International Immersion Experience Impact on Nurse Practitioner and Medical Students Readiness for Interprofessional Education

Background: Fragmentation of care and poor communication between healthcare professions contributes to poor quality, high cost healthcare, while care delivered by well-functioning team’s decreases costs and improves clinical outcomes.  Health professions students are educated in silos which are a source of fragmented care.  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 transform our healthcare delivery system.  Therefore, educational models that successfully teach interprofessional core competencies to our health professions students are needed.  Objective: 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 in a variety of clinical settings.  The students attended debrief sessions throughout the experience that included discussions about IPE.  Everyone stayed at the same hotel, ate meals together and shared free time.  The Readiness for Interprofessional Learning Scale (RIPLS) was administered before departure to Nicaragua, immediately upon returning from Nicaragua and 2 months post-intervention.  Results: Three of the four RIPLS sub-scales; teamwork and collaboration, negative professional identity, positive professional identity, all had internal consistency reliabilities exceeding 0.90.  Pre-intervention mean subscale scores exceeded 4.3 out of a maximum 5.0, indicating a strong ceiling effect.  These high mean scores dipped slightly, never below 4.0, at post-intervention.  Mean scores 2 months later rebounded and were greater than 4.5 for all three subscales.  Conclusions: Although RIPLS was a reliable instrument for this program evaluation, the high pre-intervention scores made it difficult to evaluate substantial change between pre-intervention and post-intervention.  The interprofessional educational program may have produced important changes, but the RIPLS could not detect these changes because of the high pre-intervention ceiling effect.  More research in the area of IPE, particularly in the development of valid and reliable instruments, is needed in order to create interprofessional education models that can transform clinical practice.  The implication of study abroad models of education can also serve to promote interprofessional clinical practice globally.