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Assessment for

Interprofessional Learning

Lap Ki Chan

School of Biomedical Sciences

Bau Institute of Medical and Health Sciences Education

Li Ka Shing Faculty of Medicine

The University of Hong Kong

“When students from two or more professions learn

about, from and with each other to enable effective

collaboration and improve health outcomes.” (WHO,

2010)

Interprofessional education

Patients

improves care by increasing the

coordination of services

integrates health care for a wide range of health

needs

empowers patients as active partners in care

results in better patient outcomes

Providers

increases job satisfaction due to

clearer, more consistent goals of care

and improved communication with

other providers

enables the provider to learn new skills and

approaches to care and to work to full scope of

practice

provides an environment for

innovation

allows providers to focus on individual areas of expertise

Students

provides a better understanding of other professions

provides learning on how to communicate

with other professionals and

how to work as part of an

interprofessional team

Health Systems

increases the potential for a more efficient and cost-effective delivery

of care

maximizes resources and

facilities

decreases burden on acute care facilities

3

Canadian Interprofessional Health Collaborative. 2010. CIHC National Interprofessional Competency Framework. Accessed at http://www.cihc.ca/

Benefits of collaborative practice

UK

Interprofessional Capability Framework

Canada

National Interprofessional Competency Framework

USA

Core Competencies for Interprofessional

Collaborative Practice

Australia

Interprofessional Capability Framework

Frameworks

Key thematic areas (Rogers et al., 2016)

Role understanding

Interprofessional communication

Interprofessional values

Coordination and collaborative decision making

Reflexivity

Teamwork

Pedagogies

Small group discussion 48 57.8

Patient case analysis 40 48.2

Large group lecture 31 36.1

Clinical teaching/direct patient interaction 29 34.9

Reflective exercises 29 34.0

Intervention reported as offered for credit 24 28.9

Simulation 22 26.5

Community-based projects 14 16.9

E-learning 13 15.7

Shadowing 12 14.5

Written assignments 11 13.3

Workshops 9 10.8

Other (e.g. interviews, joint lab sessions

and patient/family visits) 13 15.7

Number Percent

Abu-Rish et al. 2012 Current trends in interprofessional education of health sciences students A literature review. Current trends in interprofessional education of health sciences students: A literature review, Journal of Interprofessional Care, 26:6, 444-451

Scheduling 39 47.0

Learner level compatability 15 18.1

Preparation time required 12 14.5

Funding 10 12.0

Outcomes measurement 7 8.4

Negative interdisciplinary interactions 7 8.4

Administrative support 6 7.2

Faculty not prepared for role 4 4.8

Barriers Number Percent

Abu-Rish et al. 2012 Current trends in interprofessional education of health sciences students A literature review. Current trends in interprofessional education of health sciences students: A literature review, Journal of Interprofessional Care, 26:6, 444-451

Large number of students

-Chinese medicine 24

-medical 235

-nursing 190

-pharmacy 25

-social work 46

-total = 520

Other barriers at HKU

Interprofessional

Team-Based Learning

(IPTBL)

Our solutions

IPTBL = IPE + TBL

IPTBL: 11 programmes

HKU HKU Chinese Medicine

HKU Medicine

HKU Nursing

HKU Pharmacy

HKU Social Work

PolyU Medical Laboratory Science

Nursing

Occupational Therapy

Physiotherapy

Radiography

Social work

Total number of students per year: 1060

Six instructional units (IUs)

Six clinical issues:

1. Anticoagulation Therapy

2. Depression

3. Fracture

4. Multiple Drugs and Complementary Therapies

5. Developmental Delay

6. Cancer

Number of students in each IU

HK

U C

hin

ese

me

dic

ine

HK

U m

ed

icin

e

HK

U n

urs

ing

HK

U p

ha

rma

cy

HK

U s

ocia

l wo

rk

Po

lyU

me

dic

al l

ab

ora

tory

scie

nce

Po

lyU

nu

rsin

g

Po

lyU

occu

pa

tion

al t

he

rap

y

Po

lyU

ph

ysio

the

rap

y

Po

lyU

Rad

iog

rap

hy

Po

lyU

so

cia

l wo

rk

To

tal

1. Anticoagulation therapy 10 100 106 31 247

2. Depression 19 103 107 31 11 15 24 310

3. Fracture 13 100 31 90 15 102 83 12 448

4. Multiple Drugs and Complementary Therapies 103 213 31 346

5. Developmental Delay 100 11 90 201

6. Cancer 16 103 31 11 41 240 100 541

Small interprofessional Team

IU Fracture

Number of students 448

Team size 5-7

No. of teams 75

Team composition:

