Project Funding Details

Purpose/Specific Aims: The importance of collaborative and interprofessional care for patients at the end of life (EOL) is widely recognized. Interprofessional education to develop collaborative competencies, such as communication, shared problem-solving, and conflict resolution, has been identified as a core component of medical and nursing education. Despite many statements calling for interprofessional collaboration, educational programs designed to develop and evaluate communication and collaboration competencies for medical and nursing students in EOL care are rare. The aims of this study are to determine whether an interprofessional workshop, “Difficult Discussions at the End of Life,” improves 1) the attitudes of nursing and medical students toward nurse-physician collaboration and health care teams and 2) the self-efficacy of nursing and medical students for communicating in difficult situations.
Rationale/Significance of Study: While many types of learning strategies can be used to promote interprofessional competencies, experiential case-based learning with simulation can be an effective format to achieve goals related to interprofessional collaboration as well as EOL communication skills. As efforts continue toward sustainable interprofessional educational programs in academic settings, it is important to measure whether this simulation workshop is effective to improve attitudes and skills of medical students and nursing students related to collaboration as well as their communication skills in an EOL scenario.
Conceptual or Theoretical Framework: A recent World Health Organization (WHO) Study Group on Interprofessional Education and Collaborative Practice proposes a framework that illustrates how interprofessional education enables effective collaborative practice which in turn optimizes health-services, strengthens health systems and improves health outcomes.
Main research Variables: The main research variables are attitudes toward nurse-physician collaboration and teamwork and self-efficacy of communication during difficult discussions.
Design: The study will use a pretest-post-test design to measure changes in attitudes toward collaboration and teamwork of nursing students and medical students and self-efficacy for communication after they attend the “Difficult Discussions” workshop.
Setting: The study will take place at the University of Virginia.
Sample: The sample will include approximately 140 third-year medical students and 90 third-year BSN students and clinical nurse leader students.
Methods: Every student who attends the workshop at UVa during the 2011 calendar year will be invited to participate in the study. Participants will complete three questionnaires immediately before they participate in the workshop and within one month of completing the workshop: The Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, The Attitudes toward Health Care Teams Scale, and a Self-efficacy Confidence in Communication Scale.
Implications for Practice: Nurses are needed to partner with physicians to develop and manage interprofessional educational offerings to prepare the future workforce and to advance collaborative practice models. Researchers are called to provide evidence to show that interprofessional education and collaboration leads to improved health outcomes throughout the disease trajectory, including the end of life.