royal perth hospital student training ward - Health Sciences - Curtin ...

REPORT
ROYAL PERTH HOSPITAL
STUDENT TRAINING WARD
I
n collaboration with Curtin University, Royal Perth
Hospital (RPH) played host to the first interprofessional
student training ward in the southern hemisphere. The
project was modelled on the highly successful training
wards that have operated in Europe for the past two
decades, which have demonstrated that students who
participate in such a learning experience:
gain an ability to collaborate effectively through an
increased understanding and appreciation of each
other’s profession;
develop their own professional competence and role in
the healthcare team;
develop efficient and effective practices in the
identification of the patient’s needs so as to plan,
implement and evaluate evidence based care;
understand the role of the patient in their care;
are highly attractive to employers; and
as new graduates, are more confident in their
interprofessional competencies whilst having an
appropriate level of confidence in their clinical skills.
Six beds within a 26–bed general medical ward provided the
setting for three consecutive 2-week clinical placements for
health science students from nursing, physiotherapy,
occupational therapy, social work, pharmacy and medicine.
The students were supervised five days a week on morning
shifts.
The ward provided an authentic, practice-based learning
environment where undergraduate students developed the
knowledge, skills and attitudes required for effective
patient-centred collaborative practice. The key focus was
the application of interprofessional education (IPE)
principles to the delivery of holistic patient care, with an
emphasis on teamwork during patient contact, handover
and discharge planning. The students were also required to
demonstrate an increased level of independence as they
undertook the ward duties as a team.
Facilitators from social work, physiotherapy, occupational
therapy, pharmacy and medicine were rostered on for part
of each day. A nursing facilitator was on the ward full time.
A consumer advocate visited the ward once per week to
listen to patients and to provide feedback to the students.
All students (except medicine) and the nurse facilitator
commenced each day at 0700 and began with handover
from the night shift nursing staff. The students then
completed the medication round and prepared patients for
breakfast. The medical students joined five members of the
student team at 0800 on the ward round whilst two
students remained on the ward to care for the patients.
Following the ward round students met with their
profession-specific facilitator (an RPH staff member from
their profession) to discuss each patient and to clarify the
profession-specific tasks the students were to undertake
that day. This also provided the opportunity for students to
request assistance with any task they felt they could not
undertake without profession-specific support/supervision.
Group planning meetings followed, led by a different
facilitator each day. For example, on Monday the medical
facilitator led the meeting while on Tuesday this was the
pharmacy facilitator.
Students then undertook further patient care activities,
including handover of the patients to the afternoon shift.
Other activities included professional development and
research. Each day ended with a half hour debrief led by
one of the staff facilitators.
Student Assessment
Student’s interprofessional capabilities were assessed
using a tool Curtin developed, the Interprofessional
Capability Assessment Tool (ICAT). This tool has a 4-point
Likert scale: unsatisfactory, satisfactory, developing and
outstanding with a rubric to describe each capability at
each level. Examples of the interprofessional capabilities
include the ability to:
communicate effectively in a respectful manner;
establish and maintain effective working relationships;
demonstrate confidence in understanding their own role
as well as others;
reflect on team structure, function and roles; and
participate in and lead team meetings.
Each student received both profession-specific supervision
and interprofessional supervision (supervision by staff from
a profession other than their own). As a result of this
shared model of supervision each student’s
interprofessional capabilities assessment was completed
by the nurse facilitator with input from the other
facilitators. Students were also required to rate themselves
using this tool. All students achieved a pass grade for their
interprofessional placement with most capabilities rated at
a satisfactory or outstanding level at the completion of
the placement. Comments were typified by the following
examples:-
“(Student) was an avid participant in team discussions
actively listening to her team members but always
offering constructive input from a social work point of
view.”
“(Student) ensures that patient safety is her number one
priority.”
In addition to the interprofessional capabilities assessment,
students were asked to provide feedback to their peers in
terms of their collaborative skills using a peer evaluation
tool Curtin developed. This asked students to rate
behaviours on a 5-point Likert scale from very poor to
excellent. The results are summarised in Table 1 (over).