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1 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content Click Here to insert brief content. Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Purpose: Gaining insight into medical student inter-professional experiences in emergency medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. Methods: We used a grounded theory approach to perform a content analysis of student reflective narratives about inter-professional experiences during an EM clerkship. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within entrustable professional activity(EPA) 9:collaborate as a member of an inter-professional team as a possible assessment framework, experiences were coded for themes and categories focusing on the learning a description of the inter- professional experience, number of health care professionals involved, and the learning impact for students. Methods of analysis included counting comments within themes and Kirkpatrick outcome categories as well as identifying exemplar quotes to illustrate major themes. Results: Four major themes related to inter-professional experiences in emergency departments were identified in the analysis: 1) an understanding the roles, responsibilities, and expertise of team members, 2) an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, 3) a recognition of the importance of encouraging ideas and opinions from other health care team members, and 4) an awareness that teamwork achieves improved patient outcomes through a coordination of individual efforts within a team. Learners describe individual reaction’s (66.8%) and modifications of attitudes or perceptions (65.3%) most commonly, but acquisition of knowledge or skills (20.5%) and behavioral change (12.3%) are also described. Nurses (59%), pharmacists (35.4%), emergency medicine technicians(EMT) (36.7%) and emergency medicine service(EMS) providers (33.3%) are the most commonly reported health care professionals in narratives. Conclusions: Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter-professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO

2 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, Introduction The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO

3 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. METHOD At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Methods of analysis included counting comments within themes and Kirkpatrick outcome categories as well as identifying exemplar quotes to illustrate major themes. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325

4 Abstract References Methods Introduction Results Conclusions Figures/Graphs The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. Table: Kirkpatrick’s Expanded Outcomes Typology Levels LevelQualitative Trigger in Student Reflection 0 Just Describing “I witnessed this,..” 1 Comment and Reaction “I was surprised,..” 2aLesson Learned “I will take away,..” 2b Acquire knowledge linked to a skill “I do this” 3 Behavior change “Based on this, I will act differently,..” 4a Change in organizational practice 4bDemonstrable improvements in health of patients, families, or communities. Figure. Categories of Kirkpatrick’s Expanded Outcomes Typology that 3 rd year medical students in EM demonstrated in the reflection on the IPE. No student demonstrated level 4a or 4b. Students may demonstrate more than one level and percentages therefore exceed 100%.

5 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325 Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. RESULTS Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, Results 2 of 4 3.A recognition of the importance of encouraging ideas and opinions from other health care team members, and; 4.An awareness that teamwork achieves improved patient outcomes through a coordination of individual efforts within a team. Results 3 of 4 Learners describe individual reaction’s (66.8%) and modifications of attitudes or perceptions (65.3%) most commonly, but acquisition of knowledge or skills (20.5%) and behavioral change (12.3%) are also described. Results 4 of 4 Nurses (59%), pharmacists (35.4%), emergency medicine technicians(EMT) (36.7%) and emergency medicine service(EMS) providers (33.3%) are the most commonly reported health care professionals in narratives.

6 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. At the end of a 2 week EM clerkship rotation, 3 rd year medical students complete a narrative reflection on a personal IPE experience from the rotation. We used a grounded theory approach to perform a content analysis of student reflective narratives. Using Kirkpatrick’s expanded outcomes typology as a conceptual framework and the competencies contained within EPA 9 as an assessment framework. Experiences were coded for themes and categories focusing on the description of the inter-professional experience (Table). Inter-professional Education (IPE) is a priority. We sought to evaluate 3 rd year medical students’ depth of reflection utilizing Kirkpatrick’s Expanded Outcomes Typology. In examining the students’ reflections, 4 major themes arose, including student comprehension of team members’ roles, appreciation of professionalism, a recognition of the importance of contributions from other team members, and an awareness of improved outcomes thru teamwork. Qualitative analysis can potentially be used to assess the depth and breadth of IPE in medical students. Results 1 of 4 (Figure) Four major IPE themes in reflections were identified: 1)Students reflect an understanding of roles, responsibilities, and expertise of team members, 2.Students have an appreciation of the establishment of a climate of mutual respect, trust, and integrity in successful inter-professional teams, The Association of American Medical Colleges has listed among it’s Entrusted Professional Activities: Collaborate as a Member of an Inter-Professional Team (EPA 9). 1 To date, most IPE evaluations of medical students are based on self-reports by the student (example, Ericson, et al 2 ). Qualitative insight into medical student IPE in Emergency Medicine(EM) settings is crucial for the assessment of inter-professional competencies in medical education. Conclusions Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences. 1.Flynn, T, et al. Core Entrustable Professional Activities for Entering Residency. AAMC 2014 : www.mededportal.org/icollaborative/resource/887 2.Ericson A, Masiello I, Bolinder G. Interprofessional clinical training for undergraduate students in an emergency department setting. Journal of Interprofessional Care, 2012, 26: 319–325 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO

7 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO Results 4 of 4 Nurses (59%), pharmacists (35.4%), emergency medicine technicians(EMT) (36.7%) and emergency medicine service(EMS) providers (33.3%) are the most commonly reported health care professionals in narratives. Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences.

8 Abstract References Methods Introduction Results Conclusions Figures/Graphs Click headings to further view content Results 3 of 4 Learners describe individual reaction’s (66.8%) and modifications of attitudes or perceptions (65.3%) most commonly, but acquisition of knowledge or skills (20.5%) and behavioral change (12.3%) are also described. UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Department of Emergency Medicine ANSCHUTZ MEDICAL CAMPUS SCHOOL OF MEDICINE Department of Pediatrics ANSCHUTZ MEDICAL CAMPUS UNIVERSITY OF COLORADO Qualitative Analysis of Medical Student Reflections of Inter-professional Experiences During Their Emergency Medicine Clerkship Todd Guth, MD, 1 Michael C. Overbeck, MD, 1 Travis Smith, MD 2* and Kelley Roswell, MD 3 1 University of Colorado School of Medicine Department of Emergency Medicine, and 3 Department of Pediatrics, and 2 The Denver Health Residency in Emergency Medicine *Presenter Qualitative analysis of student reflective narratives about inter-professional experiences during an EM clerkship can be used to understand the range of inter- professional experiences occurring within emergency departments and can potentially be used to assess what students learn from these experiences.


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