Interprofessional education – students of different professions learning together, from and about each other – is increasingly common in health professional degrees. Despite its explicit aims of transforming identities, practices and relationships within/across health professions, IPE remains under-theorised sociologically, with most IPE scholarship focussed on evaluating specific interventions. In particular, the significance of a shared knowledge base for shaping professional power and subjectivity in IPE has been overlooked. In this paper we begin to develop a framework for theorising (...) IPE in allied health, by drawing parallels with a cognate area in which there has already been fruitful conceptual development: interdisciplinarity. Specifically, we offer a worked example of how the two areas may be brought into dialogue, by deploying Barry, Born and Weszkalnys’ conceptualisation of interdisciplinarity as a lens for understanding IPE. Following Barry et al. we delineate a number of ‘modes’ and ‘logics’ of knowledge-production that emerge both in IPE literature and in our own empirical study of IPE. Our empirical data are drawn from 32 semi-structured interviews with 19 allied health students participating in an IPE curriculum at one Australian university. Findings point to the emergence of interprofessional practitioner identities among students that have the potential to undermine traditional epistemological boundaries and transcend role-based distinctions in future health professions. We argue that Barry et al.’s ‘logic of ontology’ sheds light on previously unidentified processes of transformation within IPE, and offers a theoretical framework that can explain the importance of a shared pan-professional knowledge base for the reflexive individual construction of new interprofessional ontological subjects. (shrink)

Background:Ethics education is essential to the education of all healthcare professionals. The purpose of this study was to evaluate an interprofessional approach to ethics education to all students across an academic health science center.Research objectives:The objectives were to (1) compare student perception of ethics education before and after the implementation of the campus-wide ethics program and (2) determine changes in student ethical decision-making skills following implementation of a campus-wide ethics program.Research design:This study was a quasi-experimental (...) design with seniors graduating prior to the intervention serving as the control group.Participants and research context:The setting was a comprehensive health science center in the southwestern United States. All students enrolled in the university participated in the intervention; however, 976 graduating students were used for evaluation of the intervention.Ethical considerations:Study materials for each survey were submitted to the university’s IRB, and the project was approved as exempt by the Committee for the Protection of Human Subjects. Student participation in the surveys was voluntary. No names or other identifying information were collected, and responses to the survey questions were kept confidential.Findings:Students’ perception of the adequacy of time spent on the ethics content in course instruction and practical training decreased from the baseline to the fifth-year survey. Students’ overall comfort level with their abilities to deal with ethical issues increased from the baseline to the fifth year. Student ethical decision-making skills were higher at the third-year evaluation for all indicators. For the fifth-year survey, responses were also higher scoring on all four indicators.Discussion:After participation in an interprofessional campus-wide effort on health professions ethics, students demonstrated higher ethical decision-making scores according to the Health Professional Ethics Rubric. However, their scores still did not reach the proficiency level identified in the rubric.Conclusion:Examination of the effectiveness of each part of the intervention is needed. (shrink)

Effective interprofessional collaboration depends upon establishing understanding that respects differences in values and beliefs, and thus differences in response to the multiplicity of patient/client/user needs. To facilitate the latter, this article suggests that health and social care students need a formal knowledge of the meaning of values and the varieties of systems within which values are expressed. Students need especially to understand the genesis of their own professional value system and to recognize the gap that inevitably develops between the (...) values of the professional and those of the society within which a professional may function. The conceptual framework that underpins the approach to teaching values to health and social care professionals advocated here is derived from key concepts identified from the literature relating to education for, and participation in, a democratic, multicultural, multifaith society. These are: tolerance, compromise and education for dialogue. Finally, it is suggested that professional educators must take seriously the tasks of educating for professional pluralism. (shrink)

Background There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. Methods In January 2018, following the successful implementation of a peer-led, grassroots (...) medical ethics curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/ MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. Results The majority of respondents were female, white and mid-20s in age. Almost half of respondents reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos. (shrink)

