Transitions of Care as Model to Engage Rural Health Professions Learners with Interprofessional Competencies: A 3-year IPE Curriculum Study

Background:
The Centers for Medicare and Medicaid Services (CMS) define a transition of care as the ‘movement of a patient from one setting of care to another... settings of care may include hospitals, ambulatory primary care practices, ambulatory specialty care practices, long-term care facilities, home health, and rehabilitation facilities’. Although more recent science has demonstrated improvement in elements of care transition, data continues to demonstrate that care transitions are oftentimes cumbersome, non-standardized, and are rife with critical communication deficits leading to inefficient and unsafe care. Transitions of care serve as fertile learning landscape for future rural health providers, not only to apply clinical knowledge and skills, but also to employ crucial interprofessional competencies. The purpose of this three-year study was to examine the efficacy of a hybrid-modality Transitions of Care Interprofessional Education (TOC IPE) curriculum developed for learners at rural/distant campuses. With IPEC Competencies as a foundation, the curriculum effectively leveraged technology to include asynchronous didactic modules alongside episodic in-person meetings. Learners developed a foundational understanding of interprofessional competencies and produced a team-based transition of care plan.

Methodology:
Sixty-seven graduate students from rural campuses of Physician Assistant Studies and Social Work participated. This longitudinal cohort study employed pre/post-test mixed method design via the Interprofessional Collaborative Competency Attainment Scale (ICCAS) and satisfaction measures. Descriptive statistics, paired-samples t-tests, and Cohen’s d effect size estimates were calculated for practical significance.

Results:
Participants reported statistically significant gains in acquisition of interprofessional competencies. Practical significance was exemplified in medium-large effect sizes for 82% of ICCAS items. Participant satisfaction was demonstrated through means at or above benchmark of 3.0 (5-point scale) across all categories in all years. Participants regarded the hybrid delivery method effective.

Conclusion:
This curriculum effectively employed technology to meaningfully engage rural learners in acquisition and application of interprofessional competencies through development of a team-based transition of care project.

Implications:
This curriculum could be adapted to entirely asynchronous format and may be applied for other rural campus programs. Implications for future study include follow up once learners begin practice in rural health systems and participate with other providers in transitions of care.