Enhancing the understanding of safety and quality of patient care among medical and health sciences students in an interprofessional climate: An interventional study

doi:10.21203/rs.3.rs-5009895/v1

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Research Article

Enhancing the understanding of safety and quality of patient care among medical and health sciences students in an interprofessional climate: An interventional study

https://doi.org/10.21203/rs.3.rs-5009895/v1

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Background

Interprofessional education (IPE) plays an elementary role in improving healthcare outcomes by shared understanding and by reducing errors and adverse events. Unfortunately, most healthcare professionals have not received training for patient safety (PS) in an interprofessional setting, which can meet the needs of societal medical needs. This study aimed to foster the understanding of senior medical and health sciences students about PS and quality of care at the University of Sharjah in UAE.

Methods

Using a stratified random sampling technique, we recruited students from College of Medicine (CoM), College of Pharmacy (CoP), College of Dental Medicine (CDM), and College of Health Sciences (CHS) of UoS. The online synchronous real-time workshop included interactive resource sessions, breakout room discussions using real clinical cases, and pre-post surveys using a questionnaire with three domains of PS; medical professionalism, leadership in healthcare, and precision medicine.

Results

A total of 248 students and 20 facilitators participated in the workshop. CoM had the highest representation (47.5%), followed by CoP (36.5%), CHS (13.3%), and CDM (2.7%). There was a statistically improved understanding in all domains of PS across all colleges (p < 0.001). Notably, students in years four and five from CoM and CoP showed significant improvement in their perceptions than other colleges (p < 0.001). The participants encountered challenges of weak internet connections, software issues, technical failures, and power outages during the workshop.

Conclusion

This study highlights a positive impact of an IPE-based interventional workshop on the students' understanding and insights of PS and quality of care. This underscores the paramount role of IPE in improving perceptions and approaches towards PS in the context of healthcare education.

Interprofessional education

patient safety

medical professionalism

leadership in healthcare

precision medicine

Interprofessional education (IPE) refers to the educational programs where students from different disciplines and professions learn with and from each other, and gain further insights into their respective roles and responsibilities [1]. IPE has increasingly gained popularity as the delivery of healthcare gradually becomes more interconnected in an endeavour to providing high-quality patient care [2]. Training of medical and health sciences students in the climate of IPE lays the foundation for a culture of collaboration in healthcare as it helps break down the barriers between different healthcare professionals, thus promoting better communication and collaboration in the delivery of patient care [3].

A significant corpus of literature has argued that IPE leads to improved patients outcomes and quality of care by team-working, shared decision-making, and increased patient satisfaction [3] [4]. Additionally, IPE is associated with high job satisfaction among healthcare workers and improved efficiency and delivery of patient care. Similarly, during medical practice, iinterprofessional collaboration among nurses and physicians can lead to a decrease in patients’ fall rates and average length-of-stay in hospitals, and an increase in patient turnover [5]. Promoting a more patient-centered approach, IPE helps healthcare workers learn to identify and address potential safety risks and addresses the needs and perspectives of patients and their families. Such collaborative practice fosters a culture of patient safety (PS) in healthcare organizations [6]. A collective and well-understood approach, either in education or practice, is the key to mitigate the risk of diagnostic or therapeutic errors and to enhance PS. The United Nations has also developed the modular building blocks of sustainable developmental goals for transforming the world towards better education, health and well-being, food and water, cities and communities, and digital revolution [7]. Of these, PS holds a central role in improving the quality of delivery of healthcare systems [8].

There is no disagreement that healthcare professionals (HCPs) from diverse branches of the medical field including, but not limited to, medicine, nursing, pharmacy, dental medicine, paramedics, and physiotherapy should coordinate their efforts to deliver high-quality patient care [9]. However, most HCPs have not been educated or trained together in an interprofessional environment. This shortcoming in the undergraduate and graduate medical and health professions curricula can be bridged by introducing IPE courses right from the start of the program, thereby ensuring that IPE is integrated both horizontally and vertically within the curriculum [10]. Such educational reforms carry a strong promise of improving collaborative practice, role recognition, and changing attitudes towards team-work and ensuring PS [11].

