Interprofessional Learning About Therapy Teams in Schools and Early Intervention

PURPOSE: The purpose of this study was to examine the changes in attitudes toward interprofessional therapy teams and the team approach to care among graduate students enrolled in an online class about schools or early intervention (EI) practice. The Individuals With Disabilities Education Act (IDEA) mandates interprofessional practices for children receiving services in schools and EI. Early intervention services under Part C of IDEA also require interprofessional teaming with collaboration across disciplines and with families (Moore et al., 2012). In order to adequately implement team-based approaches, therapy providers must understand their role on the interprofessional team (Shasby & Schneck, 2011). Limited research is available examining the attitudes of graduate health care students toward interprofessional learning or working as part of a team in school and EI settings.

DESIGN AND METHOD: This was a mixed-methods study using an online survey and collection of discussion board posts. Data were gathered during two 16-wk online courses for graduate preservice students (N = 175) in occupational therapy, physical therapy, speech therapy, and special, regular, and early childhood education who were training to work in school-based practice or EI. Students were recruited via email and had the option to participate. A survey about attitudes toward interprofessional therapy teams and the team approach in schools and EI was developed by the researchers using three resources as a guide: Guidance for Performance Evaluation of School Occupational Therapists (American Occupational Therapy Association, 2013), the Attitudes toward Health Care Teams Scale (Heinemann, Schmitt, Farrell, & Brallier, 1999), and the Interprofessional Team Simulation Training Assessment (Brock et al., 2011). The survey was piloted with 15 students, and no changes were required. The survey was administered via an online survey tool at the start and end of each semester. Aggregate scores were analyzed using IBM SPSS Statistics.

Participants also engaged in an online discussion using discussion questions about the roles and scope of practice of their own and other disciplines in school-based practice or EI. Researchers downloaded the discussions and identifiers were removed. Qualitative data were analyzed by coding information related to understanding of interprofessional roles and categorizing patterns of similarity to identify themes. Methods of trustworthiness included triangulation, peer review, and audit trail. A scale was computed using the items related to attitudes toward interprofessional therapy teams, and reliability was found to be high (α = .81). A paired-samples t test compared pretest and posttest responses on the scale.

RESULTS: There was a significant difference for both the pretest scale scores (M = 31.5, SD = 4.7) and posttest scale scores (M = 33.6, SD = 3.4), t(38) = –2.2, p = .03. Qualitative data revealed four themes: (1) Logistics are challenging, (2) pullout treatment model is the norm, (3) knowledge about roles is lacking, and (4) there is anxiety about collaboration.

CONCLUSION: The survey findings suggest that the students’ attitudes toward interprofessional therapy teams in school and EI settings improved. Analysis of the students’ discussions showed that the educators routinely collaborated with other teachers in both school-based and EI settings, but they had much less collaboration with the related service providers. This study underscores the need for interprofessional training about the team approach in schools and EI. Therapists who are new to school and EI practice settings may need additional training and practice to effectively engage with the interprofessional team. Occupational therapists who successfully collaborate with educators and related service providers in schools and EI will generate better outcomes for children and will improve the value of occupational therapy.

References

American Occupational Therapy Association. (2013). Guidance for performance evaluation of school occupational therapists. Bethesda, MD: Author.

Brock, D., Abu-Rish, E., Vorvick, L., Wilson, S., Liner, D., Schaad, D., & Blondon, K. (2011). Interprofessional team simulation training pre/post assessment. Seattle: Center for Health Sciences Interprofessional Education, Research, and Practice.

Heinemann, G., Schmitt, M., Farrell, M., & Brallier, S. (1999). Development of an Attitudes Toward Health Care Teams Scale. Evaluation of the Health Professions, 22, 123–142.

Individuals With Disabilities Education Improvement Act of 2004, Pub. L. 108–446, 20 U.S.C. §§ 1400–1482.

Moore, L., Koger, D., Blomberg, S., Legg, L., McConahy, R., Wit, S., & Gatmaitan, M. (2012). Making best practice our practice: Reflections on our journey into natural environments. Infants and Young Children, 25, 95–105. https://doi.org/10.1097/IYC.0b013e31823d0592

Shasby, S., & Schneck, C. (2011). Commentary on collaboration in school-based practice: Positives and pitfalls. Journal of Occupational Therapy, Schools and Early Intervention, 4, 22–33. https://doi.org/10.1080/19411243.2011.573243