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Perspectives of pharmacy students, pharmacy academics and practicing pharmacists on interprofessional education and collaborative practice: a comprehensive systematic review protocol

Source:

JBI Evidence Synthesis

December 2015, Volume :13 Number 12 , page 70 - 92 [Free]

Authors

  1. El-Awaisi, Alla
  2. Diack, Lesley
  3. Joseph, Sundari
  4. El Hajj, Maguy

Abstract

Review question/objective: The objective of this systematic review is to examine the perspectives, attitudes, views and experiences of pharmacy students, pharmacy academics and practicing pharmacists towards interprofessional education and collaborative practice through quantitative and qualitative evidence.

 

Background: Interprofessional education (IPE) has been defined by the Centre for the Advancement of Interprofessional Education (CAIPE) as "two or more professions learn with, from and about each other to improve collaboration and the quality of care".1(para1) Globally, interprofessional education has gained momentum in the last twenty years. However, this has been more pronounced in developed countries such as Canada, United States, Australia and the United Kingdom. In an IPE environment, students are provided with a structured opportunity that enables them to interact with other healthcare professionals where they acquire the knowledge, skills and professional attitudes as part of their undergraduate learning experience.2 Once they graduate, they are able to translate this into practice. The practice environment is often complex and intense, and requires a high level of interpersonal skills for the health care professional to be able to work in an adaptable, flexible and collaborative environment and to appreciate the roles of the different health care professionals.2 Health professionals learning together and understanding each other better is the way forward and has been proven by international research evidence.3,4,5,6

 

As healthcare systems advance, the demand for collaborative work between healthcare professionals from different backgrounds increases; therefore, healthcare professionals need to develop the knowledge and skills required to work together effectively in order to positively impact on patient care. As a result, the World Health Organization (WHO) published a ground-breaking document titled, "Framework for Action on Interprofessional Education and Collaborative Practice" in 2010.6. In this framework, WHO strongly advocated the development and integration of IPE into healthcare curricula. They emphasized the importance of adapting team based collaborative models in all the different areas of healthcare to enhance the delivery of healthcare services. Collaborative practice occurs "when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care".6(p13) Therefore, collaboration involves solving challenging problems together, interacting, negotiating and jointly working with health workers from any background. This is where two or more healthcare professionals work cohesively to address patient needs. Benefits of collaborative practice include strengthening health care systems and improving patient care in terms of quality and safety provided, reducing the cost of care, shortening patients' duration of hospital stay, and improving health outcomes.6,7

 

In terms of pharmacy and the expanding and evolving role of the pharmacist seen in the early nineties with the emergence of the concept of pharmaceutical care concept by Hepler and Strand,8 it is important that this role is recognized and understood by other healthcare providers and healthcare students so that there is effective collaboration and team work. With this in mind, pharmacists also need to recognize and understand other professionals' roles. Pharmacists need to be able to assume new innovative roles centered on patient care rather than being product centered. These roles include medication reviews, chronic disease management, immunization services, well-being programs, prescribing and becoming an integral part healthcare decision making team based on evidence based practice.

 

A number of systematic reviews on IPE exist with the first one dating back to 1999. These found no rigorous quantitative evidence on the effects of IPE.9Table 1 summarizes the main systematic reviews to date focusing on IPE.

 

In the above best evidence systematic review of IPE published in 2007, most of the studies evaluated IPE that was delivered to healthcare students during their undergraduate studies. The majority of participants were from medicine, nursing and physiotherapy, with pharmacy students being less prevalent.3 This finding was echoed in another review which found that medical students were included in all the studies with high representation by nursing students, and less by students from other health care fields, including pharmacy.4 The pharmacy profession was represented in the primary literature reviewed but its perspective and inclusion was not explicit. Hence there is a need to conduct a systematic review to investigate literature that specifically explores the pharmacy perspective on IPE. It would be useful to investigate the interprofessional learning within pharmacy courses, as providing this information can potentially lead to the development of new and innovative teaching strategies which will potentially benefit health professionals. It is interesting to note that after searching the Cochrane Collaboration's database, JBI Database of Systematic Reviews and Implementation Reports and general literature, the authors believe that no systematic review with a uni-professional healthcare perspective has been undertaken previously; therefore, this review will be unique in that it will be the first to investigate a single healthcare profession's perspective about IPE and collaborative practice.