Several studies have objectively assessed the knowledge and attitude of undergraduate medical students about PS in the Middle East and North Africa (MENA) region and worldwide [12] [13] [14]. However, there is a scarcity of evidence about the enhancement of students’ understanding about PS in an IPE-based interventional environment [15]. Moreover, in the MENA region, there is a lack of coherent and collective efforts which can help medical educators fully understand and encourage healthcare students to learn and work in an IPE environment. Some IPE-driven workshops have been conducted as educational interventions to facilitate IPE collaboration among healthcare students, reporting a remarkably positive impact on healthcare students' knowledge and attitudes [16] [17]. However, there remains a need to understand the role of IPE-based educational interventions in determining their effectiveness for improving PS outcomes in the medical field. The overarching purpose of this study was to enhance the understanding and insights of the undergraduate medical and health sciences students about PS and quality of care at the University of Sharjah (UoS) in the United Arab Emirates (UAE) by an IPE-based interventional workshop. It is a pragmatic approach to evaluate the impact of an IPE-based workshop among medical and health sciences students. This pre-post study provides an encouraging evidence-based data for improving the understanding and insights of medical and health sciences students about PS and quality of care in an IPE environment.

This pre-post research was conducted on the medical and health sciences students of the four medical and health colleges at the UoS; College of Medicine (CoM), College of Health Sciences (CHS), College of Dental Medicine (CDM), and College of Pharmacy (CoP). Our research primarily aimed to foster the understanding of medical and health sciences students at UoS about PS and quality of care in an IPE setting.

Study settings

The CoM of UoS runs a 6-year integrated and systematic MBBS program using a problem-based learning pedagogy. All three phases of the program, basic sciences, pre-clinical and clinical, boast early clinical exposure and the professional development of medical students with a growing emphasis on PS and IPE. There is no formally recognized course on IPE in the medical curriculum. However, through the interprofessional education and practice committee of four medical and health colleges at UoS, there is a remarkable readiness and interest of the students and faculty towards collaborative education and practice. The CoP offers a pharmacy bachelor program and three postgraduate programs: Master in pharmaceutical sciences, pharm. D, and PhD in pharmaceutical sciences. PS is an essential topic and holds a pivotal position in the CoP programs. The CDM offers a 5-year program for the Bachelor of Dental Surgery. The curriculum includes four streams: dental health sciences, dental clinical practice, human biology, and community dentistry. PS module is delivered in clinical settings with an emphasis on the assessment of students’ knowledge and clinical application about the subject. Lastly, the CHS has seven undergraduate 4-year programs: nursing, physiotherapy, medical lab sciences, dietetics and nutrition, diagnostic imaging, environmental health, and health services administration. All these programs equip students with skills in conducting scientific research and prepare them to serve the patients and the scientific community. Currently, PS is interwoven in the curriculum and there is some emphasis on PS in both theory and practical. Per se, there are no formal IPE and PS courses in the curricula in all four medical and health colleges of UoS.

Study participants

Senior students (last 2 to 3 years of all programs) from CoM, CoP, CDM, and CHS of the UoS participated in this study. Most of these students were engaged in clinical clerkships during the hospital training part of their curriculum. Following the approval by the Research and Ethics Committee (REC-21-12-12), invitations were sent to all eligible students from four colleges using flyers, registration links, QR codes and consent forms via email blurbs. The interested students were required to sign up for the workshop. A participant information leaflet was distributed to the registered students for their pre-workshop knowledge and orientation. The consent form was signed at the start of the workshop and students completed the questionnaire prior to the start of the workshop. The sample size for this study was calculated to be a minimum of 130 participants, based on a sample comparison of means formula, using a power of study of 90%, and an alpha risk of 5%.

Sampling technique

Using a stratified random sampling technique, students were recruited from the CoM, CoP, CDM, and CHS of UoS. To ensure a balanced representation across disciplines, each college served as a stratum from which participants were randomly selected. The number of participants selected from each stratum was proportional to the size of the students’ body in each college, ensuring a balanced representation. This methodological clarification provides a transparent and replicable framework for participant selection, enhancing the study's methodological rigor and credibility.

