Interprofessional Continuing Professional Development in Rural Hospitals: a Mixed Methods Educational Needs Assessment

Abstract

Background. Interprofessional education (IPE) is imperative in rural hospitals, however little is known about the challenges faced in this setting for interprofessional continuing professional development (CPD) activities. The gap is critical in countries that lack standard regulations for health professional’s accreditation. We aim to understand the experience and educational needs of health professionals in a rural hospital, to describe the barriers for interprofessional CPD in these settings, and to explore their perceptions about strategies to improve interprofessional continuous learning activities. Methods. This study was approved by the institutional review board at Harvard Medical School. Using a mixed methods explanatory sequential design, between August 2019 and January 2020, we conducted 24 semi-structured interviews, 3 focus groups and 40 hours of complementary field observations, followed by an electronic questionnaire with the staff of a rural community hospital in Chiapas, Mexico. The questionnaire was responded by 13 out of 72 eligible individuals (18%). Results. Health professionals recognized the need and demonstrated interest towards learning, but a poor fit between existing learning activities and their desire for practical learning resulted in low engagement with the current educational opportunities available. Moreover, participants identified institutional barriers for interprofessional CPD, including poor leadership engagement, flaws in administration procedures and lack of resources. Finally, participants described a damaged collaborative practice climate marked by ineffective teamwork and communication that obstructed educational activities and patient care. All the survey respondents considered CPD very or extremely important, but 67% did not feel motivated to attend to educational activities. Other factors preventing them from attending were inconvenient schedule (75%), inadequate classroom (65%), high workload (60%), ineffective speakers (60%), and boring sessions (55%). Preferred learning strategies included practical workshops, simulations, and analysis of cases. Conclusion. This study described the multifactorial barriers faced by health professionals in a rural hospital for interprofessional CPD activities that affect not only individuals’ learning but also patient care. Overcome these difficulties may have play a key role for collaborative care in similar settings. Collective efforts are needed to develop evidence-based educational strategies that support IPE and CPD to overcome the unique challenges faced by health professionals in this rural context.