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REVIEW PROTOCOL TEMPLATE

Recommendation 9

The effect of inter-professional learning in both undergraduate and postgraduate programs on quantity, quality and relevance of health

professionals

Review protocol

Organization, City, Country: University of Tokyo, Tokyo, Japan Prepared by: Date:

Saw Yu Mon, Kayoko Yoshikawa July 2011

Senior supervisor Masamine Jimba Research team members Bruno Sunguya, Laura Shiao, Tamy Yamamoto, Saw Yu

Mon, Rachel Amiya, Kayoko Yoshikawa

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Table of Contents

WORKING TITLE: .................................................................................. ERROR! BOOKMARK NOT DEFINED.

A SYSTEMATIC REVIEW ....................................................................... ERROR! BOOKMARK NOT DEFINED.

1.0 Background ......................................................................................................... 3

2.0 Objective ............................................................................................................. 3

3.0 Review Question ................................................................................................. 3

4.0 Evidence gathering and study selection .............................................................. 3

5.0 Assessment of risk of bias and data extraction ................................................... 6

6.0 Data synthesis ..................................................................................................... 7

7.0 Dissemination ..................................................................................................... 7

8.0 Resource implications ......................................................................................... 7

9.0 References ........................................................................................................... 8

Appendix A: search strategy ........................................................................................... 9

Appendix B: data extraction forms (see attached excel workbook) ... Error! Bookmark

not defined.

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1.0 Background

Include definitions, answers to background questions, description of the intervention and how it might work to help better understand the question. This section is optional.

Define inter- professional learning, and briefly explain why it is important for transforming and scaling-up health professional education and training.

2.0 Objective

To assess the effect of inter-professional learning in both undergraduate and postgraduate programs on the quantity, quality and relevance of health professionals.

3.0 Review Question

For the purposes of this literature review, the population, intervention, comparators and outcomes (PICO) framework to inform the review objectives are presented below:

Population Intervention Comparison Outcome

Students in undergraduate or postgraduate programmes

Revising curricula and educational approaches for inter-professional learning

No revision of curricula and educational approaches for inter-professional learning

Quantity, quality and relevance of health professionals

Students in undergraduate or postgraduate programmes

Having (formal) agreements between schools, departments and units within (e.g. medical, nursing) and outside (e.g. medical, engineering, management) of health sciences

Not having (formal) agreements between schools, departments and units within (e.g. medical, nursing) and outside (e.g. medical, engineering, management) of health sciences

Quantity, quality and relevance of health professionals

S separate search strategy is presented in Appendix A for each question above.

4.0 Evidence gathering and study selection

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3.1 Evidence gathering

The evidence gathering approach will have four components:

3.1.1 Searching databases

The databases in the table below will be searched with a pre-determined strategy as detailed in Appendix A. In cases where the search results are small in number, search terms will be reduced to maximize the search sensitivity.

Electronic search sources

Category Sources Healthcare databases

PubMed/MEDLINE CINAHL ISI Web of Knowledge ERIC SSRN J-STAGE (Japanese) ICHUSHI (Japanese), WHO Global Index Medicus, WHO portal of clinical trials WHO’s Library Database (WHOLIS) Australasian Medical Index African Index Medicus Australasian Medical Index Index Medicus for Eastern Mediterranean Region Index Medicus for the South-East Asia Region (IMSEAR) IndMED KoreaMed LILACS Index Panteleimon Western Pacific Region Index Medicus (WPRIM)

Evidence-based reviews

Cochrane library (CDSR) BEME database Health Systems Evidence (PPD/CCNC) Campbell Library

Guidelines NHS Clinical Knowledge Summaries National Library of Guidelines

Grey literature NHS Evidence OpenGrey Association of African Universities Database of African Theses and Doctorates (DATAD)

Internet searching Google Google Scholar

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3.1.2 Hand searching

The following journals and websites will be hand-searched for relevant articles:

Resources that will be searched by hand

Journal of Interprofessional Care, WHO's Library Database (WHOLIS), SAMMS, HRH Global Resource Center, World Federation of Medical Education, International Council of Nurses, Association of American Medical Colleges, Council on Graduate Medical Education, American Academy of Family Physicians, American College of Physicians, International Pharmaceutical Federation, The Association for Medical Education in Europe, International Medical Association, World Bank, opensigle.inist.fr, HMIC database

3.1.3 Expert network consultations

A network of health professional education experts will be consulted by email to identify additional grey literature or research that has not been found through the above processes. The following experts and networks will be contacted.

Experts and networks will be contacted regarding additional articles

Gunma University, UNESCO.

3.1.4 Reference searches

Bibliographies of those papers that match the eligibility criteria below will be searched by hand to identify any further, relevant references, which will be subject to the same screening and selection process.

