Perceptions of residents, medical and nursing students about Interprofessional education: a systematic review of the quantitative and qualitative literature

Visser, Cora L.F.; Ket, Johannes C.F.; Croiset, Gerda; Kusurkar, Rashmi A.

doi:10.1186/s12909-017-0909-0

Table 5 LOT model for Guidance of the learning process in IPE. (adapted from Table 4 of Ten Cate et al. [86])

From: Perceptions of residents, medical and nursing students about Interprofessional education: a systematic review of the quantitative and qualitative literature

Source of guidance of the learning process
Learning process component	Full external guidance (from the teacher only)	Shared guidance (from students and teacher both)	Full internal guidance (from the student only)
Cognitive level
Learner: what to learn?	Learning with and about others in classroom situation - Shared learning early in training - Role clarity	Learning from others (roles and responsibilities) - Getting acquainted	Learning from other students and patients - Follow up training - Stimulating teamwork training - Learning in authentic context
Teacher: what to present to the student?	Using examples of complex patient problems - Learning in authentic context (simulation) Assessment - Assessment of IPE and specific learning goals	Facilitating students to think and plan a collaborative approach - Teacher facilitating reflection Assessment - Assessment of IPE and specific learning goals	Facilitating team work - Immersion in collaboration Assessment - Assessment of integrated IPE and specific learning goals
Affective level
Learner: why learn?	Shared learning about patients’ problems - Inform others about one’s roles & responsibilities	Learning with others to solve patients’ problems	Reflect on quality of care and patient safety - Patient problems clear? - Team communication
Teacher: how to motivate the student?	Expose stereotyped views - Discuss perception of characteristics, e.g. professional competence, academic ability	Give active, patient centred assignments - Case, simulation - Teacher facilitating reflection	Learning in authentic context - Integration of specific and IPE learning goals - Stimulating teamwork training
Metacognitive level
Learner: how to learn?	Learning goals are assessed^a	Integrating profession specific + IPE goals^b	Peer coaching
Teacher: how to instruct the student?	- Assessment at cognitive level and reflection for affective level	- Follow up of teamwork skills as formative assessment by peers	- (Self-)Assessment with reflection and portfolio

^aExamples of learning goals assessment in the included papers are: Final class presentation [58]; Judgement by IP facilitators using a rubric at end of placement [74]; Asking for 3 statements about learning in IP Training Unit [43]; Faculty and Standardized Patient using a Teamwork Global Rating Scale [80]
^bWith integrated profession specific and IPE objectives, assessment can be considered a form of guidance as stated by Broadfoot (Broadfoot, Patricia (2007) Introduction to assessment. London: Continuum, p. 135–136): “Self-assessment, therefore, is not really just an assessment practice; it is actually a learning activity. It is a way of encouraging students to reflect on what they have learned so far, to think about ways of improving their learning and to make plans which will enable them to progress as learners and to reach their goals. […] As such it incorporates the skills of time-management, action-planning, negotiation, interpersonal skills, communication - with both teachers and fellow students - and self-discipline in addition to reflection, critical judgment and evaluation”
We incorporated the facilitators found at cultural and process level (indicated with – italic, from our Tables 1, 2 and 3 in the column ‘Subcategories’). Since ‘Assessment’ can be considered a form of guidance (Crooks, 1988) and it was missing in most IPE interventions (barrier at process/curricular level), we added it at the cognitive and meta-cognitive level

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