Chin Med, Pharmacy, or Soc Work 1

MBBS 1

Nursing 1

Occupational Therapy 1

Physiotherapy 1

Radiography 1

Learning outcomes

-recognize the need to work collaboratively -collaborate with students in other professions -compare roles, responsibilities, expertise, and limitations -recognize that views held by other health care workers are

equally valid and important -recognize the stereotypical views of other health workers held

by themselves and others -communicate opinions to other professionals and listen

respectfully to others’ opinions -critically reflect on their relationships within a team

Pre-Class Study

-on approaches of different health professions to a clinical problem

Team Application Exercise

-clinical scenarios

-multiple-choice questions tackled in teams

-within-team discussion and across-team debate

Ph

ase

1

Ph

ase

2

Ph

ase

3

Individual Readiness Assurance Test (iRAT)

-multiple-choice questions tackled individually

Team Readiness Assurance Test (tRAT)

-same multiple-choice questions tackled in teams

Team Appeals

Feedback

Team-based learning (TBL)

Implementation of the

IPTBL programme of

HKU+PolyU

Venue: 2016 Cheung Kung Hai Lecture Theatres 2-4

Venue: 2017 Lee Shau Kee Lecture Center

-large, flat open area (capacity >500)

-movable chairs

-good wifi support

e-Platform: LAMS LAMS: Learning Activities Management System

-teacher’s view: real time progress of students

e-Platform: LAMS

Individual readiness assurance test

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Team selection

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Team leader selection

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Ice-breaking game for students (demo by facilitators)

