This article reports a reflection-on-practice and describes how an interprofessional education (IPE) initiative involving dental, oral health, and medical laboratory science students was designed and implemented. This initiative originated to address the need to provide IPE to undergraduate students preparing for professions in dentistry and the medical laboratory sciences at the University of Otago in Dunedin, New Zealand. Ethical approval was not sought from the Human Ethics Committee at the University of Otago for this descriptive report. A research study is planned to evaluate the next phase of this initiative. This report addresses a gap in the health professional education literature about the teaching and learning of medical laboratory sciences for clinical practice.

An increasingly important aspect of healthcare involves collaboration of interprofessional teams to provide patient care. To help develop a collaborative workforce, healthcare educators established interprofessional education (IPE) an effective method of building a team approach to healthcare (Davis et al., 1995). The term IPE is commonly used to refer to opportunities where two or more professions learn together to develop knowledge, skills, and attitudes for collaborative practice and with the goal of improving patient care. IPE activities tend to involve practitioners in fields such as medicine, physiotherapy, pharmacy, nursing and occupational therapy to a greater extent than dentistry and medical laboratory science; and this situation is also true for undergraduate IPE activities (Brown and Miller, 2016). Consequently, there is a need to report IPE activities involving undergraduate students preparing for professions in dentistry and the medical laboratory sciences.

One factor related to the success of IPE activity can be the selection of a topic that presents authentic opportunities for healthcare professionals to interact as they provide patient care. When students from multiple professions are exposed to complex situations of patient care, it allows them to establish connections with other professions and enhance the understanding of the roles and responsibilities of individuals within interprofessional teams (Thompson et al., 2016). Dentists and oral health therapists are often the first point of contact when orofacial pathology is suspected. Having knowledge of oral pathology, dental clinicians can become involved in diagnosing pathology such as the precursor lesions of oral carcinoma (Subramanyam, 2014). Oral health therapists may refer patients to dentists, who may undertake procedures such as a biopsy, or may order diagnostic tests which would be processed by medical laboratory scientists. Medical laboratory scientists tend to work behind the scenes, this IPE activity was intended to reinforce the critical nature of their role within the healthcare team (Dolce, Parker and Werrlein, 2012). Additionally, students in medical laboratory science programmes will gain valuable experience dealing with multiple patients, phone calls, and difficulties in interprofessional communication (Brown and Miller, 2016). Therefore, the topic of orofacial pathology was selected for the focus of a pilot IPE initiative.

The designers of this initiative were all but the third author of this article. The initiative was specifically designed for students in their second year of the Bachelor of Oral Health, third year of the Bachelor of Medical Laboratory Science and fourth year of the Bachelor of Dental Surgery programmes at the University of Otago. To emphasize interprofessional competencies (Canadian Interprofessional Health Collaborative, 2010), the initiative was designed so students would use their current knowledge rather than learn new scientific facts. The dental and oral health students already had experienced the provision of patient-centred care. Both groups of students had knowledge of orofacial pathology from previous coursework. For medical laboratory science students, the initiative provided a preview of potential clinical interactions before they began their 30-week clinical placement. Therefore, the overarching learning goal for the orofacial pathology IPE initiative was for students to discuss patient-centred care related to their knowledge to diagnose, investigate oral diseases and their implications to the oral environment in a collaborative, respectful, and responsible way.

The initiative used a case-study approach. Three cases were written collaboratively by academics from dentistry, including a specialist oral pathologist, oral health and medical laboratory science. The cases were based on their experiences with patients in their clinical practice and included presentations of oral manifestations of acute leukaemia, drug-associated gingival bleeding, and an ulcer subsequently diagnosed as oral cancer. Each case included patient details such as age, current concerns, general/physical appraisal, social, medical and dental history, tobacco smoking history, and clinical findings from a recent dental visit. In addition to clinical notes, each case included at least one clinical photo, histological image, and/or laboratory results from recent blood tests. (See Appendix 1 for details of Cases 1, 2, and 3).

