Exploring medical students' attitudes towards interprofessional collaboration between different types of healthcare professionals

Plain English Summary

Background and study aims
For the past twenty years, patient care has moved its focus away from acute diseases, which are managed in a hospital setting, to chronic conditions, which are usually dealt with in the community and attend to health-related quality of life issues. Such a shift means that patients now rely more on complex systems involving different health professionals. Both patients and caregivers experience distressing situations because of poor communication and collaboration between all the health professionals providing the treatment and this usually results in a lack of continuity of care.

Healthcare focuses on team-based practice and interprofessional collaboration (IPE), and supporting such teamwork has been shown to lead to better patient care. IPE in medical schools will improve attitudes toward teamwork and collaboration, leading to improved patient care upon graduation. However, the appropriate timing to introduce IPE is not known. Additionally, at the University of Bern, medical students' attitudes towards IPE are not known. This study addresses this gap by analyzing medical student's attitudes towards IPE and establishing the best time to introduce such an intervention.

Who can participate?
All medical students from the year 2019/2020 enrolled at the Faculty of Medicine of the University of Bern, Switzerland, are eligible for study inclusion.

What does the study involve?
A survey of medical student's attitudes towards interprofessional learning at different stages of their training. After filling in the questionnaire, interviews will be conducted to explore which ideas medical students have towards enhancing interprofessional education and how students feel about interprofessional learning interventions.

What are the possible benefits and risks of participating?
No direct benefits or risks are anticipated.

Where is the study run from?
Inselspital, Bern, Switzerland

When is the study starting and how long is it expected to run for?
October 2019 to June 2020

Who is funding the study?
Inselspital, Bern, Switzerland

Who is the main contact?
Joana Berger-Estilita
joana.berger-estilita@insel.ch

Study website

Type

Scientific

Contact name

Dr Joana Berger-Estilita

ORCID ID

http://orcid.org/0000-0002-8695-4264

Contact details

Freiburgstrasse 8-10
Bern
3010
Switzerland
+41 (0) 788438161
joana.berger-estilita@insel.ch

EudraCT/CTIS number

Nil known

IRAS number

ClinicalTrials.gov number

Nil known

Protocol/serial number

BEJD-2-20

Scientific title

Attitudes from medical students towards interprofessional collaboration: a mixed-methods study

Acronym

GIPAS

Study hypothesis

Research questions:
1. In which phase of their training do medical students have a more positive attitude towards interprofessional collaboration?
2. What ideas do medical students have towards enhancing interprofessional education?
3. How strongly do students feel about interprofessional learning interventions?

Ethics approval(s)

Confirmed that ethics approval not required 07/08/2019, Kantonale Ethikkomission (KEK) Bern [Bernese Cantonal Ethics Committee] (Murtenstrasse 31, 3010 Bern, Switzerland; +41 31 633 7070; info.kek.kapa@gef.be.ch), ref: Req-2019-00743

Study design

Observational cross-sectional study

Primary study design

Observational

Secondary study design

Cross sectional study

Study setting(s)

Hospital

Study type

Other

Patient information sheet

Not available in web format, please use contact details to request a participant information sheet.

Condition

Medical students' attitudes towards interprofessional learning

Intervention

The study design is a sequential quantitative to qualitative mixed-methods design (MMD) based on a sequential explanatory model (Schifferdecker & Reed, 2009). An initial quantitative survey will seek to gather information on medical students' attitudes towards interprofessional collaboration by conducting an online survey with students at different stages of their training. Attitudes will be measured with the use of the German Interprofessional Attitudes Scale (G-IPAS) in a non-experimental fashion. The original IPAS has 27 survey questions that load into 5 subscales (Norris et al., 2015):
1. Teamwork, roles and responsibilities (TRR)
2. Patient-centeredness (PC)
3. Interprofessional bias (IB)
4. Diversity and ethics (DE)
5. Community-centeredness (CC)

The original American scale with five subscales was translated and culturally adapted and validated, giving rise to the G-IPAS. This validation process lead to the deletion of the subscale 'Interprofessional Bias' and re-distribution of items from subscale 'Diversity and Ethics' to the remaining three subscales: 'Teamwork, Roles and Responsibilities', 'Patient-centeredness' and the renamed subscale 'Health Care Provision'.