Interprofessional team of teachers

Team readiness assurance test Without teacher’s intervention

Team readiness assurance test

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Appeal

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Application exercise

Application

Exercises

Feedback

iRAT

tRAT

Appeal

Team formation

Simultaneous reporting


Interteam discussion facilitated by content experts


Evaluation of IPTBL

Self-perceived attainment of learning outcomes

Learning outcomes

Scores

Mean Standard Deviation

• Collaborate with students in other professions in

solving clinical problems. 3.88 .74

• Compare roles, responsibilities, and limitations of

different health professions 3.80 .76

• Communicate opinions to other professionals

and listen respectfully to others’ opinions. 3.92 .70

• Critically review personal skills to enhance

relationship within a team. 3.85 .74

• Recognize the need to work collaboratively in the

best interest of patient. 3.90 .73

• Recognize the stereotypical views of other

health workers held by themselves and others. 3.76 .80

• Recognize that views held by other health care

workers are equally valid and important. 3.92 .72

Grand mean 3.86 0.74

Readiness for Interprofessional Learning Scale

(RIPLS) 1 2 3 4 5

1. Learning with other students will help me become a more effective member of a health care team.

1 2 3 4 5

2. Patients would ultimately benefit if health-care students worked together to

solve patient problems. 1 2 3 4 5

3. Shared learning with other health-care students will increase my ability to

understand clinical problems. 1 2 3 4 5

4. Learning with health-care students before qualification would improve

relationships after qualification. 1 2 3 4 5

5. Communication skills should be learned with other health-care students. 1 2 3 4 5

6. Shared learning will help me to think positively about other professionals. 1 2 3 4 5

7. For small group learning to work, students need to trust and respect each

other. 1 2 3 4 5

8. Team-working skills are essential for all health care students to learn. 1 2 3 4 5

9. Shared learning will help me to understand my own limitations. 1 2 3 4 5

10. I don’t want to waste my time learning with other health-care students. 1 2 3 4 5

11. It is not necessary for undergraduate health-care students to learn together. 1 2 3 4 5

12. Clinical problem-solving skills can only be learned with students from my own department.

1 2 3 4 5

13. Shared learning with other health-care students will help me to communicate

better with patients and other professionals. 1 2 3 4 5

14. I would welcome the opportunity to work on small-group projects with other

health-care students. 1 2 3 4 5

15. Shared learning will help to clarify the nature of patient problems 1 2 3 4 5

16. Shared learning before qualification will help me become a better team

worker. 1 2 3 4 5

17. The function of nurses and therapists is mainly to provide support for

doctors. 1 2 3 4 5

18. I’m not sure what my professional role will be. 1 2 3 4 5

19. I have to acquire much more knowledge and skills than other health-care students.

1 2 3 4 5

RIPLS subscales Pre Post N df t

M SD M SD • Teamwork and collaboration 4.00 .56 4.09 .59 721 720 -4.406***

• Negative professional identity 2.77 1.15 2.70 1.18 727 726 3.279***

• Positive professional identity 3.87 .63 3.95 .63 728 727 -3.566***

• Roles and responsibilities 3.11 .90 3.18 .89 729 728 -2.948**

Readiness for Interprofessional Learning Scale

(RIPLS)

Assessment in IPTBL

IPE Assessment (Rogers et al., 2016)

Conventional assessment of health professions literacy

Team-based project

Observation in simulation

Observation in practice

Reflective journaling

Team-based critique

An interprofessional portfolio

Self and peer assessment

Rogers et al. 2016 International consensus statement on the assessment of interprofessional learning outcomes. Medical Teacher. DOI: 10.1080/0142159X.2017.1270441

Assessment in IPTBL - iRAT - tRAT - AE - Peer assessment

iRAT vs. tRAT scores

iRAT

tRAT iRAT

tRAT

iRAT

tRAT

-tRAT > iRAT average of team members, consistently

-the interprofessional teams members are collaborating

Rubric:

Values/Ethics competency: The student: recognizes that views held by other

healthcare professionals are equally valid and important in taking care of

patients; respects the unique cultures, values, roles/responsibilities and

expertise of other professions

Roles/Responsibilities competency: The student: recognizes his or her

roles, responsibilities, and limitations in the team; engages diverse

professionals who complement one’s own professional expertise.

Communication competency: The student: expresses one's knowledge and

opinions to team members; listens respectfully.

Team and teamwork competency: The student: collaborates with students in

other professions; manages disagreement constructively.

Peer assessment

Peer assessment

46

Names of OTHER students

Give 10 points in total to other team members. No maximum or minimum.

47


Example:

Peer assessment

2 1 1

1 3 2

48


Example:

Peer assessment

2 1 1

1 3 2

Give another 10 points to team members for the other competency.

2

1 1

1

3

2

49

Peer assessment

A student’s score page (adjusted to team of six):

Student performance -mean score always close to 2

-does NOT indicate average performance

Mean score of all students (all disciplines) in the 4 competencies; IU Depression

1.9795 1.9787 1.9799 1.9789

0.0000

0.5000

1.0000

1.5000

2.0000

2.5000

Values/ethics Competency Roles/responsibilities

Competency

Communication Competency Team and Teamwork

Competency

Total Score(n=284)

Student performance

12

0

53

119

79

4 1

11

0 2

0 3

12

0

54

116

83

4

0

10

0 2

0 3

13

0

44

112

93

5

0

14

0 0 0 3

12

1

48

114

88

5

0

13

0 0 0 3

0

20

40

60

80

100

120

0.00-0.50 0.51-1.00 1.01-1.50 1.51-2.00 2.01-2.50 2.51-3.00 3.01-3.50 3.51-4.00 4.01-4.50 4.51-5.00 5.01-5.50 5.51-6.00

Values/ethics Roles/responsibilities Communication Team and teamwork

Score distribution of all students (all disciplines) in the 4 competencies; IU Depression

Within-team scoring 19

0

6

9

3 3

5

17

3

7

4

5

4

5

18

5

4

5 5

3

5

17

3

6 6

3

2

8

0

2

4

6

8

10

12

14

16

18

20

0 0.1001 - 0.20 0.2001 - 0.30 0.3001 - 0.40 0.4001 - 0.50 0.5001 - 0.60 >0.06

Values/ethics Roles/responsibilities Communication Team and teamwork

Distribution of within-team variance of all teams in the 4 competencies; IU Depression

1.8

0

2.2

2

2.1

6

1.4

5

1.8

5

1.7

2

1.8

1

2.2

1

2.1

6

1.4

5

1.8

3

1.9

0

1.8

0

2.2

1

2.1

9

1.3

7

1.8

9

1.7

8

1.7

6

2.2

6

2.1

6

1.4

3

1.8

5

1.6

7

0.00

0.50

1.00

1.50

2.00

2.50

MBBS (n=94) Nursing(n=104)

