A problem-based approach to discussing diversity may be applied to interprofessional education

Kevin Galbraith*, Sally Curtis*, Anne McBride§ Medical Education Development unit, School of Medicine*, and Applied Animal Behaviour Unit,

School of Psychology§, University of Southampton, UK

INTRODUCTION

Interprofessional education (IPE) for health and social care science students can enhance understanding, improve collaboration, and produce better quality of care.1 However, students enter higher education with preformed perceptions about other professional groups.2 Though IPE strategies improve knowledge and skills, there has been less success in positively influencing attitudes and perceptions towards others in the service delivery team1.

A problem-based small group tutorial on diversity was designed for medical students early in Year 1. This aimed to introduce a vertical curricular theme of diversity, and particularly explored issues relating to stereotypes. Having found this strategy to have favourable attitudinal outcomes among medical students, we explored its application to common learning with mature postgraduate Companion Animal Behaviour Counselling (CABC) students. Our findings suggested a possible novel approach to IPE, in which attitudes towards other professions could be explored in mixed-profession groups by embedding IPE within a wider diversity curriculum.

We describe here the problem-based approach used with medical and CABC students separately, and our proposed design for a combined introductory IPE session, with medical and other healthcare students together.

RESULTS

DISCUSSION

Both undergraduate medical and postgraduate CABC students felt they had gained greater insight into the thoughts of others. The lower impact among CABC students on their perception of disability, and perceived future use of stereotypes, may reflect both their age and likely greater prior exposure to diversity as an issue for discussion and learning. We feel this renders our problem-based approach more useful as comparative, rather than common learning, offering the opportunity to learn about differing perspectives among distinct professional groups. An option might be to embed IPE within our wider diversity curriculum, by using the same trigger material in sessions that group medical and other healthcare students together, and focusing on the diversity implicit in multidisciplinary healthcare teams.

TAKE HOME MESSAGE: A problem-based approach to discussion of diversity is helpful in changing attitudes of both medical and CABC students. We invite further discussion among peer educators on our proposed adaptation of these sessions to help interprofessional groups of students explore attitudes and perceptions towards others in the service delivery team.

METHODS

Groups of 8-10 Year 1 medical students (n=84) and similarly-sized groups of postgraduate CABC students (n=20) were given a paper-based trigger material including several discussion points (Figure 1) in a session lasting 1 hour. Discussion started with a deconstruction of medical and social models of physical disability, and following principles of adult learning, progressed towards the students’ own real-life experiences of peer group attachment and stereotyping.

Both groups gained insight into the thoughts of others

Proportionately more medical than CABC students altered their perception of disability

Proportionately more medical than CABC students felt they were less likely to view individuals according to stereotypesYou get together with some fellow students to do a project on Health

Promotion. As there’s currently a campaign by Hampshire police to improve road safety, you decide to contribute by setting up a display in a local shopping centre, warning people about the danger of not wearing a seatbelt. You are quite proud of a poster you downloaded from the Internet and suggest using it in the display.

Discussion points

• What strategy does this poster use to improve road safety?

• The poster uses the word “restriction.” What restriction does a wheelchair user encounter?

• Do you agree with the following statement?: “Disabled peoples’ lives are restricted by their impairment. It is hoped that medical advances will return them, wherever possible, to normal function.”

• Consider the advantages and limitations of being perceived as an individual, and of being perceived as belonging to a group.

Everyone thinks it would make a great impact, except one student, who says it looks “too sinister.” Feeling rather wounded, you say “Of course - that’s the whole point!” It’s not until later at lunch that your friend tells you that the unenthusiastic student has a disabled sister, who gets about in a wheelchair.

FIG 1. Trigger material

Do you feel the task will help you to gain insight into the thoughts of others?

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No, not at all No, not much Neutral Yes, a little Yes, a greatdeal

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Do you feel this session has altered your perception of disability?

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No, not at all No, not much Neutral Yes, a little Yes, a greatdeal

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Do you feel this session has made you more likely, or less likely to view individuals according to stereotypes?

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1. Hammick M, Freeth D, Koppel I et al. A best evidence systematic review of interprofessional education: BEME Guide No 9. Med Teacher. 2007;29:735-51

2. Tunstall-Pedoe S, Rink E, Hilton S. Student attitudes to undergraduate interprofessional education. J Interprofessional Care. 2003;17:161-72