Category: Professional Posters
Purpose: The use of interprofessional healthcare teams is becoming standard of practice. Therefore, team-based care should be implemented into health professions education. Cases are important in helping students apply didactic knowledge to real-world contexts. This study assessed the impact of the student-led clinical reasoning club (CRC) or competition on students’ perception and knowledge of working as a team and their confidence on clinical rotations.
Methods: The study was reviewed by Creighton University’s IRB and deemed exempt. Surveys were sent to all third- and fourth-year medical students and fourth-year pharmacy students (n=437). General demographics captured include gender, profession, year in school. The survey included the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R) instrument which assesses perceptions of appropriateness and benefits of interprofessional education (IPE). All students were asked the four Likert scale questions. All students were asked to identify what aspects of clinical rotations they were most and least competent. Those that completed a CRC activity were asked to comment on how they have used interprofessional collaboration information/skills gained from the CRC on rotations.
Mean SPICE-R scores were compared between students that participated in the CRC versus those that did not using Student’s t test. Qualitative response data were compiled for independent analysis by five experts. Key phrases that exemplified themes were identified and final themes were mapped to the Interprofessional Education Collaborative (IPEC) core competencies.
Results: Of 437 students contacted, 201 (46%) responded. Of respondents, 82 (41%) participated in >1 CRC activity and 119 (59%) had not. There was no significant difference in mean SPICE-R scores between those who participated in CRC versus those that did not (43.8+4.8 versus 43.2+4.4, P=0.37). There were also no significant differences in scores when stratified by type of CRC activity or profession.
Independent t-tests were also used to compare scores on the four Likert scale questions. While no significant differences were found between cohorts, the difference in understanding of roles and responsibilities trended towards significance (P=0.08), suggesting that CRC participation may have impacted this.
For both cohorts, students reported that they were most confident with patient interactions. Students in both cohorts reported they were least confident presenting to a team (CRC 22% versus non-CRC 18%). Nearly twice as many students in the non-CRC group were least confident communicating with a prescriber compared to the CRC group (11.7% versus 6%). For students in the CRC cohort, the most common themes from skills used on clinical rotations were roles and teamwork. Only three students referenced a skill that aligned to values.
Conclusion: CRC did not affect students’ perceptions of IPE but may have improved understanding of roles and responsibilities. CRC may have improved confidence in communicating with a prescriber. The fact that both cohorts were least confident in presenting to a team may be related to the Socratic pedagogy on clinical rotations. Values may have been unrepresented in the skills obtained from CRC because it’s implied in other IPEC competencies. In addition, CRC is typically completed in the first two years of the curriculum, the cases do not have explicit values and ethics components.