Student Preparation for and Delivery of Ambulatory Care Through a Comprehensive Interprofessional Clinic Experience

Background:
Interprofessional practice (IPP) requires diverse learners to organize as a team. Didactic and episodic experiences may not provide learners with skills to establish/advance teamwork in practice. A model which requires students establish “ground rules” for team-based care delivery and provides faculty-led reflection can support skill development while addressing Interprofessional Education Collaborative (IPEC) competencies. Our specific aims include assessment of student perceptions after participation in this model using a validated interprofessional survey and a quantitative/qualitative program evaluation.

Design and methods:
Interprofessional student teams developed/tested care processes through simulation prior to delivery. IPEC competencies were accomplished by team-based IPP care provided during four monthly ambulatory care clinic sessions at a charitable clinic. Structured team de-brief led by a faculty facilitator guided students through reflection on desired competencies and process improvement for subsequent care delivery. Eight teams of eight to ten students from seven colleges/schools participated in IPP during the 2017-2018 year. Parallel didactic cohorts experienced two interactive sessions six months apart. Baseline and post assessments included random assignment of 865 students (76 in the clinical cohort) to complete one of two validated interprofessional surveys. For each survey score, three comparisons were made simultaneously: 1) overall baseline vs. post-didactic cohort; 2) overall baseline vs. post-clinical cohort; and 3) post-didactic cohort vs. post-clinical cohort.

Results:
Response rates for both surveys were at or above 54%. One validated survey instrument showed significantly higher pooled results for the subdomain of teamwork, roles and responsibilities following clinic completion when compared to baseline and the cohort group only receiving didactic experience. Quantitative Likert responses and qualitative open-ended program evaluation comments by students showed agreement that intended IPEC competencies were achieved.

Conclusion:
The present model appears to modify student perceptions following a short-term IPP experience involving diverse interprofessional teams. Qualitative student comments suggest the model supports development of team-based skills which can be used in practice.

Implications:
An optimal interprofessional clinical learning environment for intentional, quality interprofessional education can occur when teams of learners establish ground rules and deliberately reflect on performance through faculty facilitation. Application of skills and behavior change in practice are areas for future research.