled only as aggregate data. Funding for this project is through Health Resources Services Administration Advanced Nursing Education Grant.
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