Study questionnaire and clinical cases for breakout rooms

We adopted a validated questionnaire by Quatrara et al., [18] with in-house modifications to tailor the questionnaire to the specific needs and research intent of our study. We reviewed the contents of the original questionnaire and selected the right-fit statements to match the primary intent of this study. Next, we tested alternatives with the original statements and correlated changes between the two versions. Finally, multiple items were averaged together to offset potential flaws in any single item. This process of questionnaire development helped us to prepare the final research instrument which contained three domains: Medical professionalism (MP) with eight statements, leadership in healthcare (LH) with six statements, and precision medicine PM with five statements. The domain of MP fosters PS by providing empathic and patient-centric approach with effective communication. LH plays a significant role in securing PS by following a visionary and collaborative strategy and by fulfilling patients’ and societal needs [19]. Lastly, PM enhances PS by providing targeted and individualized management plans using distinct genetic make-up, environmental and lifestyle factors for everyone [20]. These three domains, individually and collectively, contribute to PS by embracing the core principles of effective communication, empathic and compassionate patient care, autonomy and agency, organizational skills, team building, changing attitudes towards collaborative practice and by targeting individualized patient care [21]. Furthermore, this nested and interrelated relationship between these attributes contribute to PS by fostering diagnostic and therapeutic efficacy and by intensifying professional approaches under effective leadership. The face and content validity of the questionnaire was pretested through several rounds of deliberations till a consensus was reached.

Pre-post workshop

The online workshop was conducted through ZOOM application and all participants allowed the organizers to record the workshop proceedings. The organizational structure of this 2.5 hours workshop is illustrated in Fig. 1.

After the introduction, and prior to the workshop, all participating students were requested to fill the pre-workshop questionnaire online. The participants were required to answer their responses on a 5-point Likert’s scale from strongly agree, agree, neutral, disagree, and strongly disagree. Subsequently, three interactive resource sessions were delivered about the interchangeable roles of MP, LH, and PM in enhancing the quality of healthcare outcomes by SG, NS, and FJ. Briefly, SG set the scene about the principles and significance of PS and IPE, and NS and FJ discussed the clinical cases, which compromised PS, by using the World Health Organization (WHO) guidelines. During the next phase of the workshop, the participants were distributed into 20 breakout rooms (12–15 students each room with a facilitator) for an inter-professional learning activity in the form of small groups discussions. The composition of students in each breakout room ensured, as much as possible, similar representation from each college and discipline, to create a genuine IPE climate. The facilitators represented all four medical and health colleges of UoS, and the workshop demonstrated a genuine case mix of IPE for students and facilitators. The participants were presented four clinical cases with some degree of threats to PS and quality of care. Later, after initial presentations, participants were randomly allocated to breakout rooms where four real practice-based clinical cases were discussed in the form of interactive small group forum. These practice-based real cases were identified by the medical and health sciences students and faculty of UoS during the clinical training of the students in healthcare facilities. Broadly, these cases related to medication errors, wrong surgical procedure, and non-compliance with hand hygiene. The domains of IPE and PS in these cases covered medical professionalism, leadership, communication, teamwork, shared decision making, and personalized medicine.

During the breakout rooms, the students were invited to; 1) describe the incident related to PS (e.g., what went wrong?), 2) identify the potential underlying causes, 3) recognize the PS and quality of care domains related to the case, 4) analyze the potential measures to prevent the incident, and 5) reflect on how IPE-based practice would contribute to PS in each case. Students were encouraged to interact, brainstorm, and reflect on their opinions under the guidance and assistance of group facilitators. After the small group discussions in the breakout rooms, all students reconvened to the main workshop room, and spokespersons from each breakout room presented a summary of small group discussions and plausible solutions of the discussed clinical scenarios. Finally, all students were requested to fill the same questionnaire for a pre-post workshop analysis. The workshop was then closed by wrapping up the event and thanking all organizers, students, facilitators, and IT support staff. Prior to the workshop, a dry run was done for the online training of facilitators and organizers for the internet security, breakout rooms dynamics, PowerPoint presentations and equipment check.

