Implementation and Evaluation of an Interprofessional Education Workshop to Enhance Health Care Student Resilience and Adaptability

KEY POINTS

• Interprofessional education is valued by students and educators as an opportunity to build collaborative skills necessary in health care settings.

• A remotely delivered workshop facilitated by educators was effective in increasing student self-perceptions of adaptability and resilience.

• Preprofessional health care students indicated that content designed to enhance adaptability and resilience was an important supplement to their technical skill-focused education.

• In delivery of an intervention program, prior planning and flexibility is critical to the execution and success of the curriculum.

• In much the same way as interprofessional education programming is designed to bring together learners of various backgrounds, integrating the experiences of professionals with differing backgrounds as instructors working to achieve a common set of learning objectives aids in the development of a more well-rounded program.

INTRODUCTION

Individuals in the helping professions face numerous challenges including supporting others within an ever-changing environment where outcomes are uncertain, stakes are high, and both external and internal pressures abound. In addition to these consistent work challenges, health care professionals are subject to stress from unexpected challenges and change both in their personal lives and at the societal level, including the recent COVID pandemic. All of these trials place demands on professionals which can take a toll on their wellbeing, leading to decreases in work performance and overall quality of life and eventually, if untreated, withdrawal from the profession.¹ In fact, many of the earliest studies on burnout were conducted with those in the health care settings such as nursing and social work because these individuals often worked long hours, felt low appreciation from patients and supervisors, and were poorly compensated.² While professionals learn the basic technical requirements of their jobs in training programs, recent calls have implored educators to increase curriculum focused on dealing with interpersonal and intrapersonal challenges in addition to more traditional programmatic learning objectives.³

One teaching innovation that holds promise in helping professionals learn how to better manage these various stressors is interprofessional education (IPE). According to the World Health Organization,⁴ IPE involves individuals from two or more professions learning about, from, and with each other to enable effective collaboration. In explaining the usefulness of IPE, many researchers have described development of interprofessional identity as an important step to develop and implement collaborative skills.⁵ Tong et al⁵ proposed a definition of interprofessional identity as a multifaceted sense of belonging to an interprofessional community which is necessary to achieve shared context-dependent goals. Through development of interprofessional identity and enhanced collaborative skills, IPE models have demonstrated effectiveness in supporting the refinement of skills and attitudes in health care students and can be used as a platform to enhance participants' individual and collaborative approaches to managing the complex stressors in the setting.⁶ Therefore, using IPE techniques with preprofessional health care workers holds particular promise in terms of helping these individuals cope with a challenging and consistently evolving environment. Ultimately, programs that support the ability of health care professionals to cope with stressors have both direct and indirect effects on the wellbeing of individuals in these positions, patient outcomes, and the efficacy of the professions. Therefore, programs designed to build these skills should be investigated for their effect. The purpose of this paper is to introduce an IPE workshop series for preprofessional health care workers from a variety of backgrounds aimed at increasing collaboration, communication, and developing resilience and adaptability so other professionals can use this model in their work.

FOUNDATIONAL CONCEPTS AND CONTENT

PROGRAM DESIGN AND EVALUATION

An IPE program was designed for participants to collaborate and learn from health care peers during large, midsize, and small group activities. Intentional distribution of participants from each program increased exposure to a wide range of perspectives and encouraged questions and collaboration in a controlled and safe environment. Many of these students would be moving forward as leaders in the health care field, and it was hoped that, through this programming, they could learn best practices for collaborative work in patient care. While the program was designed for future health care workers, the format can be adapted to the target professions, and the social and psychological skills taught can benefit students across all fields of study. The critical IPE objectives, including incorporating multiple perspectives, focusing on complex problem solving, shared learning and reflection, and being adaptive in one's decision making could be incorporated early in educational programs to prepare students for consistently evolving learning and employment landscapes.

Due to the nature of the health care field, this program focused on 2 primary constructs: helping students develop and demonstrate resilience and practicing adaptability and flexibility in the health care setting. The program was initially designed as an in-person half-day workshop that would explore both resilience and adaptability, but with virtual learning necessitated by the COVID-19 pandemic, the design team demonstrated their own adaptability and flexibility with a shift to 2 separate, 2-hour workshops that occurred 2 weeks apart.

