This study examined RN-to-BSN and Master of Social Work students’ attitudes and readiness for interprofessional (IP) practice and educational experiences. The Attitudes toward Health Care Teams Scale (ATHCTS) developed by Heinemann et al. measures attitudes toward health care teams including the quality of care/process and physician centrality. Students’ readiness for IP education was measured by the Readiness for Interprofessional Learning Scale (RIPLS) developed by Parsell and Bligh. Discussion of an interprofessional activity including student reactions is provided. Statistically significant differences were found in the mean scores for the Patient-Centeredness subscale of the RIPLS and in overall ATHCTS scores as well as the Physician Centrality subscale scores. Overall, participants demonstrated readiness and benefits of IP education.
The health care environment is at a crossroads, and interprofessional (IP) education leading to a more integrated, seamless approach to care is critical. The National Academy of Medicine (formerly the Institute of Medicine (IOM)) Committee on Quality of Health Care in America [
All members of the health care team, including physicians, nurses, pharmacists, and social workers, are not typically educated together, yet they are increasingly required to cooperate and collaborate more closely in the delivery of care. Successful IP education can be achieved only through committed partnerships across professions. Professional nurses and social workers with graduate degrees can contribute to the knowledge base to effectively provide up-to-date, safe patient care, participate in health care decisions, and provide the leadership needed to become full partners in health care redesign efforts [
Faculty plays a key role to facilitate IP education on both an organizational and individual levels. Innovative teaching/learning strategies that prepare health professions students to understand roles of each other and the importance of teamwork that promotes effective communication and collaboration is needed [
Interprofessional learning experiences (IPE) are based on constructivist learning theory that postulates that meaning is developed through the dialogue process. IPE provides a foundation to link to real-world experience [
Blue and Zoller [
Curran et al. [
Readiness to learn in health care teams has been supported in a range of studies but often with differing results. In a longitudinal study of preregistration health and social care students in Scotland, McFayden et al. [
Barnes et al. [
The strongest influence on student attitudes toward IPE appears to be their professional program [
The RIPLS instrument, originally developed by Parsell and Bligh [
The importance of teamwork and collaboration among health care professionals cannot be underscored. Although the RIPLS instrument measures students’ readiness for IP learning experiences, determining the individual’s attitudes toward working in collaborative practice settings is important as attitudes influence behaviors [
Some have argued that IPE should be conceptualized as a process, rather than an intervention. Use of problem-based group learning strategies where students discuss clinical problems together has been described as the ideal environment for IPE [
The University of Wisconsin-Green Bay (UWGB) mission directs efforts to engage students in interdisciplinary, problem-focused educational experiences designed to address complex issues in a multicultural and evolving world [
The study employed a descriptive, cross-sectional design to determine the attitudes and readiness for IP practice and educational experiences among RN-to-BSN and Master of Social Work students attending one Midwestern university. Participants included undergraduate nursing students with extensive professional practice experience and graduate social work students with varying professional practice experience. Participants completed a 51-item survey containing questions from the Readiness for Interprofessional Learning Scale (RIPLS) [
Mean scores and reliability of scales and subscales.
Scale/subscale (possible range of scores) | Mean (SD) (95% CI) | Cronbach’s alpha |
---|---|---|
Attitudes toward health care teams scale (19–95) | 66.35 (5.27) (65.47–67.52) | 0.76 |
Quality of care processes (14–70) | 52.75 (4.57) (51.94–53.56) | 0.855 |
Physician centrality (5–25) | 13.60 (2.91) (13.08–14.11) | 0.588 |
Readiness for interprofessional learning scale (23–115) | 90.98 (6.12) (89.97–92.24) | 0.752 |
Teamwork and collaboration (13–65) | 55.12 (5.69) (54.46–56.49) | 0.898 |
Patient centeredness (5–25) | 23.91 (1.57) (23.66–24.24) | 0.811 |
Sense of professional identity (5–25) | 11.71 (2.55) (11.23–12.18) | 0.447 |
A convenience sample of RN-to-BSN and Master of Science in Social Work (MSW) students at a Midwestern United States public university was used. Ethics approval was received from the Institutional Review Board of the University of Wisconsin-Green Bay, and then, students were sent an electronic invitation to participate in the study. The invitation contained a link to the consent form and anonymous online survey. Students agreeing to participate were taken to the survey. A series of e-invitations were sent over an 8-week period. As an incentive, students were offered the opportunity to enter a drawing for a $25 gift card. Following completion of the survey, students were redirected to a separate online site where they could enter their contact information if they wanted to be in the drawing.