Statistical analysis

Data were presented as frequencies with percentages for categorical variables and as median with interquartile (IQR) for numerical variables. A series of Wilcoxon signed-rank test and McNemar test were conducted to determine if the medical professionalism, leadership in healthcare and precision medicine scores and percentages were different at two-point times (pre and post workshop) and if there were significant differences according to the year of study and college. Moreover, Chi square tests were performed to compare the percentages of agreement pre and post workshop. Statistical significance was set at p value ≤ 0.05 (two-sided). The data analysis was performed using the IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows Version 28.0.

We invited 851 students from CoM, CoP, CHS and CDM, and 455 attended the workshop in part or in full (response rate of 53.4%). A total of 248 students attended the workshop completely. The majority (47.6%) of students were from CoM, followed by CoP (36.7%) and CHS (13.3%), while the lowest representation was noticed from CDM (2.4%) as shown in Table 1.

Table 1

Characteristics of the study participants (n = 248).
Variable	Frequency	Percentage
Year of study
3	40	16
4	135	55
5	73	29
College
Medicine	118	48
Pharmacy	91	37
Health sciences	33	13
Dental medicine	6	2

Table 2 shows the impact of the workshop on students by comparing the pre and post workshop responses to the questionnaires. The differences between pre and post responses were significant for three main domains of MP, LH, and PM (p < 0.001) as shown in Table 2. This reflects a significant impact of the workshop in improving the students’ insights about PS in an IPE climate.

Table 2

Pre-post-workshop differences in understanding about medical professionalism, leadership in healthcare, and precision medicine (n = 248).
Variable	Pre-workshop Median (^*IQR)	Post-workshop Median (^*IQR)	p value
Medical professionalism	38 (32.3–40)	40 (36–40)	< 0.001
Leadership in healthcare	29 (24–30)	30 (27.3–30)	< 0.001
Precision medicine	23 (20–25)	25 (22–25)	< 0.001

Later, we analyzed differences in responses of the participants between pre-post surveys by each theme in each year of study from each college. For MP, although the pre-post differences in responses among students varied widely for three years, however, CoM and CoP showed statistically significant improvement in pre-post scores, as shown in Table 3, (p < 0.001).

Table 3

Comparison of the pre-post workshop perceptions of the participants about medical professionalism by the year of study and college (n = 248).
Variable	Pre-workshop median (^*IQR)	Post-workshop median (^*IQR)	p value
Year of study
Three	37 (32–40)	40 (34–40)	0.006
Four	39 (33–40)	40 (37–40)	< 0.001
Five	38 (32–40)	40 (37–40)	< 0.001
College
College of medicine	38 (32–40)	40 (38–40)	< 0.001
College of pharmacy	38 (32–40)	40 (35.5–40)	< 0.001
College of health sciences	40 (32.8–40)	40 (36.5–40)	0.131
College of dental medicine	38.5 (35–40)	40 (38–40)	0.285

Table 4 depicts the comparison of the pre-post workshop perceptions of the participants about LH by the year of study and college. It’s evident that Y4 and Y5 students (p < 0.001) demonstrated a substantial difference in their pre-post responses, and CoM (p < 0.001) and CoP (p < 0.024) showed statistically significant differences.

Table 4

Comparison of the pre-post workshop perceptions of the participants about leadership in healthcare by the year of study and college (n = 248).
Variable	Pre-workshop Median (^*IQR)	Post-workshop, Median (^*IQR)	p value
Year of study
Three	28.5 (24.3–30)	30 (24.5–30)	0.206
Four	29 (24–30)	30 (28–30)	< 0.001
Five	29 (24–30)	30 (27–30)	< 0.001
College
College of medicine	29 (24–30)	30 (27.8–30)	< 0.001
College of pharmacy	28 (24.5–30)	30 (26.5–30)	0.024
College of health sciences	30 (24–30)	30 (28.5–30)	0.167
College of dental medicine	28 (24.7–30)	30 (28–30)	0.066

Lastly, for the domain of PM, students from all years showed statistically improved knowledge and understanding between their pre-post levels, and all colleges except CDM showed significant improvement (Table 5).

