MEDEV

School of Medical Sciences Education Development

Introduction

Interprofessional education (IPE) is currently a high priority for government, professional bodies and higher education providers.

This article describes a mini-project in which sought to develop a clinical case-study approach for ward-based learning, setting medical and nursing students the task of working together to prepare a case history and assessing their response.

According to Barr (1) the aims of IPE are to promote collaborative practice, prepare students for effective teamworking and ultimately to improve patient care.

Although the provision of interprofessional learning opportunities is now a requirement of the curricula of many healthcare professions, appropriate methods to assess the skills and knowledge gained during these events have yet to be developed (2).

Current debate has indicated that the clinical area might be an appropriate environment to facilitate interprofessional learning (3) and this project focused on developing assessment appropriate for IPE delivered in this setting.

It also built upon work already undertaken in the schools of medicine and nursing at QUB, where an IPE programme in Child Health and Children's Nursing has been delivered to fourth year medical and third year nursing students since 2000 (3).

Project description

During a shared clinical placement medical and nursing students worked together in teams of four to six students.

The project was delivered in three hospitals and one nurse and one medical consultant co-ordinated the project at each site.

Each team of students was required to take a history from a patient recently admitted to a paediatric ward. Students were instructed that the clinical condition they were to focus on was respiratory disease and hence they must select a patient who had a previously diagnosed respiratory condition.

One student from each profession took a history, and the other students observed. The purpose of this task was to provide students with an opportunity to learn about the history taking techniques used by members of the healthcare team.

After taking the history each team worked together to prepare an interprofessional care plan for the patient.

On completion of the programme students were required to complete two assessments. Each team had to prepare a 15-minute oral presentation describing the care plan they had developed.

Each student was also required to prepare a 1,000 word reflective commentary outlining the knowledge and skills they had acquired during this learning experience.

The resultant presentations and reflective commentaries were assessed by an interprofessional team of teachers at each clinical site.

The following resources were prepared to support the project:

1) A student information pack, which included:

• Aims and learning outcomes for the IPE programme Assessment criteria and marking schedules
• Guidelines for preparation of oral presentation and reflective commentary

2) Guides for teachers, which included information about the philosophy underpinning the programme and details about the assessment prcedures.

Project evaluation

Each cohort of students participated in a focus group on completion of the programme. Most students evaluated the project positively, and acknowledged the importance of assessing learning on completion of IPE.

This is demonstrated by the following quotation from one medical student:

Having an assessment in IPE made me take this part of the course seriously. If there was no assessment I would not have made the effort to ensure that I met with the nursing student to complete the care plan.

Lessons learned

The guidelines provided by curriculum planners about the categories of patients selected for interview should be flexible.

The first cohort of students was instructed to take a history from an asthmatic child. However, there were no asthmatic patients on some wards. Subsequent cohorts of students were advised to take a history from a child with a respiratory condition.

An oral presentation and reflective portfolio were identified as the most appropriate assessment tools for this project. They were selected because they encouraged students to continue to work collaboratively following completion of the clinical task.

In addition both forms of assessment provided students with an opportunity to reflect on the learning experience. Reflecting on this experience enabled students to enhance their understanding of the function of the multiprofessional team in healthcare delivery and increased their awareness of the roles and responsibilities of individual team members.

Benefits of project

This project has demonstrated that it is possible to devise an assessment strategy that is acceptable to staff and students from different professions and meets some of the educational requirements of healthcare regulatory bodies and HEFCE.

For example, in addition to participating in IPE students were encouraged to engage in reflective practice and were provided with opportunities to enhance key transferable skills including teamworking and presentation skills.

Feedback from students

The following quotations from the reflective commentaries prepared by students demonstrate some of the educational benefits of the project:

• We based the care plan on a problem management approach and I was surprised to learn that this was also how the student nurse approached her management. (Medical student)
• Having completed this exercise I realise how important it is to communicate with nursing staff when forming a plan of care for a patient. (Medical student)
• Medical students were very motivated and willing to take advice...very knowledgeable and I learnt from them also. (Nursing student)
• IPE should become available in all hospitals and should be integrated into medical training, pre-registration and post registration nurse education. (Nursing student)