Effective interprofessional collaboration depends upon establishing understanding that respects differences in values and beliefs, and thus differences in response to the multiplicity of patient/client/user needs. To facilitate the latter, this article suggests that health and social care students need a formal knowledge of the meaning of values and the varieties of systems within which values are expressed. Students need especially to understand the genesis of their own professional value system and to recognize the gap that inevitably develops between the (...) values of the professional and those of the society within which a professional may function. The conceptual framework that underpins the approach to teaching values to health and social care professionals advocated here is derived from key concepts identified from the literature relating to education for, and participation in, a democratic, multicultural, multifaith society. These are: tolerance, compromise and education for dialogue. Finally, it is suggested that professional educators must take seriously the tasks of educating for professional pluralism. (shrink)

Background Ethical dilemmas that arise in the clinical setting often require the collaboration of multiple disciplines to be resolved. However, medical and nursing curricula do not prioritize communication among disciplines regarding this issue. A common teaching strategy, problem-based learning, could be used to enhance communication among disciplines. Therefore, a university in southern Taiwan developed an interprofessional ethics education program based on problem-based learning strategies. This study described tutors’ experience teaching in this program. Aim To explore the phenomenon of (...) teaching and learning in interprofessional ethics education for medical and nursing students from the perspectives of tutors. Design Phenomenological qualitative research. Methods Medical and nursing students completed a 6-week interprofessional ethics education program moderated by either physician or nurse tutors. At the conclusion of the ethics education program, all 14 tutors were invited to participate in focus group interviews. Among them, six tutors (three nursing tutors and three physician tutors) participated in additional individual interviews. All of the contents from the focus group interviews and individual interviews were recorded and transcribed. Using the phenomenological approach, the phenomenon of teaching and learning in interprofessional ethics education were generated. Ethical consideration The study was approved by the Institutional Review Board. Findings Three themes emerged from the tutors' teaching perspectives, including the instructor’s motivation to teach, the use of narrative case scenarios, and the emphasis on improving interprofessional ethics communication. Discussion Problem-based learning creates an interprofessional communication platform in interprofessional ethics education. The phenomenon of value convergence between tutors and students, between different students’ professions, and between different students’ professional maturities is observed. Conclusion Problem-based learning is an effective teaching strategy for creating a communication platform for interprofessional ethics education. Ethic curriculum should emphasize motivating instructor, use narrative case scenarios, and focus on interprofessional communication. (shrink)

Interprofessional collaboration has become accepted as an important component in today’s health care and has been guided by concerns with patient safety, quality health-care outcomes, and economics. It is widely accepted that interprofessional collaboration improves patient outcomes through enhanced communication among health-care providers and increased accessibility to services. Although there is a paucity of research that provides confirmatory evidence, interprofessional competencies continue to be incorporated into the curricula of health-care students. This article examines the ethics of (...) class='Hi'>interprofessional collaboration and ethical issues that arise from the mainstream adoption of interprofessional competencies and the potential for moral distress in nursing. (shrink)

This article discusses the nature of interprofessional ethics and some of the ethical issues and challenges that arise when practitioners from different professions work closely together in the fields of health and social care. The article draws on materials from a conference on this theme, covering issues of confidentiality and information sharing in practice and research with vulnerable people; challenges for teaching and learning about ethics in interprofessional settings; the potential of virtue ethics and an ethic of care (...) for understanding and handling ethical issues in interprofessional practice; and the extent to which interprofessional working may be about surveillance and control. It concludes that the need to understand and handle ethical issues in interprofessional working is contributing to the revitalisation of professional ethics as a dynamic field of study. (shrink)

Background: One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. Objectives: The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. Design: The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For (...) the pilot of the book, a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. Participants and research context: A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. Ethical considerations: The project was approved as exempt by the university’s Committee for the Protection of Human Subjects. Findings: The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. Discussion: Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. Conclusion: The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity. (shrink)

The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled (...) justification, all things considered; relational ethics on intersubjective, professional, and institutional relations; and virtue ethics on prephilosophical tradition and what it means to be good and to be human embedded in social and political community. Analysis suggests that interprofessional collaboration-in-practice may be more rhetoric than actuality. Key challenges of interprofessional collaboration-in-practice and specific conditions perpetuating dissension and conflict are outlined with specific education and policy recommendations included. (shrink)

The author created a new course, called “Seminar in Public Health Law and Policy in an Interprofessional Setting” to address the need for interprofessional education to equip graduate and professional students for collaborative practice at the systemic and policy levels in the health care and public health fields. Despite important work being done at the clinical practice level, limited existing IPE models examine larger systemic issues. The course is designed specifically to enable students in social work, law, (...) and public health to recognize the reciprocal relationships between policy and interprofessional collaborative practice, including the need for understanding of the impact of team-practice work at the system and policy levels. (shrink)