Table 5

Comparison of the pre-post workshop perceptions of the participants about precision medicine by the year of study and college (n = 248).
Variable	Pre-workshop Median (^*IQR)	Post-workshop, Median (^*IQR)	p value
Year of study
Three	23.5 (20.3–25)	25 (21–25)	0.022
Four	24 (20–25)	25 (23–25)	< 0.001
Five	23 (20–25)	25 (21.5–25)	< 0.001
College
College of medicine	23 (20–25)	25 (22–25)	< 0.001
College of pharmacy	24 (20.5–25)	25 (22–25)	0.011
College of health sciences	22 (20–25)	25 (23–25)	0.015
College of dental medicine	25 (21–25)	25 (22.3–25)	1.000

An itemized analysis of each statement of the questionnaire with reference to the pre-post scoring is presented in Table 6. The analysis showed a significant improvement in the knowledge and understanding of students in most of the items.

Table 6

Differences between pre- and post-workshop responses by items (n = 248).
A. Medical Professionalism (Teamwork and communication)	Pre-workshop, n (%)				Post-workshop, n (%)				*p value
A. Medical Professionalism (Teamwork and communication)	Agree/ S. Agree	Neutral	Disagree/ S. disagree	Mean (SD)	Agree/ S. Agree	Neutral	Disagree/ S. disagree	Mean (SD)	*p value
Reflective practice helps me in becoming a better healthcare professional	242 (97.6)	2 (1.6)	2 (0.8)	4.6 (0.6)	246 (99.2)	0 (0)	2 (0.8)	4.8 (0.5)	< 0.001
Shared learning facilitates my collegial work with other healthcare professionals	235 (94.8)	11 (4.4)	2 (0.8)	4.5 (0.6)	246 (99.2)	0 (0)	2 (0.8)	4.8 (0.5)	< 0.001
Shared learning with peers from other medical fields enhances my clinical problem-solving skills	234 (94.4)	12 (4.8)	2 (0.8)	4.5 (0.6)	244 (98.4)	2 (0.8)	2 (0.8)	4.7 (0.5)	< 0.001
Shared learning encourages me to understand my own limitations	236 (95.2)	10 (4)	2 (0.8)	4.5 (0.6)	244 (98.4)	2 (0.8)	2 (0.8)	4.7 (0.5)	< 0.001
Shared learning among healthcare learners and professionals improves my communication with patients	236 (95.2)	9 (3.6)	3 (1.2)	4.5 (0.6)	241 (97.2)	5 (2)	2 (0.8)	4.7 (0.6)	< 0.001
Learning with peers helps me to become an effective member of a healthcare team	239 (96.4)	6 (2.4)	3 (1.2)	4.5 (0.6)	243 (98)	2 (0.8)	3 (1.2)	4.7 (0.6)	< 0.001
Patients would ultimately benefit if health sciences students worked together to solve patient problems	239 (96.4)	6 (2.4)	3 (1.2)	4.6 (0.6)	245 (98.8)	1 (0.4)	2 (0.8)	4.7 (0.5)	0.004
Effective communication with team member, patients, and families enhances patient safety	240 (96.8)	6 (2.4)	2 (0.8)	4.7 (0.6)	243 (98)	4 (1.6)	1 (0.4)	4.8 (0.5)	0.011
B. Leadership in healthcare
Healthcare leaders need to work with public health administrators and policy makers to improve patient safety	240 (96.8)	7 (0.8)	1 (2.8)	4.6 (0.6)	242 (97.6)	4 (1.6)	2 (0.8)	4.7 (0.6)	0.004
Healthcare leaders must work with the legislators to develop regulations and policies to improve patient safety and to prevent medico-legal complaints	237 (95.6)	10 (4)	1 (0.4)	4.6 (0.6)	245 (98.8)	1 (0.4)	2 (0.8)	4.7 (0.5)	< 0.001
Healthcare leaders need to target on populations to deliver effective healthcare	234 (94.4)	10 (4)	4 (1.6)	4.5 (0.7)	243 (98)	3 (1.2)	2 (0.8)	4.7 (0.6)	< 0.001
It is essential for healthcare leaders to acknowledge and recognize unique cultures, values, and norms of all health professions	240 (96.8)	7 (2.8)	1 (0.4)	4.6 (0.6)	243 (98)	3 (1.2)	2 (0.8)	4.7 (0.6)	0.002
Healthcare leaders should develop a shared understanding with patients, families, physicians, and other healthcare workers to improve patient safety	240 (96.8)	7 (2.8)	1 (0.4)	4.6 (0.6)	245 (98.8)	1 (0.4)	2 (0.8)	4.7 (0.6)	0.002
Healthcare leaders should understand what it takes to communicate across cultures effectively	240 (96.8)	7 (2.8)	1 (0.4)	4.6 (0.6)	243 (98)	3 (1.2)	2 (0.8)	4.7 (0.6)	< 0.001
C. Precision medicine
Understanding the patient's side of the problems	242 (97.6)	4 (1.6)	2 (0.8)	4.6 (0.6)	242 (97.6)	4 (1.6)	2 (0.8)	4.7 (0.6)	0.044
Using new types of therapies or interventions to help target patients’ specific medical needs	235 (94.8)	11 (4.4)	2 (0.8)	4.5 (0.6)	242 (97.6)	4 (1.6)	2 (0.8)	4.7 (0.6)	< 0.001
Respecting the unique requirements of patients while maintaining their confidentiality in medical practice	235 (94.8)	11 (4.4)	2 (0.8)	4.6 (0.6)	244 (98.4)	2 (0.8)	2 (0.8)	4.7 (0.6)	< 0.001
Using a patient’s genetic information to assist in decision-making	215 (86.7)	28 (11.3)	5 (2)	4.4 (0.8)	236 (95.2)	9 (3.6)	3 (1.2)	4.6 (0.7)	< 0.001
Applying genome-guided prescribing strategies using patient’s genetic information	215 (86.7)	28 (11.3)	5 (2)	4.4 (0.8)	238 (96.0)	9 (3.6)	1 (0.4)	4.7 (0.6)	< 0.001