Pharmacy(n=31)

Chinese Med(n=15)

Social work(n=32)

OccupationalTherapy (n=8)

Values/ethics Competency Values/ethics Competency

Values/ethics Competency Values/ethics Competency

Discipline performance

Discipline mean score in the 4 competencies; IU Depression

Pharmacy

Occupational therapy

Social Work

Chinese

Medicine

MBBS

Nursing


Comparison of how students of one discipline assess students of other disciplines;

IU Depression

Pharmacy


Social Work

Chinese

Medicine

MBBS

Nursing

*** p < 0.001

** 0.001 < p < 0.05


Advantages of peer

assessment in IPTBL -Done efficiently

-Provide early feedback

-Perceived as feedback rather than punishment

-Make learning outcomes very clear to students

-Encourage student involvement and responsibility

-Promote reflection of their own performance

-Relevant to teamwork

-Promote cooperation rather than competition

-Considered to be fair by students

Disadvantages of peer

assessment in IPTBL

-Collaborative assessment may occur

-No direct observations by educators

-Risk of low reliability of score

-Students not confident or reluctant to assess others

-Victimization

-Friend/foe bias

-Additional briefing time

Conclusions

-IPTBL is a practical implementation of IPE for a large number

of pre-licensure health and social care students

-Peer assessment in IPTBL offers early and relevant feedback

to students, but richness of the data is still being explored

Acknowledgement: -UGC

-HKU Technology Enhanced Learning Initiative

IPTBL promotional video produced by HKU Technology-enriched Learning initiative, TELI

https://www.youtube.com/watch?v=G04YWHjNfxU




Issues Does one profession consistently assess another profession

better or worse?

LOs remain ill-defined

Rogers et al. 2016 International consensus statement on the assessment of interprofessional learning outcomes. Medical Teacher. DOI: 10.1080/0142159X.2017.1270441

Perceived Collective Efficacy Scale

Pre Post N df t

M SD M SD • Collective team efficacy 3.85 .60 3.97 .61 720 719 -5.698***

Student reflection: log book

Scheduling

Learner level compatability

Preparation time required

Funding

Outcomes measurement

Negative interdisciplinary interactions

Administrative support

Faculty not prepared for role

Professional identity

Large number of students

Barriers and solutions Saturdays

Senior years

1.5 years

UGC >5M HKD

Validated instrument

Role models

With UGC funding

Dedicated faculty members

Senior years

TBL

http://radiopaedia.org/cases/femoral-neck-fracture

-teacher’s view: real time progress of students

IPTBL e-Platform: LAMS

Pharmacy


Social Work

Chinese

Medicine

MBBS

Nursing

Score: comparison of disciplines

Peer assessment -anonymous

Student 2

Student 5

Student 4

Student 3

Student 6

Student 1

Pharmacy


Social Work

Chinese

Medicine

MBBS

Nursing


-iRAT vs. tRAT scores

-self reporting of attainment of learning outcomes

-pre-post survey using RIPLS

-student reflections

-peer assessment

Multiple sources

Chin Med, Pharmacy, or Social Work 1

MBBS 1-2

Nursing 2-3

Occupational Therapy 1

Team size 5-7

No. of teams 87

Number of students 520

Interprofessional Education Collaborative

Competency 1: Values/Ethics for Interprofessional Practice

Competency 2: Roles/Responsibilities

Competency 3: Interprofessional Communication

Competency 4: Teams and Teamwork

Core competencies

Core competencies


Work with individuals of other professions to maintain a climate of mutual

respect and shared values.


Use the knowledge of one’s own role and those of other professions to

appropriately assess and address the health care needs of patients and to

promote and advance the health of populations.


Communicate with patients, families, communities, and professionals in

health and other fields in a responsive and responsible manner that

supports a team approach to the promotion and maintenance of health and

the prevention and treatment of disease.


Apply relationship-building values and the principles of team dynamics to

perform effectively in different team roles to plan, deliver, and evaluate patient

population centered care and population health programs and policies that are

safe, timely, efficient, effective, and equitable.

Interprofessional Education Collaborative


Work with individuals of other professions to maintain a climate of mutual

respect and shared values.