Definition of the problem Interprofessional learning of nursing trainees and medical students offers numerous opportunities for future cooperation aiming to provide high-quality care for patients. Arguments Expert panels, therefore, demand early integration of interprofessional teaching and learning structures in order to be able to achieve effective and sustainable improvements in practice. In Germany, interprofessional learning formats are increasingly used in undergraduate education of the two professions in selected—compulsory and optional—themes and courses. Conclusion So far, the field (...) of health care ethics has scarcely been taken into consideration. The article examines the situation of interprofessional ethics teaching in Germany and highlights its opportunities and limitations against the background of a pilot project. (shrink)

In June 2013, faculty from the University of Maryland Carey School of Law, along with students from the law school and several health professional schools at the University of Maryland, Baltimore, visited Malawi, in southeast Africa. While there, they met with faculty and students at the University of Malawi Chancellor College to discuss the possibility of establishing an ongoing collaboration between the two universities’ law schools. The starting point for our discussion was the potential establishment of a multi-professional, comparative health (...) law clinic that would focus on serving individuals living with HIV and AIDS. This goal would serve two objectives of the Law & Health Care Program at Maryland: to increase interprofessional education opportunities and to expose law students to more global health law issues. Establishing this clinic would also be consistent with two strategic objectives of the University of Malawi Faculty of Law: to establish links with other law schools providing clinical legal education, and to contribute to Malawi’s efforts to solve HIV/AIDS-related problems. (shrink)

In June 2013, faculty from the University of Maryland Carey School of Law, along with students from the law school and several health professional schools at the University of Maryland, Baltimore, visited Malawi, in southeast Africa. While there, they met with faculty and students at the University of Malawi Chancellor College to discuss the possibility of establishing an ongoing collaboration between the two universities’ law schools. The starting point for our discussion was the potential establishment of a multi-professional, comparative health (...) law clinic that would focus on serving individuals living with HIV and AIDS. This goal would serve two objectives of the Law & Health Care Program at Maryland: to increase interprofessional education opportunities and to expose law students to more global health law issues. Establishing this clinic would also be consistent with two strategic objectives of the University of Malawi Faculty of Law: to establish links with other law schools providing clinical legal education, and to contribute to Malawi’s efforts to solve HIV/AIDS-related problems. (shrink)

Drawing both on cultural-historical activity theory and on a dialogical approach to discourse, this article expands a method of analysis developed by Engeström & Sannino to capture discursive manifestations of contradictions in an activity system. The data consist of recorded meetings of an interprofessional team working with persons living with both a mental handicap and psychiatric disorders. The mission of this team is to coordinate socio-educative and psychiatric work. A sequence taken from one of these meetings was submitted to (...) a step-by-step discourse analysis and examined how the participants negotiated and managed the obstacles met with in their daily work. The analysis showed how an initial obstacle presented as a conflict was gradually turned into a critical conflict and finally into a dilemma between two rules: professional confidentiality and transparency towards the patient. It showed how the participants collectively coped with this dilemma, and came to define it as a problem related to work organisation, and not only to interpersonal relationships. The study shows the importance of discourse processes in collaborative work and in fostering professional learning and focus upon discourse processes through which team members deal with obstacles in their daily work and to provide a fine-grained analysis of systemic contradictions. (shrink)

Professional, Ethical, Legal, and Educational Lessons in Medicine: A Problem Based Approach provides a comprehensive review of the complex and challenging field of professional medical practice. Its problem-based format incorporates a vast pool of practical, board-exam-style multiple-choice questions for self-assessment, and is an ideal resource for exam preparation as well as ongoing clinical education among trainees and clinicians The practice of medicine is not only about clinical care of patients. Physicians must navigate ethical conundrums, legal pitfalls, and quality improvement (...) issues while maintaining scrupulous professionalism and being exemplary educators. This volume addresses common issues in the realm of professional medical practice not typically covered in other texts. Each of the 73 chapters presents a problem-based case that branches out into an oral board examination type stem questions. A discussion section with brief review articles summarizes the most recent literature. Multiple-choice questions with answers allows for comprehensive self-assessment or interactive group quizzes. This book will appeal to medical and allied health professionals in all specialties of medicine. It is an excellent and hands-on reference for the related but diverse domains associated with professional healthcare practice by students, physicians, and other healthcare providers compacted into one volume. (shrink)

The maintenance of professional competence is a core ethical responsibility of health professionals. Continuing Education (CE) is one quality assurance mechanism that helps health professionals to...

