Identifying Communication Behaviors That Promote Interprofessional Teamwork Among Health Care Profession Students

PURPOSE: The purpose of this study was to identify key communication behaviors of students on an interprofessional team that impact patient and team satisfaction.

BACKGROUND: Interprofessional collaboration fosters quality of patient care, reduces medical errors, and enhances satisfaction among health professionals (Lehrer et al., 2015). However, the types of interprofessional education (IPE) experiences learners receive is inconsistent, and evidence that IPE improves patient outcomes is limited (Holtschnieder & Park, 2015; Poore, Cullen, & Shaar, 2014).

DESIGN: The design was a mixed-methods descriptive simulation study conducted at a standardized patient center. Observational and survey methods were used. The inclusion criteria for participation were being a student participating in an IPE simulation and providing consent. Participants included 21 medical students, 16 nursing students, 23 occupational therapy students, 17 pharmacy students, and 17 physical therapy students. At the end of the simulation experience and after all behavioral ratings were captured, students were invited to participate in the study.

METHOD: Students were assigned to an interprofessional team in which they reviewed medical chart information from each discipline and then formulated a discharge plan that reflected recommendations from all team members. Then students practiced flexibility and teamwork to reevaluate the patient and modify their plan when the patient’s status changed due to a fall. Trained raters observed and coded the students’ communication behaviors in real time using a modified version of the Relational Communication Scale (RCS; Hartmark-Hill, 2013). The adapted RCS is a 34-item instrument that uses a Likert scale to measure bidirectional communication between two people. The scale has been validated in multiple studies and includes domains of involvement, affection, depth, trust, inclusion, dominance, composure, formality, and task. After the event, patient and team satisfaction ratings were collected via a survey that used a Likert scale. Correlation studies and analysis of variance were used to determine which behaviors by discipline were linked to patient and team satisfaction.

RESULTS: Patient satisfaction was positively linked to medical students showing high depth and low formality, occupational and physical therapy students showing task orientation, nursing students displaying affection, and pharmacy students showing affection and low formality. Team satisfaction was positively linked to medical students displaying inclusion and low dominance; occupational therapy students showing task orientation, low formality, inclusion, and involvement; physical therapy students displaying inclusion; nursing students showing affection and trust; and pharmacy students displaying trust and dominance. Team Rank was correlated with Patient Satisfaction, Spearman rho (205) = –.55, p <.001.

CONCLUSION: Behaviors related to team satisfaction appear to differ from those related to patient satisfaction and also differ by profession. This study identifies the complex set of behaviors that influence patient and team satisfaction at an individual provider level. This is a necessary first step in understanding how to improve communication in interprofessional education.

IMPACT STATEMENT: Prior interprofessional education research efforts have not investigated how health care students and providers behave at an individual level to meaningfully impact their team and patient satisfaction. These findings provide key information that can be used when developing interprofessional educational experiences designed to foster team performance and quality of care.

References

Hartmark-Hill, J. (2013). Critical synthesis package: Relational Communication Scale (RCS). MedEdPORTAL. Retrieved from https://www.mededportal.org/publication/9454

Holtschneider, M. E., & Park, C. W. (2015). Interprofessional simulation: Prioritizing interprofessional competencies to improve patient outcomes. Journal for Nurses in Professional Development, 31, 305–306. https://doi.org/10.1097/NND.0000000000000208

Lehrer, M. D., Murray, S., Benzar, R., Stormont, R., Lightfoot, M., Hafertepe, M., . . . Maio, A. (2015). Peer-led problem-based learning in interprofessional education of health professions students. Medical Education Online, 20, 28851. https://doi.org/10.3402/meo.v20.28851

Poore, J. A., Cullen, D. L., & Schaar, G. L. (2014). Simulation-based interprofessional education guided by Kolb’s experiential learning theory. Clinical Simulation in Nursing, 10(5), e241–e247. https://doi.org/10.1016/j.ecns.2014.01.004