3.2 Eligibility criteria

After gathering the evidence, the following eligibility criteria will be applied to the results and all identified references screened independently by two reviewers (put reviewers initials here) using a three-stage approach to reviewing the title, abstract and full text.

3.2.1 Types of studies:

All types of evaluative study designs are eligible for inclusion, including grey

literature. Studies will not be selected on methodological quality.

3.2.2 Types of participants:

Students in undergraduate or postgraduate programmes Medical Doctors - both Generalist and Specialist Practitioners, including Public

Health Doctors Nursing Professionals, including Public Health Nurses Midwifery Professionals, including Public Health Midwives Dentists

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Pharmacists Medical Doctors - both Generalist and Specialist Practitioners, including Public

Health Doctors Nursing Professionals, including Public Health Nurses Midwifery Professionals, including Public Health Midwives Dentists Pharmacists

3.2.3 Types of intervention:

A school-based intervention aimed to improve collaboration between students of all health professions, and with students of related professions (e.g. management, engineering) by revising curricula and educational approaches, which may include(formal) agreements between schools, departments and units in health and related professions (e.g. management, engineering, etc.).

3.2.4 Types of outcome measures:

The primary outcomes of interest are the quantity, quality and relevance of practicing health professionals. These are defined by a number of measurable outcomes found in the Outcomes Framework document. Other important outcomes include values and preferences, resource use/costs, benefits and harms, as well as all other unintended effects of the intervention. Studies that include other outcomes should not be excluded at this stage in the evidence retrieval. Other secondary outcomes can also be defined, as needed.

3.3 Exclusion criteria

Editorials, newspaper articles and other forms of popular media will be excluded. Failure to meet any one of the above eligibility criteria (section 3.2) will result in exclusion from the review and any apparent discrepancies during the selection process will be resolved by a third, independent reviewer. The number of excluded studies (including reasons for exclusion for those excluded following review of the full text) will be recorded at each stage.

5.0 Assessment of risk of bias and data extraction

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Following the initial selection of literature, the reviewers should consult with the WHO Secretariat regarding the process to be followed for summarizing the studies. Data will be extracted from relevant papers using predefined evidence summary templates attached in Appendix B. Data will be collected regarding the reasons for exclusion, characteristics of included studies, participants, interventions (including comparators) and outcomes. The final decision for inclusion or exclusion will be made by a team consisting of the WHO Secretariat, methodologist and researchers conducting the review. Any potential disagreement will be recorded and resolved by further discussion.

Risk of bias across studies will be assessed using the approach outlined by the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group. Any disagreements will be recorded and resolved by involvement of an additional reviewer.

6.0 Data synthesis

The availability of appropriate data and resources to conduct a meta-analysis will be considered, where feasible.

7.0 Dissemination

A final set of tables including a GRADE Evidence Table and Descriptive Evidence Table will be produced and submitted to the WHO Secretariat as stipulated in the Procedures for the Retrieval of Evidence and Summary of Evidence. In addition, a manuscript will be prepared for submission to a peer-reviewed journal (a more specific dissemination proposal can go here as well).

8.0 Resource implications

The project lead will work closely with the WHO Secretariat to define the scope and methods of the review and facilitate access to unpublished literature, supporting translation of foreign language literature where necessary. Proposed milestones and timescales are outlined below:

TIMESCALE Evidence retrieval protocol developed Identifying and retrieving the evidence Conduct literature review, hand searching and contacts with experts and networks

Summarize the evidence Develop Descriptive Evidence Table Develop GRADE Evidence Table

Submit Descriptive Evidence Table and GRADE Evidence Table to the WHO Secretariat; upload PDFs of articles to FTP site

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9.0 References

When citing articles, please use the WHO standard citation format, called the Vancouver style. Some examples:

Article in a Journal Burt BA, Pai S. Sugar consumption and caries risk: a systematic review. Journal of Dental Education, 2001, 65:1017–1023.

Chapter in a book Melton L J III. Epidemiology of fractures. In: Riggs BL, Melton L J III, eds. Osteoporo¬sis: etiology, diagnosis, and management, 2nd ed. Philadelphia, PA, Lippincott-Raven, 1995:225–247.

Corporate author Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20 536 high-risk individuals: a randomised placebo-controlled trial. Lancet, 2002, 360:23–33.

WHO Publication with no named author The international pharmacopoeia, 3rd ed. Vol. 5. Tests and general requirements for dosage forms; quality specifications for pharmaceutical substances and tablets. Geneva, World Health Organization, 2003.