Reflections on incivility and why civility matters -- The costs and consequences of incivility : rationale for change -- The inextricable link between stress and incivility -- The "dance of incivility and civility" in nursing education -- Raising awareness, naming the problem, and creating a vision for civility -- Principled leadership and the power of positive role-modeling and mentoring -- Pathway for fostering organizational civility : institutionalizing change -- Fostering effective and meaningful communication -- The first day of class (...) : co-creating a positive learning environment -- Scholarly teaching, engaged learning, and finding our joy -- The healing power of stress management and self-care -- Seeking and keeping civility in nursing education. (shrink)

Child Family Health International is a U.S.-based nonprofit, nongovernmental organization that has more than 25 global health education programs in seven countries annually serving more than 600 interprofessional undergraduate, graduate, and postgraduate participants in programs geared toward individual students and university partners. Recognized by Special Consultative Status with the United Nations Economic and Social Council , CFHI utilizes an asset-based community engagement model to ensure that CFHI’s programs challenge, rather than reinforce, historical power imbalances between the “Global North” (...) and “Global South.” CFHI’s programs are predicated on ethical principles including reciprocity, sustainability, humility, transparency, nonmaleficence, respect for persons, and social justice. (shrink)

Global health is by definition and necessity a collaborative field; one that requires diverse professionals to address the clinical, biological, social, and political factors that contribute to the health of communities, regions, and nations. While much work has been done in recent years to define the field of global health and set forth discipline-specific global health competencies, less has been done in the area of interprofessional global health education. This paper documents the results of a roundtable that was (...) convened to study the need for an interprofessional team skills competency domain for global health students. The paper sets forth a preliminary set of team competencies based on existing scholarship and the results of the roundtable. Once an agreed upon set of competencies is defined, a valuable next task will be development of a model curriculum to teach team skills to students in global health. The preliminary competencies offered in this paper represent a good first step toward ensuring that global health professionals are able to collaborate effectively to make the field as cohesive and collaborative as the mighty task of global health demands. (shrink)

Global health is by definition and necessity a collaborative field; one that requires diverse professionals to address the clinical, biological, social, and political factors that contribute to the health of communities, regions, and nations. For universities with global health programs, the interprofessional nature of global health presents both vast opportunities and distinct challenges. In addition to helping students develop mastery within their chosen fields, universities must also ensure that students learn to collaborate with other professionals to address complex global (...) health needs. While much work has been done in recent years to define the field of global health and set forth discipline-specific competencies, less has been done in the area of interdisciplinary or interprofessional global health education. This gap in scholarship is troubling given the clear and well-acknowledged need for professionals across a broad spectrum of disciplines to take part in global health initiatives. (shrink)

Viewing difficulty as an opportunity for learning runs counter to the common view of difficulty as a source of frustration and confusion. The aim of this article is to focus on the idea of difficulty as a stepping-off point for learning. The literature on difficulty in reading texts, and its impact on thinking and the interpretive process, serve as a foundation for the use of poetry in healthcare ethics education. Because of its complexity and strangeness compared to the usual (...) scientific and clinical texts health science students encounter, poetry is an excellent means to achieve the aim of thinking through difficulties in ethics. Specific examples of teaching and learning strategies for turning difficulty into opportunities for learning are presented, including the difficulty paper and the triple mark-up method. Both methods require students to examine their process of working through difficulties, reflect on how they make sense of difficult texts and then share their process and interpretations in a collaborative manner with peers. The importance of framing difficulties as a public, visible, collaborative process rather than a personal process is emphasized. Working together to hypothesize reasons for difficulty and map out plans to come to terms with difficulty are equally relevant for reading text as they are for reading complex ethical situations. Finally, I argue that transference of this kind of personal and collaborative learning about difficulties benefits interprofessional clinical practice, particularly when dealing with ethical issues. (shrink)

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The (...) DIT contains certain philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision. (shrink)