A descriptive analysis of the survey data will be conducted. Global scale and individual items will be assessed for normal distribution with Shapiro-Wilks test and visual assessment of residuals and Q-Q Plots. A sub-group analysis per year of studies will be performed. Establishing statistical significance of the relationships between variables will be performed using the Chi-square test. Correlation analysis will also be attempted. A statistician will be involved to oversee the data analysis. All quantitative data will be analysed using SPSS v23.

The findings from the initial quantitative data analysis will be used to guide and further explore themes in a qualitative approach (Schifferdecker & Reed, 2009). A format will be developed for semi-structured interviews to examine how individual trainees experience interprofessional collaboration and the impact this has on their own professional development.

Data from the semi-structured interviews will be processed according to the Miles and Huberman (2014) data analysis framework. This includes data reduction (with editing, segmenting and summarizing the data), then data display and finally verifying conclusions. Coding will be done first with descriptive and then with pattern codes. Memoing will be performed parallel to coding. MaxQDA software (VERBI, 2017) will be used to perform this analysis.

Quantitative phase:
Attitudes towards interprofessional learning will be measured with the use of the German Interprofessional Attitudes Scale (G-IPAS) in a non-experimental fashion. Students will receive an e-mail with the link to the survey, posted online in the Surveymonkey (R) platform. The platform will be open from 07th October to 15th December 2019. Up to 2 reminders will be sent.

Qualitative phase:
The second component is qualitative methods design using semi-structured interviews with medical students with the aim to explore the findings of the quantitative research. At the end of the online survey G-IPAS questionnaire, students will have the opportunity to tick a box signalling their availability to take part in a semi-structured interview group. Students who agree to participate will be invited to a 60-minute semi-structured interview, to be planned at a convenient date.

Intervention type

Behavioural

Primary outcome measure

Attitudes towards interprofessional collaboration assessed using the German Interprofessional Attitudes Scale (G-IPAS)

Secondary outcome measures

Students' experiences and views about interprofessional education and collaboration between medical students and other healthcare groups assessed using semi-structured interviews designed using results from the online survey. They will seek to answer research questions such as "What ideas do medical students have towards enhancing interprofessional education?" and "How strongly do students feel about interprofessional learning interventions?".

Overall study start date

01/06/2019

Overall study end date

30/06/2020

Reason abandoned (if study stopped)

Participant inclusion criteria

All medical students from the year 2019/2020 enrolled at the Faculty of Medicine of the University of Bern, Switzerland, are eligible for study inclusion.

Participant type(s)

Other

Age group

Adult

Sex

Both

Target number of participants

The sampling method will be a non-probability convenience sample. All medical students from the Faculty of Medicine of the Bern University of in the year 2019/2020 who wish to participate will be included in the sample. All students currently enrolled in the Faculty of Medicine of the University of Bern will be asked to participate (around 1300 students). In survey research, one hundred observations for each of the major sub-groups in the survey should be aimed for (Borg & Gall, 1989): since the medical curriculum at the University of Bern consist of a 6-year Degree, our sample size will need to include 600 students, 100 students for each year.

Total final enrolment

683

Participant exclusion criteria

1. Non-medical students from the University of Bern
2. Students from other medical Faculties

Recruitment start date

01/10/2019

Recruitment end date

15/12/2019

Countries of recruitment

Switzerland

Study participating centre

Inselspital
Freiburgstrasse 8-10
Bern
3010
Switzerland

Organisation

Inselspital

Sponsor details

Department of Anaesthesiology and Pain Medicine
Inselspital
Bern University Hospital
Freiburgstrasse 8-10
Bern
3010
Switzerland
+41(0)31 632 24 83
rita.krattinger@insel.ch

Sponsor type

Hospital/treatment centre

Website

www.anaesthesiologie.insel.ch

ROR

https://ror.org/01q9sj412

Funder type

Hospital/treatment centre

Funder name

Inselspital

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Publication and dissemination plan

The results are planned to be written up as a dissertation for completion of the Master of Medical Education of the University of Dundee and published in the journal Medical Education.

Intention to publish date

30/07/2020

Individual participant data (IPD) sharing plan

The datasets generated during and/or analysed during the current study are/will be available from Joana Berger-Estilita, joana.berger-estilita@insel.ch, from November 2020 for a period of 10 years, upon reasonable request.

IPD sharing plan summary

Available on request

Study outputs