A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety

ABSTRACT

Interprofessional education (IPE) has been used for instilling a positive safety culture within healthcare, yet what interventions work to change healthcare student attitudes and how improved patient safety outcomes are best achieved with this intervention, is unclear and challenging to evaluate. A realist synthesis was undertaken to ascertain how, why, and in what circumstances IPE activities result in a positive change to student attitudes to patient safety. Database searches of CINAHL, MEDLINE, Scopus, and Eric were undertaken in April 2022 to identify relevant studies. Synthesis with a realist framework of analysis, coupled with the development of a program theory was conducted to identify interactions among contexts, intervention, mechanisms, and outcomes (CIMO). Twenty-three articles eligible for inclusion articulated environments in which varied contexts, interventions, and mechanisms were activated to influence student attitudes to patient safety. Findings from this realist synthesis informs awareness into the methods of delivering and evaluating IPE activities and offers new perspectives for educators in planning and evaluating future IPE from a collaborative and positive safety culture perspective.

KEYWORDS:

• Attitudes
• collaboration
• interprofessional education
• interprofessional learning
• perceptions
• safety culture

Acknowledgments

The authors would like to thank authors of the original articles for their research, discussions, and clarifications. We would also like to acknowledge the reviewers and editors for their helpful comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Elizabeth Cleary

Elizabeth Cleary, is a registered nurse, midwife, lecturer and senior project officer at the Chief Nursing and Midwifery Office, ACT Health Directorate. Her research interests focus on interprofessional education, patient safety and workplace culture.

Jacqueline Bloomfield

Jacqueline Bloomfield, is a registered nurse and Associate Professor of Nursing. Her research interests centre on health profession education, with a specific focus on interprofessional education. Further research interests include nursing workforce development, digital health, and supportive cancer care.

Astrid Frotjold

Astrid Frotjold, is a registered nurse and a senior lecturer in acute care nursing. Her research interests focus on interprofessional education, patient safety, clinical simulation and digital health technologies.

Carl Schneider

Carl R Schneider, is a registered nurse, registered pharmacist and a university associate professor in pharmacy practice, with a broad range of experience across acute and community care settings. His research interest focuses on patient safety via quality use of medicines and collaborative care. Additional research interests include health services design, implementation and evaluation.