More on the WHO-style can be found here: http://www.nlm.nih.gov/bsd/uniform_requirements.html

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Appendix A: search strategy

Search terms

Search Concept MeSH headings Keywords/ Text word Population Students

Graduate education

Education status

Medical education

Education, professional

Cooperative behavior

Interpersonal relations

Internship and residency

Students, Health

Occupations

Students, Public Health

Students, Medical

Internal Medicine

School, Health

Occupation

Health facilities

Health care students

Medical students

Students, Health Occupations

Graduate Education

Post graduate Education

Post-graduate Education

Medical Internship and Residency

Health Occupations

Interprofessional Relations

Health Facilities

Interpersonal Relations,

Interprofessional teamwork

Interprofessional collaboration

Interprofessional communication

Interprofessional education

Inter-professional

Inter-professional learning

Inters-professional learning

Interprofessional learning

Graduate school

Post-graduate school

Post-graduate program

Postgraduate program

Postgraduate school

Intervention Schools, Health

Occupations

Curricula

Education

Teaching

Educational Measurement

Health Facilities

Inservice training

Education, Professional

Institutes and Academies

Academic Medical

Curricula*

Curriculum

Revising

Course*

Education

Approach*

School*

Interprofessional

Education

Educational

Status

Professional

Educational

Measurement

Teaching

Learning

Inservice Training

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Centers

Training

Institutes

Academies

Mix

Skill

Skill Mix Training

The Effect of Skill Mix Training

Academic Medical Centers

Agreement

Formal Agreement

Department*

Unit*

Department and Unit

Schools

Contract*

Memorandum of Understanding

Memorandum

The above MeSH thesaurus headings, keywords and free text terms will be amended as required in accordance with each different database used to maximize sensitivity. The scope of each free text search should include the study title and abstract where possible. Individual MESH and free text terms will be combined with the Boolean operator OR, unless otherwise specified. Each search concept should then be combined with the Boolean operator AND as follows: population AND intervention. An example search outlining the appropriate combination of terms is detailed below, executed using PubMed.. Search limits

Limit category Specified limit

Languages English, Japanese,

Publication type None

Date of publication 1995-2011

Study design None

Other limits Human data

Search sources

Category Sources Healthcare databases

MEDLINE, CINAHL, Web of knowledge, Cochrane Library (CDSR),

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Health Systems Evidence (PPD/CCNC), Campbell Library, UK Pubmed Central, ERIC, BEME database, J-STAGE (Japanese), ICHUSHI (Japanese), WHO Global Index Medicus, WHO portal of clinical trials, African Index Medicus, Australasian Medical Index, Index Medicus for Eastern Mediterranean Region, IndMED, KoreaMed, LILACS, Index Medicus for the South-East Asia Region (IMSEAR), Panteleimon, Western Pacific Region Index Medicus (WPRIM), WHO's Library Database (WHOLIS)

Evidence based reviews

Bandolier Cochrane library (CDSR)

Guidelines NHS Clinical Knowledge Summaries National Library of Guidelines

Grey literature Web of science NHS Evidence OpenSIGLE – system for information on grey literature in Europe

Internet searching Google Google scholar

Example search output – PubMed (DATE)

Cut and paste from PubMed here, for example:

No. Search term Hits

1 Education 789806

2 Student 156400

3 Students, Health Occupations 39043

4 Education, Graduate 41080

5 Education, Post graduate 15990

6 Education, Post-graduate 2639

7 Education, Medical 222658

8 Internship and Residency 22912

9 Schools, Health Occupations 32812

10 Health Occupations 1181307

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No. Search term Hits

11 Interprofessional Relations 46248

12 Health Facilities 548098

13 Interpersonal Relations 209077

14 Tranprofessional education 789806

15 Tranprofessional Collaboration 50833

16 Tranprofessional teamwork 3898

17 Interprofessional teamwork 762

18 Interprofessional 39896

19 Interprofessional collaboration 4612

20 Interprofessional communication 9039

21 Interprofessional education 13742

22 Inter-professional 369

23 Inter-professional learning 68

24 Inters-professional learning 131

25 Intersprofessional learning 322532

26 Graduate program 17689

27 Graduate school 156196

28 Post-graduate school 736

29 Post-graduate program 523

30 Postgraduate program 2033

31 Postgraduate school 9728

32 OR/1-33 1586629

33 Curricula 66917

34 Curriculum 642924

35 Revising Curricula 90

36 Education Approaches 12899

37 Education approach 39207

38 OR/35-43 994567

39 Inservice Training 21053

40 Training institute 62873

41 Skill Mix Training 518

42 The Effect of Skill Mix Training 16

43 OR/41-44 141942

44 Academic Medical Centers 61984

45 Agreement 147192

46 Formal Agreement 759

47 Department and Unit 145914

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No. Search term Hits

48 Formal Agreement Between Schools 27

49 Memorandum of Understanding 57

50 Memorandum 422

51 OR/46-52 291937

52 34AND 40 798859

53 34 AND 45 130165

54 34 AND 53 35421

55 34 AND 40 AND 45 AND 53 2011

56

57 [Limit to: Humans and (Languages Chinese or

English or French or German or Japanese or

Portuguese or Russian or Spanish) and Publication

Date from 1995/01/01 to 2011]

1519

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