title: A Prospective Evaluation of Interprofessional Team-Based Clinical Education at the School of Dentistry and Oral Health, Griffith University
Creators: name: Storrs, Mark J
Publisher: name: Griffith University
Year: 2020
Subjects: subject: oral health professionals
subject: interprofessional education
subject: Dentistry
subject: FOS: Clinical medicine
subject: Oral Health
subject: interprofessional
subject: clinical learning

description: Students in diverse health programs taught separately from each other with a focus on profession ‘specific’ content rather than comprehensive collaborative patient care promotes a limited understanding of and respect for the collaborative role of different health professionals when undertaking treatment planning and patient-centred care. This may result in oral health graduates educated within a uniprofessional context becoming ill-prepared to manage patients with complex conditions that require collaboration with different oral health professionals (OHPs) through a team-based patient-centred approach. As the potential value of interprofessional education (IPE) is strongly advocated in the literature, the Griffith University School of Dentistry and Oral Health (DOH) introduced the interprofessional teams-based treatment planning (TBTP) process in 2009 to address these educational challenges and facilitate IPE. The TBTP process incorporated student practice teams and an expansion of peer learning through collaboration between students enrolled in three different oral health programs, namely dentistry, dental technology and oral health therapy. It was perceived that shared learning, understanding of complementary knowledge, collaborative participation in managing patient care, and having knowledge/respect for each professions’ role were all necessary to improve communication and teamwork skills in a pre-qualification context in readiness for collaborative oral health practice. However, a systematic evaluation of the TBTP process, its contribution to student clinical learning and experiences, and whether those experiences contributed to advancing interprofessional competencies and capabilities at DOH has not been conducted since its commencement. This thesis documents an evaluation that researched the attitudes, perceptions and experiences of students, clinical teaching staff, patients and newly graduated OHPs involved with the TBTP process at DOH between 2012 and 2015. The evaluation framework proposed in this research uses the first three levels of Kirkpatrick’s expanded typology of learner outcomes for educational interventions as a feedback process. The levels include student reaction to the learning experience such as a change in attitude towards interprofessional practice, acquisition of knowledge/skills which incorporates collaborative oral health learning experiences and behavioural change. This study employed a mixed methodology, primarily quantitative supplemented by a qualitative approach where data were collected prospectively and annually at similar points in time between 2012 and mid-2015. The first phase of this study developed, and pilot tested instruments to collect relevant information from the cohorts included in the study and conducted a psychometric evaluation of the student survey to establish its validity and reliability. The second phase prospectively collected data utilising instruments specific for each of these cohorts. Quantitative and qualitative analyses of collected data and an interpretation of the results were then employed to answer the research question: ‘What is the impact of interprofessional student team-based processes, based on best practice principles, on attitudes, perceptions and experiences of students, clinical teaching staff, patients and newly graduated OHPs affiliated with DOH?’ A triangulation of data determined the amount of convergence in the study results thereby enhancing confidence in the findings and the research methodology as being well developed, comprehensive and robust. The results suggest that students had positive attitudes towards shared learning as indicated by their willingness to share information about patients with students in other oral health programs and engage in collaborative discussions to arrive at mutually agreed decisions about treatment plans within a team environment. The TBTP process was identified as a supportive environment where interprofessional clinical learning and experience was gained. It was perceived that effective supervision in this context facilitated collaborative treatment planning and teamwork skills, positive opinions of other OHPs, enhanced communication with colleagues and an improved understanding of clinical problems where students engaged in patient-centred collaborative care. New graduates noted that their behaviour became more respectful towards other OHPs as indicated through improved communication and by effectively contributing as part of a patient’s interprofessional team-based care. Interprofessional shared learning alone had a large predictive effect and correlated strongly and significantly with students’ interprofessional clinical learning and experiences. The effect that chance, selection bias, measurement bias and confounding may have had on findings were considered and outcomes attributed to students were found to possess internal validity. Findings from clinical teaching staff were deemed valid and reliable within DOH, and information collected from other cohorts was considered innovative and provided meaning to help answer the research question. Through the TBTP process students acquired several interprofessional competencies and capabilities that included an understanding of roles and interprofessional values; interprofessional communication including collaborative decision-making and an ability to recognise and resolve conflict, and teamwork abilities relevant towards providing team-based patient-centred care. This research provides valuable information for accrediting authorities and oral health educational providers seeking to incorporate interprofessional team-based clinical oral health education within their curricula to improve program outcomes. Strategies to guide a more efficient and effective interprofessional model of clinical oral health education at DOH have been proposed in this thesis. Recommendations have also been made for further research opportunities, both nationally and internationally, to improve an understanding of the educational needs of oral health students and graduates to better equip educational facilities to expedite students’ interprofessional clinical learning and experience reflective of best practice clinical oral health education.