 

This is the first systematic review investigating pharmacy perspectives of IPE worldwide. It is anticipated that this review will consolidate and synthesize existing findings regarding pharmacy perspectives on IPE and provide a better understanding of what shapes this perspective. It will also provide us with the platform needed to develop and implement IPE activities that are meaningful, comprehensive and unique. The outcomes of this research will provide a set of recommendations to be used by pharmacy and other healthcare educators to plan and implement innovative IPE activities that are relevant and meaningful to students.

 

Article Content

Inclusion criteria

Types of participants

The quantitative and qualitative components of this comprehensive systematic review will consider studies that include pharmacy students (undergraduate and postgraduate), practicing pharmacists (community, hospital and primary healthcare) or pharmacy academics (teaching in academic institutions) as participants.

 

Types of Intervention(s)/phenomena of interest

The quantitative component of the review will consider studies that investigate interprofessional education and collaborative practice. More specifically, studies that investigate the perspective of pharmacy students, pharmacy academics and practicing pharmacists towards interprofessional education and collaborative practice will be considered.

 

The qualitative component of this review will consider studies that investigate the phenomena of interest of the perspectives, attitudes, views and experiences of pharmacy students, pharmacy academics and practicing pharmacists toward interprofessional education and collaborative practice.

 

Any quantitative or qualitative methods of capturing any of the following will be considered:

 

* Perspectives

 

* Experiences

 

* Attitudes

 

* Views

 

 

of pharmacy students, pharmacy academics and practicing pharmacists towards IPE and collaborative practice.

 

Types of outcomes

This review will consider studies that include the following outcomes:

 

Quantitative outcomes will include participant perspectives including experiences, attitudes or views on IPE as captured by surveys, questionnaires or any other instruments capturing quantitative data.

 

Context

The context will be university academic settings and pharmacy practice settings, i.e. community, hospital and primary healthcare worldwide.

 

Types of studies

The quantitative component of the review will consider both experimental and epidemiological study designs including prospective and retrospective cohort studies, case control studies and analytical cross sectional studies for inclusion.

 

The qualitative component of the review will consider studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.

 

Search strategy

The search strategy aims to find both types of published studies. A three-step search strategy will be utilized in this review as follows:

 

1. An initial limited search of MEDLINE and CINAHL will be undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe articles.

 

2. A second search using all identified keywords and index terms will then be undertaken across all included databases.

 

3. Thirdly, all the reference lists of all identified articles will be searched for any additional relevant studies.

 

 

Only studies published in English will be considered for inclusion in this review. Studies published from 1999 will be considered for inclusion in this review. The reason for focusing only on this period is to capture the most recent trends in IPE.

 

The databases to be searched include:

 

* MEDLINE

 

* EBSCO host

 

* EMBASE

 

* CINAHL

 

* Web of Science

 

* ScienceDirect

 

* International Pharmaceutical Abstracts (IPA).

 

 

The following will be hand searched to find additional articles:

 

* Journal of Interprofessional Care (1999-2014), relevant conferences and websites such as:

 

* All Together Better Health Website

 

* CAIPE - Centre for the Advancement of Interprofessional Education

 

* AHIC - The American Interprofessional Health Collaborative

 

* AIPPEN - The Australasian Interprofessional Practice and Education Network

 

* CIHC - The Canadian Interprofessional Health Collaborative

 

* EIPEN - The European Interprofessional Practice and Education Network

 

* JAIPE - The Japan Association for Interprofessional Education

 

* JIPWEN - The Japan Interprofessional Working and Education Network

 

* NIPNET - The Nordic Interprofessional Network

 

 

The following keywords will be used:

 

Interprofession* or Inter-profession*, Multidisciplin* or Multi-disciplin*, Perspectives, Attitudes, Experiences; Views; Pharmac*

 

Studies not involving pharmacy will be excluded to focus on the objectives of the research.

 

Assessment of methodological quality

Quantitative studies selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. All reviewers have undertaken the JBI comprehensive systematic review training program.

 

Qualitative studies selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.

 

Data extraction

Data extraction will be conducted independently by two reviewers. Where possible, authors will be contacted for missing or incomplete data.

 

Quantitative data will be extracted from articles included in the review using the standardized data extraction tool from JBI-MAStARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.