Use the knowledge of one’s own role and those of other professions to

appropriately assess and address the health care needs of patients and to

promote and advance the health of populations.


Communicate with patients, families, communities, and professionals in

health and other fields in a responsive and responsible manner that

supports a team approach to the promotion and maintenance of health and

the prevention and treatment of disease.


Apply relationship-building values and the principles of team dynamics to

perform effectively in different team roles to plan, deliver, and evaluate patient

population centered care and population health programs and policies that are

safe, timely, efficient, effective, and equitable.

Abu-Rish 2012 Current trends in interprofessional education of health sciences students A literature review

Paper 339

LAMS 170 (26)

Paper 170

LAMS 312 (46)

LAMS 340

(340)

509 students 482 students 340 students

Anticoagulation Multiple Drugs and Complimentary

therapies

Developmental Delay

Paper vs LAMS

Further development -autosubmission in iRAT, tRAT, AE -interface enhancement (remove multiple horzontal lines in appeal page; hide MCQs without appeals in the appeal page; remove the (a), (b), (c), and (d) in AE MCQ, etc)

-real time statistics (e.g., tRAT, AE answers of all teams)

-iRAT at home -purchase of server

https://www.pinterest.com/pin/104075441362130408/

- Using appropriate language when speaking to other healthcare providers or patients/family

- Understanding that all healthcare providers contribute to the team or collaborative unit

- Showing respect and building trust among team members

- Introducing new members of the team in a way that is welcoming and gives them the information they need in order to be a contributing member

- Turning to colleagues for answers

- Supporting each other when mistakes are made, and celebrating together when success is achieved.

Benefits of collaborative Practice

Canadian Interprofessional Health Collaboration, 2010

Developmental delay Coffee, tea, chocolate were very welcomed

Students’ achievement in interprofessional

team-based learning: A cross-discipline comparison involving

biomedical sciences, Chinese medicine, medicine, nursing, pharmacy, and social work students in Hong Kong

Fred Ganotice Lap Ki Chan

too many words of the same size, the essence did not stand out, now better

Add affiliations

12 participating programmes

HKU HKU Biomedical Sciences HKU Chinese Medicine HKU Medicine HKU Nursing HKU Pharmacy HKU Social Work PolyU

Medical Laboratory Science Nursing Occupational Therapy Physiotherapy Radiography Social work

Maybe we should include here the programmes that took part in 2016, i.e. 7, not all 12 Depends on how you are describing our programme

Objectives 1.Examine if there are significant iRAT and tRAT score differences

in three instructional units: anticoagulation therapy, multiple drugs and complementary therapies, and developmental delay;

2.Identify if there are significant differences in pretest and posttest scores of the disciplines involved along the following affective dimensions:

a. teamwork and collaboration; b. negative professional identity; c. positive professional identity; d. roles and responsibilities; e. overall satisfaction with team experience; f. team impact on quality of learning; g. team impact on critical reasoning ability; h. professional development; and i. collective efficacy?

Too many words, need to simplify, see next page

Objectives 1.Differences between iRAT and tRAT? 2.Differences among disciplines in pretest and posttest: a. teamwork and collaboration; b. negative professional identity; c. positive professional identity; d. roles and responsibilities; e. overall satisfaction with team experience; f. team impact on quality of learning; g. team impact on critical reasoning ability; h. professional development; and i. collective efficacy?

Too many words, need to simplify

Design - Pretest-posttest single group design - Self-report measures were administered before and after

Participants

- 802 students from HKU and PolyU - average age was 21.32 years old (SD = 1.30) - second year (n=222 or 27.68%), third year (n=94 or 11.72%),

and fourth year (n=486 or 60.59%). - from seven health and social care programmes of The Hong

Kong University (HKU) and The Polytechnic University of Hong Kong (PolyU)

Measures -Cognitive measures: Readiness Assurance Test (10 multiple-choice questions) Application Exercise (5 MCQs for the face-to-face application exercise,

-Affective measures: Readiness for interprofessional learning scale (RIPLS, Parsell & Bligh, 1999), students’ team experience questionnaire (TEQ, as cited by Currey et al., 2015), and generalized self-efficacy questionnaire (GSEA, Schwarzer, 1999).

