Pilot of a community-based interprofessional “student-infused” pulmonary rehabilitation program in Saint John, New Brunswick

Abstract

Background: With the increasing prevalence of chronic pulmonary conditions in New Brunswick and Canada it is necessary to consider innovative interventions to improve access to rehabilitation and supportive care for affected clients. In Fall 2018 we piloted a pulmonary rehabilitation (PR) program for persons with moderate to severe chronic obstructive pulmonary disease (COPD) to demonstrate a novel approach of bridging interprofessional education of students in health care fields with provision of care in a community setting. Methods: An 8-week PR program was implemented and evaluated using a quasi-experimental design with pre-and post-testing to measure the effects of the program's exercise and educational interventions on persons with COPD. Participants were assessed using the 6-Minute Walk Test (6MWT), the St. George's Respiratory Questionnaire (SGRQ), and a custom questionnaire that rated the participants' activities of daily living and the PR program. Results: Seven participants completed our PR program. Following the intervention, participants' self-reported health demonstrated a statistically significant improvement. Even though changes on the 6MWT and SGRQ were not shown to be statistically significant, there was evidence of clinically meaningful improvements in those measures. On average, participants walked 25 m further postintervention and showed clinically meaningful improvements on the SGRQ. Conclusions: This pilot project demonstrated that a community-based PR program with active involvement of students from multiple health care programs can have positive outcomes for clients with COPD. It also illustrated how educational programs can provide an innovative means for increasing access to rehabilitation and supportive care for clients in the community.

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review

“… Describing and/or evaluating the overall IPP initiative. Fourty-four articles provided a description of planning, implementation and/or evaluation of elements of an IPP program [ 48 – 50 , 57 , 59 , 60 , 62 , 65 , 67 , 69 , 71 , 72 , 75 , 78 , 81 , 87 – 91 , 93 , 96 , 100 – 121 ], while the intent of one article was to describe the importance of IPP in relation to service delivery, care and meeting the needs of a population [ 122 ]. Program evaluation of the overall implementation or outcomes of an IPP initiative, such as curriculum design, was identified as a primary purpose in 13 articles [ 56 , 59 , 75 , 95 , 98 , 114 , 117 , 123 – 128 ] and evaluation of impact of the IPP initiative on stakeholders (i.e., clients, health agency placements, etc.)…”

“… Impact of the IPP initiative on stakeholders . The effect of IPP on client and service outcomes that included health status was a purpose in two articles [ 59 , 62 ], while other articles aimed to evaluate experiences and perspectives of clients and their families on students engaged in IPP [ 50 , 78 , 84 ]. Six studies sought to assess the impact of the IPP initiative on clinical stakeholders and partnerships, such as effects of IPP on staff, collaboration or teamwork, practice efficiencies, and the health agency hosting placements [ 53 , 59 , 63 , 64 , 133 , 148 ].…”

“…Similar to our findings for purpose, several articles appeared to have more than one intention for the IPP initiative. In 22 articles, creation of learning initiatives for planned and/or authentic placements and experiences for interprofessional experiences was an intention of the IPP education initiative [ 51 , 58 , 62 , 64 , 67 , 76 , 78 , 81 , 85 , 89 , 95 , 101 , 103 – 105 , 107 , 117 , 118 , 120 , 134 , 139 , 148 ]. Related to this, 20 of the initiatives were designed to build on IPE, IPL, and/or IPC theory or experiences through the initiative [ 48 , 59 , 70 , 80 , 87 , 92 , 106 , 109 , 111 , 112 , 114 , 128 , 131 , 133 , 135 , 137 , 138 , 140 , 141 , 144 ].…”

Understanding Student-Run Health Initiatives in the Context of Community-Based Services: A Concept Analysis and Proposed Definitions

“…6,22,29,35,41,45,47,61 Specific differences identified through our concept analysis included the degree of student autonomy in running the initiatives; the extent of involvement by academic institutions; the role of volunteerism in contrast to clinical placements; and whether credit was awarded for student participation. This was highlighted by Doucet et al 118 who introduced the term student-infused in conjunction with an institution-led pulmonary rehabilitation program noting that students had "limited ability to independently provide clinical interventions, required liability coverage, and did not have input" into the design of the program (p. 27).…”

“…For example, we found the additional terms student-infused and student-assisted outside of the literature search for this concept analysis. 118 , 119 We attempted to account for these challenges by using adjacency searching to address multiple possible phrasings. Still, this explains why we found the terms student-infused and student-assisted outside of the search process.…”