 

Qualitative data will be extracted from articles included in the review using the standardized data extraction tool from JBI-QARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.

 

Data synthesis

For quantitative data and due to the nature of the review objectives and the data to be extracted, it will not be possible to conduct statistical pooling on the data; rather narrative synthesis will be conducted and the findings will be presented in narrative form with tables, figures and text to aid in data presentation where appropriate.

 

Qualitative research findings will, where possible, be pooled using JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, JBI Database of Systematic Reviews and Implementation Reports through assembling the findings (Level 1 findings) rated according to their quality, and categorizing these findings on the basis of similarity in meaning (Level 2 findings). These categories will be subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings (Level 3 findings) that can be used as a basis for evidence-based practice. Where textual pooling is not possible, the findings will be presented in narrative form.

 

Conflicts of interest

There is no potential conflict of interest anticipated for this systematic review.

 

Acknowledgements

This protocol has been peer reviewed by Dr Kay Cooper, Deputy Director of the Scottish Centre for Evidence-based Multi-professional Practice: an Affiliate Center of the Joanna Briggs Institute.

 

References

 

1. CAIPE 2002, Interprofessional education - a definition, 2002 [Homepage of Centre for the Advancement of Interprofessional Education (CAIPE)], [Internet]. [Cited on 01/06/2015]. Available from: http://caipe.org.uk/about-us/defining-ipe/ [05/11, 2015]. [Context Link]

 

2. Horsburgh m, Lamdin R, Williamson E. Multiprofessional Learning: The Attitudes of Medical, Nursing and Pharmacy Students to Shared Learning. Med Educ 2001; 35(9): 876-883 [Context Link]

 

3. Hammick M, Freeth D, Koppel L, Reeves S, Barr H. A best evidence systematic review of interprofessional education: BEME Guide no. 9. Med Teach 2007; 29(8): 735-751. [Context Link]

 

4. Remington TL, Foulk MA, Williams BC. Evaluation of evidence for interprofessional education. AM J Pharm Educ 2006; 70(3): 66-66. [Context Link]

 

5. Reeves S, Zwarenstein M, Goldman J, Barr H, Freeth D, Hammick M, Koppel I. Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database Syst Rev (2008) (1):CD002213. [Context Link]

 

6. World Health Organization. Framework for action on interprofessional education and collaborative practice, Health Professions Network Nursing and Midwifery Office, Geneva: Department of Human Resources for Health (2010). [Context Link]

 

7. Buring SM, Bhushan A, Brazeau G, Conway S, Hansen L, Westberg S. Keys to successful implementation of interprofessional education: learning location, faculty development, and curricular themes. AM J Pharm Educ 2009; 73(4): Article 60. [Context Link]

 

8. Hepler C, Strand L. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990; 47: 533-543. [Context Link]

 

9. Zwarenstein M, Atkins J, Barr H, Hammick M, Koppel I, & Reeves S. A systematic review of interprofessional education. J Interprof Care 1999; 13(4): 417-424. [Context Link]

 

10. Zwarenstein M, Reeves S, Barr H, Hammick M, Koppel I, Atkins J. Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database Syst Rev (2001) (1):CD002213.

 

11. Cooper H, Carlisle C, Gibbs T, Watkins C. Developing an evidence base for interdisciplinary learning: a systematic review. J Adv Nurs 2001; 35 (2): 228 - 237

 

12. Clifton M, Dale C, Bradshaw C. Impact and effectiveness of inter-professional education in primary care: an RCN literature review. London: The Royal College of Nurisng Primary Care Educators Forum (2007).

 

13. Lapkin S, Levett-Jones T, Gilligan C. A systematic review of the effectiveness of interprofessional education in health professional programs. Nurse Educ Today 2013; 33(2): 90-102.

 

14. Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: Effects on professional practice and health care outcomes (update). Cochrane Database Syst Rev, 3, CD002213 (2013).

Appendix I: Appraisal instruments

QARI appraisal instrument

MAStARI appraisal instrument[Context Link]

Appendix II: Data extraction instruments

QARI data extraction instrument

MAStARI data extraction instrument[Context Link]

 

Keywords: interprofessional education; collaborative practice; pharmacy; perspective; pharmacy students pharmacy academics; practicing pharmacists; systematic review

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