Each bullet point has too many words, see next page

Measures -Cognitive measures:

RAT (10 MCQs) AE (5 MCQs)

-Affective measures: Readiness for interprofessional learning scale (RIPLS) Students’ team experience questionnaire (TEQ) Generalized self-efficacy questionnaire (GSEA)

You orally elaborate them

Measures Readiness for Interprofessional Learning Scale: Subscales

HKU Teamwork and collaboration (9 items) Negative professional identity (3 items) Positive professional identity (4 items) Roles and responsibilities (3 items)

Students’ team experience questionnaire: Subscales Overall satisfaction with team experience (5 items) Team impact on quality of learning (3 questions) Team impact on clinical reasoning ability (3 items) Professional development (4 items)

Perceived Collective Efficacy Scale Collective efficacy (4 items)

Statistical Analyses -Paired t-test -Analysis of variance (ANOVA)

Results and Discussion

iRAT, tRAT, and Application Exercise scores

74.58

92.27

81.84

0

10

20

30

4050

60

70

8090

100

Anticoagulationtherapy (n=466)

Multiple drugs andcomplementary

therapies (n=357)

Developmental delay(n=167)

Teams’ average score in tRAT

45.70

73.80

55.60

0.00

10.00

20.00

30.00

40.0050.00

60.00

70.00

80.0090.00

100.00

Anticoagulationtherapy (n=466)

Multiple drugs andcomplementary

therapies (n=357)


Students' average score in iRAT

55.6

69.6 76.2

0

10

20

30

40

50

60

70

80

90

100

Anticoagulation therapy(n=466)

Multiple drugs andcomplementary therapies

(n=357)


Teams' average score in AE

Differences between tRAT and averaged iRAT scores

Instructional Units tRAT iRAT

df t M SD M SD

1. Anticoagulation

therapy (n=464) 74.82 9.61 45.64 7.19 463 74.856***

2. Multiple drugs and

complementary

therapies (n=359)

92.39 6.86 73.15 12.90 358 28.547***

3. Developmental

delay (n=167) 82.06 8.48 55.81 6.78 166 33.285***

Total (n=990) 82.42 11.64 57.33 15.74 989 69.224***

*** p < 0.001 iRAT and tRAT should swap position (being on the left indicates earlier in time)

Mean comparisons of students’ scores on Readiness for Interprofessional Learning Scale (RIPLS)

RIPLS subscales Pretest Posttest

N df t M SD M SD

1. Teamwork and

collaboration 3.89 .52 4.02 .56 676 675 7.687***

2. Negative professional

identity 2.33 .79 2.27 .86 691 690 -2.178**

3. Positive professional

identity 3.74 .57 3.87 .60 692 691 6.409***

4. Roles and

responsibilities 2.24 .50 3.31 .51 695 694 3.503***

** p <0.01, *** p < 0.001

Comparisons of pretest-posttest difference in RIPLS subscales by discipline

RIPLS subscales

Pretest-posttest

difference df F

M SD 1. Teamwork and collaboration

1. Biomedical Sciences (n=10) -.0667 .34

(5, 670) .895

2. Chinese Medicine (n=13) .2308 .43

3. MBBS (n=185) .1069 .51

4. Nursing (n=412) .1459 .42

5. Pharmacy (n=21) .1746 .35

6. Social Work (n=35) .0730 .34

2. Negative professional identity


(5, 685) 1.643

2. Chinese Medicine (n=13) -.2308 .49

3. MBBS (n=187) -.0553 .63

4. Nursing (n=412) -.0705 .64

5. Pharmacy (n=21) .0000 .66

6. Social Work (n=39) .2051 .67

Comparisons of pretest-posttest difference in RIPLS subscales by discipline

RIPLS subscales

Pretest-

posttest

difference df F

M SD 3. Positive professional identity


(5, 686) .273


3. MBBS (n=189) .1402 .61

4. Nursing (n=422) .1262 .51

5. Pharmacy (n=21) .1667 .50

6. Social Work (n=37) .1486 .41

4. Roles and responsibilities

1. Biomedical Sciences (n=10) .0167 .34

(5, 689) .275


3. MBBS (n=189) .0476 .28

4. Nursing (n=424) .0346 .26

5. Pharmacy (n=21) .0714 .23

6. Social Work (n=38) .0132 .33

Comparison of posttest-pretest differences in RIPLS by discipline

-0.07

0.23

0.11

0.15

0.17

0.07

-0.20

-0.23

-0.06

-0.07

0.00

0.21

-0.05

0.13

0.14

0.13

0.17

0.15

0.02

0.01

0.05

0.03

0.07

0.01

-0.30 -0.20 -0.10 0.00 0.10 0.20 0.30

Biomedical Sciences (n=10)

Chinese Medicine (n=14)

MBBS (n=212)

Nursing (n=443)

Pharmacy (n=22)

Social Work (n=39)

Roles and responsibilities Positive professional identity

Negative professional identity Teamwork and collaboration

Why is this “posttest-pretest” while the earlier ones are “pretest-posttest”?