Each of the workshops had associated learning outcomes to focus the activities on the most important goals of the program and to ensure alignment with the overall goals of the IPE program and the workshop learning activities. Each of the learning outcomes included multiple aligned activities to best support the learning and growth of workshop attendees. Table 1 describes the workshop learning outcomes, sample activities connected to each outcome, and participant comments regarding the activities attained from a postworkshop survey.

Table 1 IPE Workshop Learning Outcomes, Sample Activities, and Reflections

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To increase attention and motivation, which could in turn affect learning and retention, the presenters designed the program to incorporate a variety of learning activities. Although both workshops followed a loose general outline, each workshop focused on a different content base and overviewed a varying number of constructs. Specifically, when a topic was introduced, a recorded or scripted lecture of approximately 10 minutes was presented to ensure participants had a foundation of understanding on a specific topic or construct before engaging in learning activities. After this brief topic introduction, students engaged in 5-person small group breakout discussions and activities guided by reflection questions and prompts that focused on applying the concepts to their own lives. The composition of the small groups was intentionally selected by the facilitators to ensure each included participants from a variety of health care fields and universities. The facilitators created a document displaying the group assignments for all participants and used the breakout rooms feature of the video conferencing application to move participants into their assigned groups.

After the initial, student-driven breakout session, several groups were combined to form 15-person midsize groups which were facilitated by one of the presenters or another health care profession faculty member to ensure productive discussions on the topic and encourage perspective sharing. As the midsized groups were formed of the intentionally created small groups, each retained a diverse composition of participants. The presenters again used the video conferencing application to create these groups and send students into the proper breakout rooms. The facilitators of each group introduced themselves and, in addition to guiding the discussion, added brief examples and experiences with the content relevant to their field. At the conclusion of the time allotted for the breakout sessions, workshop participants were guided by the presenter through a debriefing discussion with an opportunity for additional participant sharing with the full workshop participation. This general format, outlined in the Figure, was replicated throughout each of the workshops to provide content, application, and discussion throughout the sessions, culminating with a problem or case study for the participants to develop a solution.

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Demographics

Program participants were drawn from 3 universities in the northwestern region of the United States and represented several allied health and related professional degree programs including athletic training, genetic counseling, health education, health science studies, nursing, radiological sciences, respiratory care, and social work. Before the program, attendees completed a demographics survey, and after completion of the second workshop, they completed an evaluation of the program that contained both numerical rating scales and open-ended questions. Sixty students attended each of the workshops from a variety of health care professions, and participants included a mixture of undergraduate and graduate students. In total, 48 attendees completed the demographics survey. Participants were from a range of academic years across both the undergraduate and graduate level, but most were from their first (n = 26) or second year (n = 13) of graduate school. Further, most individuals identified as White (n = 34), but other students identified as Hispanic (n = 8), Asian (n = 2), and prefer to self-describe (n = 4). Additionally, the group was primarily female (n = 33; male n = 15). Table 2 includes a sample of participants and their demographics to better demonstrate the variety of students who took part in the workshop series.

Table 2 Example IPE Workshop Participants With Reported Demographic Characteristics

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LESSONS LEARNED FROM THE IPE WORKSHOP

Even though skills such as demonstrating resilience and adaptability are mentioned consistently as important developmental goals within academic coursework, it is unusual to focus specifically on teaching them explicitly and directly. Therefore, the research team suggests that, either within a curriculum or throughout several independent classes, efforts are made to teach these skills in a context specific, problem-based format. Students appreciated this applied focus with one participant indicating, “I felt the activities where groups talked about real-life situations in our future careers which may come up were beneficial.” Overall, this program was well received by students, but by no means should it be the only time students are exposed to practicing the skills of resilience and adaptability. A more direct focus on these skills is beneficial for students in both their current studies and their future career endeavors. Future efforts could be made to implement the activities surrounding these skills into normal curriculum offerings.