Our pre-post workshop-based research reported an enhancement in understanding and insights of medical and health sciences students at UoS about PS and quality of care in an IPE climate using an online interactive workshop under the supervision of facilitators. The diversity of students, facilitators, and speakers from different medical disciplines speaks volumes of the interest, willingness, and enthusiasm of the cohort towards the common goal of patient safety. The workshop also reported meaningful students’ engagement in developing communication skills and appreciating each other’s roles within healthcare teams. Students recognized the opportunity to collaborate with others and to contribute to in teams for enhancing PS. This signifies the need to provide ongoing opportunities for students from the diverse medical disciplines to interact earlier in their academic programs. This may facilitate the development of role understanding, clear communication, and mutual respect, all of which are fundamental requisites for ensuring PS and quality of care.

The findings from our study have significant implications for the design and implementation of IPE curricula. First and foremost, the positive impact of the IPE-based interventional workshop on enhancing students' understanding across different domains of PS underscores the effectiveness of active and collaborative learning approaches. Moreover, the variability in improvements across different years of study and among colleges encourages the researchers to tailor IPE curricula to meet the specific learning needs and experiences of students from different healthcare disciplines [22]. This could involve the development of modular content that can be adapted or expanded upon, depending on the audience, ensuring relevance and engagement for all participants. Additionally, the incorporation of real-world scenarios and case studies, as demonstrated by the clinical case discussions in our workshop, should be a cornerstone of IPE, allowing students to apply theoretical knowledge to practice effectively.

