Assessing Interprofessional Education and Work: A Systematic Review

• In Event: Roundtable Session 8
  In Roundtable Session: Assessing Interprofessional Education and Work in the Health Care Professions

Abstract

Background: The nature of the ‘hypercomplex environment’ in which health care occurs is characterized by several decision makers, whose roles are embedded in an ‘extreme hierarchical differentiation’, and assurance of patient safety requires interaction and communication in ‘compressed time’ with a ‘high degree of accountability’ (Baker, Day, & Salas, 2006). The hypercomplexity of the context in which health care occurs is characterized by specialization, where team members have specific roles, responsibilities and knowledge (Orchard, King, Khalili, & Bezzina, 2012). Because errors, although rare, result in serious consequences, teamwork is essential. Knowledge of their own roles and responsibilities, monitoring of team member performance, and a positive attitude towards teamwork have been shown to relate to team effectiveness (Baker et al., 2006; Driskell & Salas, 1992). The increasing emphasis on the link between effective teamwork and positive patient outcomes (World Health Organization, 2010) demands that research provide evidence supporting training programs as well as assessment and evaluation of team processes in healthcare.

Purpose: The purpose of the current study was to review published articles to examine trends and to describe research on evaluation of interprofessional learning and practice amongst healthcare professionals.

Methods: The National Library of Medicine’s indexed database PubMed was used to identify potential articles for inclusion in the review. To develop this proposal, only articles published in English between 2006 and 2012 were searched for potential inclusion. Using the search term “assessment OR evaluation AND teamwork”, a total of 549 articles were retrieved. Only those articles that referenced assessment or evaluation of teamwork were selected for inclusion. Articles were classified by healthcare profession (e.g., pharmacy, medicine, nursing), specialty (e.g., surgery, oncology, anesthesiology), type of research (e.g., program evaluation; quality assurance), and factor measured (process, skill, or task). A total of 158 articles were selected for potential inclusion, and of those, 46 were included because they presented findings on evaluation or assessment of interprofessional education in healthcare.

Results: Based on the review of 46 articles meeting the criteria, reported research focused on program evaluation (12 articles, 26%), and 26 (56%) focused on the psychometric characteristics (i.e., reliability and/or evidence of validity) of the instrument used in the research conducted. A number of the studies included various members of the healthcare team (16 articles, 35%), but some were focused solely on physicians (28 articles, 61%). Most of the articles focused on the assessment of skills (48%), and only 1 focused on patient outcomes. Still, a number of articles referred to the challenge in assessment of teams: finding reliable measurement tools that assess group interaction in practice (Morgan, Pittini, Regehr, Marrs, & Haley, 2007; Murray & Enarson, 2007).

Significance: Despite this research, more work is needed in development of measures that are reliable, based in theory, and well matched to the objectives of interprofessional educational programs. Securing and training raters to produce reliable measures has been challenging (Morgan et al., 2007), although recent work has shown promise (Russ et al., 2012).

Author

• Danette Waller McKinley, National Conference of Bar Examiners