Grant recipients:
Elaine Lillie, School of Pharmacy
Margo Mountjoy, Department of Family Medicine, McMaster University
Project team:
Tami Everding, McMaster, Waterloo Regional Campus
Andrew Costa, McMaster, Waterloo Regional Campus
Jenifer McLeod, IPE Program, School of Pharmacy
Graham Campbell, McMaster, Waterloo Regional Campus
Penny Schmiedendorf, McMaster, Waterloo Regional Campus
(Project Timeline: May 1, 2017 - April 30, 2018)
Description
Healthcare students in professional programs continue to face harassment (bullying, public embarrassment, etc.) while in training and need support to manage these encounters (AFMC 2016). Experiences with mistreatment are associated with higher levels of burnout, lower career satisfaction and symptoms of post-traumatic stress disorder (Cook at al., 2014). Healthcare learners can feel intimidated by assessors who have significant influence over their career trajectories. Students often do not report incidents of harassment due to fear of the impact on assessments and references (Rees et al., 2014).
To address common harassment issues, UW and McMaster collaborated to create an inter-institutional blended learning program. An online module was complemented with a workshop. Surveys and a focus group provided data about improved knowledge and attitudes, the effectiveness of the learning experience and the value of learning in an interprofessional context.
This module is part of a larger vision to create a professionalism platform.
Questions investigated
Our goal was to:
- Deliver a blended learning experience that:
- Increased knowledge of learners about the nature and impact of harassment.
- Improved knowledge of learners about managing and reporting harassment.
- Positively affected the attitude and confidence of learners in identifying and managing harassment.
- Create an interprofessional learning environment that enhanced learning about harassment while building collaborative skills.
- Gather information to inform future stages of the larger professionalism project between McMaster and the University of Waterloo
Findings/insights
Findings from this pilot study indicate that both medical and pharmacy students appreciate and feel the need for increased education, awareness, and understanding of professionalism issues (in this case, specifically harassment). Student comments on the module include “I knew that it was applicable. It’s stuff that happens every day. It’s important”. The blended learning model was well received by students who appreciated easy access to the resource in addition to the in-person opportunity to learn with and from each other. Looking ahead to future delivery of the program, it was evident that when completion of the online module was not mandatory student engagement was lower.
Module evaluation surveys showed that 88% of respondents reported having more or much more knowledge of how to report harassment. 93% of respondents indicated having an increased understanding of the impacts of harassment. Significant improvements were also demonstrated around identifying harassment and self-confidence in managing and reporting it when it occurs. After completing the workshop students were surveyed using a validated Interprofessional Collaborative Competencies Attainment Survey (ICCAS). 88% of students indicated improved collaboration skills after completing the workshop. 100% of students agreed that they could promote effective communication among members of an interprofessional (IP) team and actively listen to the perspectives of IP team members.
To provide guidance on the future of the initiative, the project team has compiled a list of useful suggestions and feedback around design and topics for an online platform on Professionalism in Clinical Learning (PCL).
Interviews with principal investigators revealed the overall strength of this project in terms of partnership and collaboration between the University of Waterloo and McMaster University learners and those involved with the project. Principal investigator Dr. Margo Mountjoy acknowledged from the administrative viewpoint the perceived need for interprofessional collaboration in medical and pharmacy learners and further stated, “What I didn’t foresee being a great advantage was that our students felt the same way [about the need for interprofessional opportunities]. Feedback from students about the workshop found that the interprofessional education [IPE] component was a very positive aspect for them because they got to work together”.
Co-principal investigator Elaine Lillie echoed Dr. Mountjoy’s sentiments, stating, “The interprofessional approach highlighted collaboration and teamwork between different institutions and disciplines while allowing students to work together to spearhead change – this was something they liked”
Both investigators commented on the cohesiveness of the partnership between the two institutions. One investigator noted, “This model worked especially well because of the people working on the team. Having invested and dedicated team members is key to the success of the project. We have the same vision; same problems that our students are facing and we had a common, shared way of reaching solutions and working together. The people we were working with were great. In the future I would definitely recommend an IPE approach to issues that are common to different healthcare professions.”
Dissemination and impact
- At the individual level: The online module was a mandatory component of a second-year Pharmacy course. It was an optional session for second-year medical residents. A joint workshop was held with attendance from both programs. The workshop was facilitated by the Assistant Dean of the Michael G. DeGroote School of Medicine and featured a medical resident sharing her story of harassment during training.
- At the Department/School and/or Faculty/Unit levels: The online module has been shared with the School of Pharmacy’s 14 Regional Clinical Coordinators who have direct access to co-op employers and clinical rotation preceptors across Ontario. The module has also been shared with the Grand River/ St. Mary’s Hospital Chief of Staff (Dr. Peter Potts) who has agreed to incorporate the module into credentialing requirements for medical staff to improve professionalism practice in the local teaching hospitals.
- At the institutional (uWaterloo) level: Project findings were shared at the University of Waterloo’s 2018 Teaching and Learning Conference in a session titled Blended, Interprofessional Model Addresses Harassment in Experiential Settings.
- At the provincial, national and/or international levels: Results of the pilot have been presented at the following conferences: Group on Regional Medical Campuses (GRMC) Spring Meeting held in Washington April 4-5, 2018; Canadian Conference on Medical Education held in Halifax April 28 – May 1, 2018; Waterloo-Wellington Clinical Research & Quality Improvement Symposium held in Kitchener May 31, 2018; Canadian Pharmacy Education and Research Conference (CPERC) 2018 held in Ottawa June 12-15, 2018. A manuscript has also been developed to submit for publication.
Impact of the project
- Teaching: As a result of this pilot study, we plan to continue to use student feedback to refine the development of the PCL platform. We hope to enhance usability, flow, and accessibility by adding more visual interest and shortening the time it takes users to complete any single module. We also plan to expand the number of modules offered to address e-professionalism, sexual harassment, resilience and other related content areas.
- Involvement in other activities or projects: The harassment module was a pilot project, testing the value of the content, the delivery method and the working relationship. Success on all fronts has encouraged the team to move forward realizing its vision for creating a professionalism platform targeted at healthcare learners. Ultimately, we hope to share the platform with learners in a range of healthcare programs within UW, McMaster and beyond. Both PIs are members of national bodies examining professionalism issues and are sharing findings at that level.
- Connections with people from different disciplines, faculties, and/or disciplines about teaching and learning: As part of the dissemination plan, PIs have shared findings at a variety of conferences facilitating discussion with colleagues in Medicine and Pharmacy programs across Canada and the U.S. The desire to support students and the value of a blended model that leverages an interprofessional/inter-institutional partnership has resonated with educators with a similar desire to support students, particularly in high-stakes clinical settings.
References
Project Reference List (PDF)