One specific aim of this program was to engage several students with a diverse set of backgrounds in terms of courses taken and future employment trajectories. This was done with the realization that students will inherently be working in interdisciplinary teams in the future to confront complex issues situated in health care or other related fields. The nature of IPE helps to focus on students' shared experiences and pushes them to find shared links instead of focusing on individual silos of information. Solving complex case-based problems with a group of students from unique backgrounds forced students to explore a variety of viewpoints with the lens of best addressing an issue. While many workshops focus on keeping cohorts together, the presenters intentionally assigned students to interdisciplinary groups to build connections and expose them to other perspectives. This tactic led to opportunities for introspection as students learned how others approached problem solving and considered their own approaches to relevant issues. One participant believed the increased diversity of opinions influenced their own viewpoints and indicated:

Getting everybody's input on how they would cope with the situation helped me reflect on what I would do and how I would deal with the situation better based on other group members strategies.

Purposeful mixing of diverse yet related subfields was critical to helping expand the participants' current viewpoints and should be a goal of any program focused on IPE. In future seminars, we would strive to include an even greater diversity of participants who also could affect decisions made in health care environments, such as hospital administrators, but who are often neglected in many programs, including our own.

Multiple delivery methods can be employed to engage students in the development of these skills. The online mode was not the intended method of delivery for this workshop, but due to the pandemic, the transition to a virtual workshop was necessary to comply with institutional guidelines. Although we would have preferred an in-person workshop to replicate the teamwork involved in solving a complex problem that could appear in a traditional health care setting, online programming did have its own unique benefits. Specifically, the online format allowed inclusion of students from several institutions across the region rather than only students who were near the presenters' locations. This switch allowed for a more diverse set of participants in terms of their experiences, perspectives, and training. Further, the shift to online programming allowed for a longer lasting product that could be used in the future with additional cohorts. Specifically, because presenters and participants could not meet in person, each presenter prerecorded or carefully scripted mini lectures that overviewed important concepts or described application of concepts. This practice allowed for a more refined product that can be archived and used in future training. In the future, we would suggest that educators consider the benefits of in-person and online learning environments before deciding which would be best in their specific context. In future iterations of our own workshop, we would aim for in-person programming but try to connect early in the process with local programs and professionals to increase the diversity of participants who can attend.

Lastly, the presenters purposely voiced the challenges associated with the shift in this program online to the participants and, by doing so, demonstrated some of the concepts that were taught in the workshop including coping and flexibility. This disclosure allowed for a focused discussion on using these constructs in every portion of one's life and not just during classroom exercises. Several past researchers have advocated for instructors to demonstrate how they use these types of skills to provide a lasting effect on student retention and learning.²⁸ By describing examples of their use of resilience and adaptability in the last year, the instructors helped students recognize the constructs as less abstract and more relevant to their own lives.

CONCLUSIONS

Due to the nature of this team's faculty appointments in health-sciences-related fields, the workshops focused on applying skills in the health domain where many of the preprofessional participants could be employed. However, this is by no means the only field for which these proficiencies are important, nor is this style of program the only method for teaching these proficiencies. The coping, social support, resilience, and adaptability skills taught in the program could be taught in any context. In fact, the team advocates for expanding the scope of this programming to include more perspectives to broaden the real-world possibility of problem solving. For example, this seminar could have included nonclinical professions such as administrators, information technologists, and maintenance directors to allow for a more holistic look at realistic challenges in health care settings. For those not working in the health-related fields, a crucial step is the development of creative real-world challenges that a team can address in a collaborative manner. Learning how to address a challenge in a realistic and relatable setting, working collaboratively within a diverse team, or confronting a more global problem are examples that can be employed after explaining topics such as beneficial coping skills and communication. The more diversity in thought and opinion for the activity, the more creative participants can be in addressing a problem with unique and realistic solutions.

Finally, for those who intend to engage in programming that is focused on collaboration with individuals from various academic backgrounds and diverse personal experiences, it is important to think critically about how to structure a final case study or problem-solving exercise for participants. When designing activities, attention should be paid to the way that individuals must collaborate within a group throughout the process. The goals of an IPE approach will not be achieved if individuals work in parallel, with each individual or small group working in isolation to solve pieces of the larger challenge. Introductory activities should outline the key aspects of IPE, with an emphasis on creating an expectation of perspective sharing and communication. Facilitators should encourage teams to use collaborative work throughout all aspects of the problem. It is through this process that individuals bring their own perspectives and ideas on how best to address a complex issue. Students and professionals often rely too heavily on using one's specific expertise to solve a piece of the problem, rather than working collaboratively to optimally solve a problem. If individuals are working parallel to each other without a need for collaboration until the end of the activity, the goals of using IPE are not achieved.