Interprofessional education focused on medication safety: a systematic review

Safe medication use necessitates interprofessional working, with calls to enhance interprofessional education (IPE) focusing on medication safety (MS) in healthcare professional (HCP) curricula. Little is known about the design, delivery or evaluation of such activities. This systematic literature review describes MS-focused IPE activities in pre-qualification HCP programmes. MedLine, EMBASE, CINAHL and ERIC were searched, relevant studies identified and data extracted. The McGill Mixed Methods Appraisal Tool was employed. The 3P (presage-process-product) theory structured deductive analysis. Thirty-one studies were included, reporting on 30 activities, mostly undertaken in North America or United Kingdom. Presage/Design: Most reported activities involved pharmacy, nursing, medical or physician assistant students learning with one or more other HCP group. Few studies matched student groups’ skills or experiences. Few studies reported theoretical underpinnings. Process/Delivery: Multiple pedagogical approaches were employed, mostly social construction, and low- and high-fidelity simulation-based learning. Few studies reported learning outcomes or summative assessment, more reported formative assessment. Product/evaluation: Outcomes measured were learners’ opinions, satisfaction or attitudes toward interprofessional working and findings were generally positive. Few studies reported on student development or outcomes specific to medication safety. Lack of integration of qualitative/quantitative components of mixed methods studies and limited outcome measurements' validity or reliability weakened study quality. MS-focused IPE for pre-qualification HCPs is well received by students. Design of future activities could be enhanced by employing theory and ensuring matching of students’ and groups’ skills, professional identity and learner attributes to enhance learning in an interprofessional setting. Future delivery should embed MS-focused IPE into the standard curricula to optimize constructive alignment, learner engagement, quality and drive development. The required skillset in pre-qualification HCP programmes to facilitate future safe medication practice, together with the associated learning outcomes and assessment approaches, should be defined. The quality of scholarly studies examining these activities needs improvement.

安全用药有赖于跨专业协作，学界呼吁在医疗保健专业人员（healthcare professional, HCP）的课程体系中强化聚焦用药安全（medication safety, MS）的跨专业教育（interprofessional education, IPE）。目前针对此类教育活动的设计、实施与评估的相关研究仍较为匮乏。本系统综述旨在梳理针对预执业阶段HCP的、聚焦用药安全的跨专业教育活动。研究检索了MedLine、EMBASE、CINAHL及ERIC数据库，筛选出相关研究并提取数据，采用麦吉尔混合方法评价工具（McGill Mixed Methods Appraisal Tool）进行质量评估，并以3P（预测-过程-产出，presage-process-product）理论框架开展演绎式分析。最终纳入31项研究，共涉及30项教育活动，其中绝大多数开展于北美或英国。【预测-设计环节】多数报道的活动由药学、护理、临床医学或医师助理专业的学生与至少一类其他医疗保健专业群体共同开展学习；仅少数研究匹配了不同学生群体的技能水平与实践经验，且鲜有研究提及活动的理论基础。【实施-过程环节】研究采用了多种教学方法，其中以社会建构主义教学法、低/高仿真模拟教学最为常见；仅少数研究提及学习成果或终结性评估，更多报道了形成性评估的实施情况。【产出-评估环节】研究所测量的结局多为学习者对跨专业协作的看法、满意度或态度，整体结果均呈积极倾向；仅少数研究报道了学生的能力发展或针对用药安全的特定学习成果。混合方法研究中质性与量化成分整合不足，且结局测量的效度与信度受限，均削弱了研究的整体质量。针对预执业阶段HCP的聚焦用药安全的跨专业教育活动深受学生认可。未来的活动设计可通过引入理论框架，并确保不同学生群体的技能、专业身份与学习者特征相匹配，以优化跨专业场景下的学习效果。在实施层面，应将聚焦用药安全的跨专业教育纳入标准课程体系，以优化建构性对齐、提升学习者参与度与研究质量，并推动相关能力发展。应明确预执业阶段HCP课程中为支撑未来安全用药实践所需的技能体系，以及与之配套的学习成果与评估方法。当前针对此类教育活动的学术研究质量仍有待提升。