Mean comparison of students’ scores in their Attitudes towards various aspects of team learning

Subscales Pretest Posttest

N df t M SD M SD

1. Overall satisfaction

with team experience 3.66 .53 3.88 .57 683 682 10.307***

2. Team impact on

quality of learning 3.45 .63 3.75 .66 682 681 11.836***

3. Team impact on

clinical reasoning

ability

3.64 .57 3.85 .63 686 685 9.061***

4. Professional

development 3.69 .53 3.84 .60 685 684 7.152***

*** p < 0.001

Comparisons of pretest-posttest difference in Attitudes towards various aspects of team learning

* p <0.05

Subscales

Pretest-posttest

difference df F

M SD 1. Overall satisfaction with team experience


(5, 677) 1.410


3. MBBS (n=183) .2142 .65

4. Nursing (n=417) .2187 .48

5. Pharmacy (n=21) .1619 .45

6. Social Work (n=39) .1897 .56

2. Team impact on quality of learning


(5, 676) 2.623*


3. MBBS (n=184) .3442 .80

4. Nursing (n=418) .2735 .57

5. Pharmacy (n=21) .6667a .64

6. Social Work (n=36) .1111b .54

Comparisons of pretest-posttest difference in Attitudes towards various aspects of team learning

* p <0.05

Subscales

Pretest-posttest

difference df F

M SD 3. Team impact on clinical reasoning ability


(5, 680) .543


3. MBBS (n=185) .1964 .75

4. Nursing (n=420) .2175 .53

5. Pharmacy (n=21) .2222 .66

6. Social Work (n=37) .2342 .52

4. Professional development

1. Biomedical Sciences (n=10) -.4500a .67

(5, 679) 2.793*

2. Chinese Medicine (n=13) .2500b .47

3. MBBS (n=185) .1595b .65

4. Nursing (n=419) .1730b .51

5. Pharmacy (n=21) .1310 .62

6. Social Work (n=37) .0473 .46

Comparison of posttest-pretest differences in Attitudes towards various aspects of team learning by discipline

-0.6000 -0.4000 -0.2000 0.0000 0.2000 0.4000 0.6000 0.8000



MBBS (n=183)

Nursing (n=417)

Pharmacy (n=21)

Social Work (n=39)

-0.1000

0.4923

0.2142

0.2187

0.1619

0.1897

0.0667

0.4359

0.3442

0.2735

0.6667

0.1111

0.0333

0.4359

0.1964

0.2175

0.2222

0.2342

-0.4500

0.2500

0.1595

0.1730

0.1310

0.0473

Professional Development Team impact on clinical reasoning ability

Team impact on quality of learning Overall satisfaction with team experience

* *

Why is this pink bar of pharmacy so much longer?

Why is this “posttest-pretest” while the earlier ones are “pretest-posttest”?

Perceived Collective Efficacy Scale

Pretest Posttest N df t

M SD M SD

Collective team efficacy 3.65 .54 3.88 .58 681 680 10.433***

*** p < 0.001

Comparison of pretest-posttest differences in collective team efficacy by discipline

0

0.3654

0.2296

0.2236

0.1786

0.2703

0 0.2 0.4



MBBS (n=184)

Nursing (n=417)

Pharmacy (n=21)

Social Work (n=37)

Conclusions -IPTBL yielded positive results in cognitive outcomes among

various disciplines; -Similarly, IPTBL has positive impacts on affective outcomes of student learning across students from various disciplines;

-Similar pattern of results was indicated among various disciplines except for Biomedical Sciences.

Simplify the points, see next

Conclusions -positive results in cognitive outcomes -positive impacts on affective outcomes -Similar among disciplines except Biomedical Sciences

What about Chinese medicine

What is the difference between “results” and “impact”

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