To navigate the logistical and technological challenges inherent in delivering IPE programs, especially in a predominantly online format, educational institutions should consider investing in training faculty and technical staff in the latest digital education methodologies [23]. Furthermore, establishing a feedback loop with students to continually assess and refine the delivery of IPE activities can ensure that these programs remain responsive to the needs of learners and the realities of the healthcare environment [24]. Ultimately, our study advocates for an iterative approach to IPE program development, where continuous evaluation and flexibility in design are key to addressing the complexities of IPE in healthcare. All-together, this study demonstrates statistically improved understanding of students in all three domains of PS namely MP, LH, and PM. Lastly, the degree of students’ engagement in the synchronous online workshop remained high which speaks volumes of the interest and readiness of the cohort to work in IPE teams.

In a systematic review and meta-analysis by Guraya and Barr, the authors have diligently presented the case of the effectiveness of IPE in healthcare [25]. The study has shown a positive impact of IPE-based educational interventions in the medical field. However, the complexity of medical curricula and teaching pedagogies with overcrowded timetables pose special caveats to the integration of IPE courses. In the absence of a robust teaching framework for IPE, the linkages between the determinants and processes of collaboration at the levels of education, training, and practice will remain elusive [26]. Such a disconnect between education and practice of IPE and collaboration will extend the gap between learners, educators, professionals, and organizations. Our study has vividly elucidated the enthusiasm of the participants towards bringing plausible solutions to the real practice-based clinical scenarios during interactive deliberations. The interprofessional climate encouraged the cohort to discuss case scenarios openly and objectively with compromised PS and, this fact signifies the fundamental role of IPE in the medical field [27]. Our study was able to provide an enhanced virtual learning experience with significant outcomes and an appreciation of each other roles as health professionals.

Our pre-post statistical analysis for each year and each college reported a substantial overall upswing in the knowledge and understanding of the participants towards medical professionalism, leadership in healthcare, and precision medicine (p < 0.001). This finding draws on the universal impact of the educational intervention in improving the students’ knowledge about PS in IPE climate. This capacity of IPE in bringing students and faculty from different professional and educational backgrounds is well-established [28]. Our study reaffirms the binding power of IPE by changing attitudes and by encouraging different stakeholders in the medical field to work towards the novel mission of improving PS and health systems.

In our study, for MP, there were remarkable differences in pre-post knowledge among students for three years, however, CoM and CoP showed statistically significant pre-post scores (p < 0.001). Such variations outline a natural phenomenon of gradually improved knowledge and proficiency of learners. A better improvement of the knowledge of the students of CoM and CoP might be related to a higher number of participants from these colleges or due to a better prior understanding or both. MP refers to the set of values, behaviors, and responsibilities that allows the HCWs to gain trust in society [29]. However, the subject of MP must be grounded both in the nature of a profession and in the conduct of HCPs, which can reflect societal expectations [30]. By adhering to the prescribed codes of MP including communication, team- work, privacy, agency, justice, accountability, and duty of care, HCPs can potentially enhance PS and quality of patient care [31]. Likewise, the charter on MP outlines three fundamental principles of primacy of patient welfare, patient autonomy, and social justice [32]. The elements of patient welfare and safety indicates a caring and compassionate approach towards patients which can be realized by a more coherent and collegial IPE approach in the medical field [33]. Our study endorses the crucial role of MP in enhancing PS in an IPE-based learning activity.

Literature has signaled a positive correlation between LH and improved patient wellbeing and safety [34]. The current empirical evidence highlights the value of leadership, both formal and informal, in enhancing and sustaining PS [35]. Like the MP domain, our study showed a significant improvement in the understanding of the participants in LH. This finding is in agreement with other published reports [36] [37]. The underlying premise refers to the fact that healthcare leaders should develop a shared understanding with patients, families, physicians, and other healthcare workers to improve PS and quality of care. In our study, Like other attributes of the study questionnaire, PM was well understood by most of the participants as reflected by statistically significant improvement of their knowledge except for CDM. This may be partially explained by a small number of participants from CDM. PM narrates disease by genomic sequencing and other technologic intersections with more precise targeting of subgroups of clinical conditions [38]. This specialized field carries a great potential to enhance patient care through high quality diagnostic sensitivity and precise therapeutic targeting [39]. Though a difficult subject, most participants thoroughly understood the concept of PM in the IPE atmosphere as reflected by improved understanding in the post-workshop survey.