The initiative was conducted over four weeks. It was supported by three one-hour interactive sessions at weeks 1, 3 and 4. The initiative had three facilitators, one from each participating programme. The first six students from each programme to respond to an invitation to participate were included in the project. Participating students were organised into groups of six with two students from each programme. Students were encouraged to communicate and collaborate between sessions. To avoid timetable clashes, meetings were held between scheduled classes with lunch provided. The student workload was approximately ten hours.

In the first session, facilitators gave a brief overview of IPE and the learning objectives of the project. Students introduced themselves to one another and discussed their professional roles in their groups. Students were encouraged to discuss the role and responsibility of each profession included referral pathways to foster holistic, patient-centred care. In the second session, students worked in their groups with facilitator support to develop a holistic care plan for their patient case. The third session was held in a small lecture theatre with an audience of interested students and staff. Each group presented a treatment plan that included a description of each profession’s roles in the process of managing their oral pathology case. After the third session, students were issued an electronic certificate acknowledging their participation and effort in the initiative.

In addition to reviewing the teaching and learning resources and logistical arrangements required for this initiative, the designers of the initiative constructed a student questionnaire to collect information to evaluate the feasibility of incorporating the initiative permanently into the undergraduate dental, oral health, and medical laboratory science programmes. Items in the questionnaire reflected six interprofessional competencies. Five competency domains were from the National Interprofessional Competency Framework (Canadian Interprofessional Health Collaborative, 2010). The sixth competency was ‘cultural practice’ to reflect the importance of demonstrating culturally appropriate professional behaviours in the New Zealand context (New Zealand Ministry of Health, 2003). The resulting questionnaire asked students to rate nine statements using a five-point Likert-type scale (‘agree to a very small extent’ = 1 and ‘agree to a very large extent’ = 5) and to provide written comments about the initiative (See Table 1).

As part of regular teaching practice at the University of Otago, evaluation information was collected electronically, voluntarily with informed consent, and anonymously from students after the third interactive session. Evaluations were managed by the University’s Quality Advancement Unit. The designers of the initiative reviewed and summarised evaluation information.

In general, the designers felt that they had successfully designed and implemented an IPE initiative involving dental, oral health, and medical laboratory science students. The designers considered that the teaching and learning resources were fit for purpose and that the logistical arrangements were acceptable for a small scale pilot involving 3 facilitators and 18 students. The designers noted that students rated items corresponding to five of the six interprofessional competencies highly. Students’ written comments were interpreted to suggest that the initiative addressed the competencies of patient-centred care, role clarification, team functioning, collaborative leadership, and communication effectively. Of concern to the designers was the moderate agreement from students that the initiative addressed the cultural practice competency and that there were no written comments provided by students about this aspect of the initiative.

Given the successful design and implementation of this orofacial pathology IPE initiative, the designers are planning to expand and research this initiative in the future. The evaluation information interpreted by the designers to suggest that when students from three health professional programmes interacted with one another to manage a case in orofacial pathology, they appreciated learning with, from, and about each other. This finding is consonant with evaluation results reported previously, where 80% of students from different health professional programmes agreed that a course in interprofessional learning would have an effect on their future relationships with other professional groups (Tsakitzidis et al., 2015). A notable design issue to be addressed is the cultural practice competency. Given the importance of developing culturally appropriate professional behaviours in New Zealand (New Zealand Ministry of Health, 2003) this feature will be enhanced before the initiative is repeated in the future.

When considering the usefulness of applying ideas from this reflection-on-practice for use elsewhere, it is important to note that only a small number of facilitators and students were involved in piloting this initiative. Additionally, the rating scale used to collect evaluation data was biased because it only allowed positive ratings. The open-ended nature of written comments may have provided students with opportunity to make negative statements about the initiative, however, none chose to do so. Despite these limitations, educators in health professional programmes involving dentistry, oral health, and medical laboratory science may find the features of this initiative useful for initiating discussions with colleagues in their institutions.

Given the acceptability of this initiative with facilitators and students, the next step is to consider the feasibility of scaling-up this small voluntary project into a permanent component of the dentistry, oral health, and medical laboratory science programmes. Considerations will include staffing, scheduling, assessment, and attention to cultural perspectives.