Of a possible 792 RN-to-BSN students (
Differences between RN-to-BSN and MSW students’ readiness of IPE were analyzed using the total RIPLS score as well as for each of the subscale scores. An independent samples
Using an independent samples
RIPLS and ATHCTS scores by discipline.
|
Mean (SD) [95% CI] | ||
---|---|---|---|
RN-BSN | SW | ||
RIPLS | |||
Teamwork and collaboration | 0.200 | 4.24 (0.45) [4.14–4.34] | 4.33(0.37) [4.20–4.46] |
Patient centeredness | 0.459 | 4.81 (0.29) [4.75–4.87] | 4.73 (0.36) [4.59–4.86] |
Sense of professional identity | 0.712 | 2.35 (0.54) [2.23–2.46] | 2.31 (0.40) [2.17–2.46] |
Total RIPLS | 0.574 | 90.80 (6.12) [89.59–92.30] | 91.82 (6.18) [89.25–93.92] |
|
|||
ATHCTS | |||
Quality of care processes | 0.263 | 3.79 (0.33) [3.72–3.86] | 3.72 (0.30) [3.60–3.82] |
Physician centrality |
0.005 | 2.82 (0.59) [2.69–2.95] | 2.48 (0.53) [2.31–2.67] |
Total ATHCTS |
0.006 | 67.01 (5.50) [65.93–68.29] | 64.42 (4.0) [62.92–65.89] |
Demographic differences were analyzed using the independent samples
The connection of teaching and shared learning in developing higher levels of readiness and acceptance of IPE and practice can be reinforced in health professions curriculums. Examination of barriers to IPE can be utilized to further enhance IPE. Addressing barriers such as different perceptions of teamwork, skill levels, and power within teams [
The Reid et al. [
When assessing attitudes using the ATHCTS, female subjects with prior health care experience had more positive attitudes toward IP practice [
Changing work climates and expectations for the two professional groups over recent years may impact the overall attitudes as evidenced in the ATHCTS results. It may be that there is a cohort effect that could be connected to systems’ changes. Attitudes toward IP practice can be impacted by the increasing emphasis on collaboration for younger cohorts, as well as extended practice experience in settings with significant IP communication that highlights the value in those who have been in practice the longest. Heinemann et al. [
Health care settings could be interpreted as outside that of the physical health setting to include behavioral health. These settings might influence attitudes toward IP practice differently. The social work students identified a range of practice areas as health services that may not be typically identified when discussing health professions settings. Expanding to include other areas of professional practice where medical professionals interface will answer questions relative to practice experiences and their impact on IP attitudes.
RN-to-BSN students in many instances bring a wealth of health care experiences to the classroom; this could influence their attitudes toward interprofessional education [
Significant research with the RIPLS exists; however, lack of consistency of questions utilized and adaptation of the scale makes it difficult to generalize the findings broadly. In addition, use of different student population groups in other studies makes comparisons to this study challenging. Often, these studies included undergraduate students and did not include social work students as a member of the health care team. Because this study was completed with postgraduate students, results differ.
Use of an electronic survey invitation also limits responses [
Further research could examine if there are differences in the mode of instruction and readiness for IPE. In this study, the RN-to-BSN students were enrolled in a fully online program, whereas the MSW student courses were primarily face to face. Although communication across disciplines has been demonstrated to be positively affected by IPE, the specific strategies for such communication have not been studied.
In an effort to insure relevant, contemporary learning approaches, faculty embarked on an interprofessional activity based on a contemporary film, My Sister’s Keeper©. This film was chosen because of its focus on ethical dilemmas associated with evolving genetic innovations. Health care professionals, including nurses and social workers, often deal with the ethical fallout that comes with these advances. The associated assignment requires students to examined personal/professional values and the utility of their respective professional codes of ethics.
A pedagogical consideration when designing this interprofessional activity was the challenge of bringing these two distinct groups of students together in a virtual classroom. In order to engage these two distinct groups of health professions students in discussion, faculty created a separate online course specific to this assignment. This served to reduce the barrier of geography and varying class and personal schedules of students.
When asked to evaluate the perspectives shared by all members of the discussion, it was noted that both focused on what was best for the patient, but there were differences in reasoning. One social work student noted, “it was eye-opening to see and read the different viewpoints and rationales. No matter what the viewpoint may be, both professions had the patient’s safety and best interest at heart.”
Communication and teamwork was repeatedly highlighted as crucial. Students commented that, “we are both experts in two very different fields that often collaborate … all viewpoints are valuable to the interprofessional team. Another student indicated that the exercise helped her to “think outside the box.” Reading the other profession’s viewpoints allowed students to think a lot deeper about the situation and risks involved. Another student observed, “Doing this exercise just reminds me how important both communication and interprofessional teams really are.” Still another remarked that the exercise, demonstrated that “having perspectives from multiple viewpoints can help come up with a very well-rounded comprehensive solution to a problem.” Finally, “it is apparent that many aspects, as both parts of the team being in the helping professionals, have similar interests in mind and we can utilize each other in the areas that we may lack knowledge.”
This study shows a readiness for interprofessional learning within the RN-to-BSN and Master of Social Work Students. Because efficient and effective services within the health care system require cross-disciplinary communication and collaboration [
Professional education in health care has moved toward increasing opportunities to interact with students from other disciplines in engaging, interactive ways. Interprofessional exercises engage students in discussion of the implications of contemporary problem-based learning opportunities. Students noted their practice experiences along with IP exercises foster better understanding of other disciplinary perspectives.
The survey data used to support the findings of this study are available from the corresponding author upon request.
Authors were employed by the University of Wisconsin-Green Bay while research was conducted.
The authors declare that there are no conflicts of interest regarding the publication of this article.