The findings from our workshop underscore the importance of integrating quality and safety education within the framework of IPE. This integration not only broadens the scope of traditional IPE curricula but also aligns with the pressing need for healthcare professionals who are adept at navigating complex healthcare environments with a patient safety-first mindset. The positive feedback and significant improvements in participants' understanding and attitudes towards PS and interprofessional collaboration indicate that such a holistic approach to curriculum design can effectively prepare future HCPs. It is imperative that medical and health sciences education continues to evolve by embedding these intertwined principles into all aspects of learning, ensuring that graduates are well-equipped to contribute to the culture of safety in healthcare settings.

Study limitations

As many as 248 participants were able to attend the workshop in its entirety which is a strength and could be considered a large sample. Although we were not able to establish the reason why participants left the workshop early, a plausible explanation could be that there was pressing academic matters to attend to, or they had to attend to clerkship duties in their clinical training sites. Furthermore, internet outrage and poor internet connectivity could be taken into consideration to justify why some participants did not stay for the complete session. The relatively low response rate may influence the study findings. In addition, the low representation by the CDM is hereby acknowledged as a limitation. Nevertheless, the findings may be viewed with caution as only senior year students participated in the workshop. Additionally, the findings may not be generalizable across four colleges as students may have had different exposures to IPE and representations from each college was not comparable specially from CDM. This is likely to have skewed the results. Despite these limitations, overall results of the study demonstrated a collective improvement of the participants’ understanding about IPE. Lastly, the convenient sampling technique used in this study may limit generalizability of the findings and the possibility of selection bias cannot be ruled out.

This pre-post research provides compelling evidence in fostering the understanding of medical and health sciences students towards PS in a climate of IPE. The study endorses the value of IPE in improving the insights about PS domains of MP, LH, and PM. Medial educators are encouraged to utilize this data for the integration of IPE in fostering PS domains in health professions curricula. Additional research is essential to explore the longitudinal effects of IPE and its translation into PS within the clinical settings.

Availability of data and materials

The SPSS raw dataset and other material are available on request. The corresponding author will provide additional data, if requested.

Acknowledgments

Authors are indebted to all students who actively participated in this research and contributed with their insightful comments during the workshop. At the same time, authors are grateful to Amna Othman, Eteman Ibrahim, Mais Abdalla, Munazza Ahmed, Sadeq Ibrahim, Dawood Al Shetiwi for facilitation of the workshop.

Authors’ contributions

SG and NS conceived the research concept, designed and lead implementation of the study. SG, NS, and SSG supervised the development of study tools and interventions and revised the manuscript. AH and VAS managed the online workshop and data collection. IM was responsible for data cleaning, analysis, and presentations. MHT, FJJ, JA, SK, MAH participated in the interventional phase of the study and in manuscript editing and revisions. LRD, JMD, FJJ, MH, NRD, AAQ, SS, MW, and IM worked on the recruitment of participants through their respective colleges and contributed to data collection and initial and final write up of the article. All authors have contributed to promoting the study at their college, engagement, and recruitment students, and reviewed the manuscript.

Funding

Not applicable.

Ethics approval and consent to participate

The UoS Research Ethics Committee approved this study (REC-21-12-12). An informed consent was obtained from all participants and the process followed the recommended policies and guidelines of the Declaration of Helsinki. No minors or illiterate participants were involved in the study.

Consent for publication

All participants provided informed consent to participate in this study.

Availability of data and materials

Data is provided within the manuscript and can be provided if requested.

Competing interests

Prof. Salman Yousuf Guraya is a senior editorial board member of BMC Medical Education. Sausan AL Kawas and Jacqueline Maria Dias are editorial board members of the BMC Medical Education. All other authors don’t have any conflict of interest.

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No competing interests reported.

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Editorial decision: Revision requested
04 Sep, 2024
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Enhancing the understanding of safety and quality of patient care among medical and health sciences students in an interprofessional climate: An interventional study

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