Attitudes of Health Professionals toward Interprofessional Healthcare Teams in Mongolia

Patient have complex health needs and typically require more than one discipline to address issues...


Introduction
Many countries use the term "interprofessional education" and address collaboration and the patient perspective, such as the Australian Health Department which defines interprofessional education (IPE) as: "A collaborative, interdisciplinary education and learning process designed to produce effective, multidisciplinary patient-centered care". One definition that seems clearer, more manageable and closer to the focus of our project is the Centre for the Advancement of Interprofessional Education (CAIPE) definition: "Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care" [1]. Implementing IPE often relied on goodwill between teachers of different professions, between university and practice, and between facilitators and students [2]. Within the theoretical perspective of activity theory, it can be argued that the most troublesome challenges in relation to implementing IPL could be embraced as contradictions that may lead to change [3]. Patients have complex health needs and typically require more than one discipline to address issues regarding their health status (Lumague et al.) [4]. The World Health Organization (WHO) recommends that institutions engaged in health professional education and training consider implementing interprofessional education (IPE) in both undergraduate and postgraduate programs (WHO, 2013) [5]. The purpose of this study was to investigate the attitudes of faculties at MNUMS toward IPE.

Study Design and Participants
A descriptive, cross-sectional design was used to survey participants from a convenience sample of faculty at the Mongolian National University of Medical Sciences (MNUMS) located within a large university system in the Mongolia. The colleges represented were medicine, dentistry, nursing, pharmacy, public health, biomedicine and traditional medicine. An email was distributed to all MNUMS faculties inviting potential participants to complete an online survey. The survey instrument contained four scales to evaluate faculty attitudes toward IPE and teamwork adapted from the methods of Curran et al. [6]. Each scale asked respondents to rate their attitudes towards statements on a 5-point Likert scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree). First, fourteen items were in field of attitudes towards interprofessional health care teams scale gauged how faculty feel about interprofessional health care teams, such as participation of three or more professions in collaborative patient care. Secondly, fifteen items in attitudes towards IPE to students' development as health care professionals, specifically in relation to shared learning activities involving students from more than one health care professional program were included.

Statistical Analysis
The data were analyzed using Statistical Package for the Social Sciences (SPSS), version 23.0J. Assumptions for parametric testing were met for multiple regression; a priori α level was set at 0.05.
The predictor variables for each analysis included school affiliation (medicine, biomedicine, nursing, dentistry, pharmacy, public health, traditional medicine). Outcome variables were interprofessional learning in the health care setting, IPE and interprofessional health care teams. The scale was subject to exploratory factor analysis to examine the underlying constructs of the survey. The suitability of the correlation matrix was determined by the Kaiser-Meyer-Olkin estimate of sampling adequacy and Bartlett's Test of Sphericity. The number of factors retained for the initial solutions and entered the rotations were determined with application of Kaiser's criterion (eigenvalues>1). The initial factor extractions were performed by means of principal components analysis. To define the structure clearer, an exploratory factor analysis using varimax rotation was conducted. The level of significance was p<.0001 for all tests [7][8][9][10].

Results
The survey was completed by 10.8% of the faculty members from medicine, 18.9% of the faculty of nursing, 14.3% biomedical, 10.3% pharmacy, 8.1% public health, 5.4% traditional medicine (5.4%), and 16.2% of the faculty of dentistry. The survey was completed by 16.2% of faculty of the Darkhan's medical school was 2451.053 (p<0.0001). Cronbach's alpha of the 13 items was 0.918, revialing a high rate of internal consistency.

Conclusion:
In conclusion, international research study's result showed for important of IPE. In contrast to Mongolia our, the inclusion of interprofessional, health care professionals-led IPE programs should be developed through identified proponents of IPE initiatives. Results suggest that health care professionals in Mongolia could learn, at least in part, about CP through on-site practical training. IPE programs may be useful in learning about team efficiency in addition to strengthening attitudes toward the value of IPE to health care providers and receivers among undergraduate students.
The modified ATHCTS questionnaire was categorized into the two factors "Quality of care" and "Team efficiency" (Table 2).   (Table 4).

Discussion
The present results showed that the overall mean modified attitude toward IPT and attitude toward IPE score of faculties was significantly higher of faculties at MNUMS. Factor analysis revealed two factors in the modified ATHCTS used here. The factor mean score for 'Quality of care "of faculties was significantly higher than that mean score for "Team efficiency" and the modified 15 item questionnaire was categorized into the two factors mean score for "Expertise" and "Competency" of faculties was significantly higher. The factor mean score for "Faculty should be rewarded for participation in interprofessional courses", and "Accreditation requirements limit interprofessional efforts" of faculties was significantly positive attitudes, while there was no significant difference (1.2) [11][12][13][14].

Concluding Comments
In