Interprofessional Education Programme for Nursing and Physiotherapy Students Providing Home-Based Care to Older Adults

Hong Kong Metropolitan University150 enrolled

Overview

The goal of this mixed-methods research is to investigate the impact of interprofessional education on the professional development and clinical skills of nursing and physiotherapy students who provide home-based care to older adults in Hong Kong. The main questions it aims to answer are: 1. Is an interprofessional home-based digital frailty management program feasible for training nursing and physiotherapy students ? 2. Can the training enhance students' skills in providing holistic, home-based care, interprofessional teamwork and communication? 3. Can the training improve elderly health awareness, behavior, and outcomes? The study will involve 50 students from Hong Kong Metropolitan University, including nursing and physiotherapy students in clinical placement courses. Approximately 100 older adults with mild health conditions, living in home-based community settings, will take part as care recipients. Students will: 1. Attend a training programme delivered by healthcare professionals, including nurses, physiotherapists, and social workers. 2. Carry out supervised home visits in pairs, working directly with older adults to assess their needs, provide health education, and support healthy lifestyle changes. 3. Use a tablet-based digital platform to record care plans, share information, and follow up with participants.

Background: The global ageing population has created a growing demand for healthcare services, particularly for older adults with chronic conditions and complex care needs. In Hong Kong, home-based community care services are delivered through government-NGO partnerships, allowing older adults to stay within their communities while enhancing their quality of life. Interprofessional education (IPE), which involves collaborative learning among students from different health and social care professions, is a proven approach to fostering teamwork, effective communication, and patient-centred care. However, IPE programmes in Hong Kong are often classroom-based, with limited opportunities for real-world application in community care settings. Objectives: The project aims to assess the feasibility of an interprofessional home-based digital frailty management program that integrates professional education and community services, enhancing students' skills in providing holistic, home-based care, interprofessional teamwork and communication, and improving elderly health awareness, behavior, and outcomes. Methods: With strong academic-community partnerships, 50 nursing and physiotherapy students will enrol in a 3-month clinical placement programme. Prior to the clinical placement, students will participate in a two-session training workshop, conducted by a multidisciplinary team including nurses, physiotherapists, and social workers. During the placement, students will conduct supervised home visits to approximately 60 families, involving around 100 older adults with mild impairments, focusing on the elderly's frailty, including brief health, frailty, and home safety assessments and education on medication adherence, healthy living habits, and the use of "HA Go" and instant messaging. Students will use a digital case management and handover platform to enter all elderly information, issues, management plans, and actions for handover and follow-up. For each visit, at least one of the team members will accompany students to conduct the visit. After the first home visit, Students will also deliver booster e-health mobile messages (twice a week for a month). One month after the first home visit, the second home visit to these elderly will be conducted by students to assess their health-related behaviour changes and improvement in home safety. Four levels of evalauation framework will be used to assess students' satisfaction with the program (reaction), changes in perceived skills and knowledge, or attitudes after program completion (competency), and the extent to which changes in professional behaviour in actual clinical work (clinical practice), changes in elderly's health-related behaviour (health care outcomes). The first three levels will be conducted for students through questionnaire surveys and qualitative interviews at three time points: prior to the training (T1), immediately after the completion of clinical placement (T2), and three months post-training (T3). The fourth level will be conducted for the elderly at the first home visit and one month after the first home visit. Findings will be disseminated through academic publications and conference presentations. Expected Impacts: This programme will integrate student learning with community service, benefiting students, communities, academia, and policy. For students, it will enhance students' skills in interprofessional collaboration, communication, and holistic, person-centered care while building confidence through hands-on experience with digital case management platforms. The digital case management handover platform provides hands-on practice in case handover, management, action planning, and follow-up for elderly care, with potential applications in other programs or courses. For communities, it will promote healthier aging by improving health awareness, enabling early detection of concerns, and enhancing care services through regular student and teacher interactions. In academia and policy, it will provide evidence to guide educational approaches, support the adoption of digital tools, and promotes innovative healthcare education.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Students Inclusion criteria: * Aged 18 years or above. * Nursing students: Year 3 Higher Diploma in Nursing students at HKMU enrolled in NURS N222C Clinical Practicum. OR Physiotherapy students: Year 3 and Year 4 Bachelor of Science (Hons) in Physiotherapy students at HKMU enrolled in PHSI N212F Clinical Practicum II. * Able to read Chinese and English, and speak Cantonese. * Willing to participate in the training workshop and conduct home-based intervention. Older Adults Inclusion criteria: * Aged 60 years or above. * Service users of AKA. * Mild impairments (non-bedbound, physically capable of participating in simple exercises). * Able to read Chinese and/communicate in Cantonese. * Willing to participate in health surveys, home visits, and follow-ups, and to receive and respond to text messages. * Must own a smartphone and know how to use it. Students Exclusion criteria: * Unwilling to provide consent. * Cannot read Chinese or speak Cantonese. Older adults Exclusion criteria: * Not a registered service user from AKA. * Unwilling to provide consent. * Cannot read Chinese or speak Cantonese. * Unwilling to participate in the interventions conducted by students. * Severe communication impairments. * Do not own a smartphone.

Outcomes

Primary Outcomes

Changes in students' satisfaction and self-confidence in learning

This outcome will assess students' satisfaction with the program and their self-confidence in mastering the learned knowledge and skills. The 10-item Modified Student Satisfaction and Self-Confidence in Learning Scale includes two subscales: satisfaction with the program (items 1-5) and self-confidence in learning (items 6-10). Each item is rated on a 5-point Likert scale from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). Subscale scores are summed, with higher scores indicating greater satisfaction or confidence.

Time frame: Immediately after the training workshop; immediately after the follow-up home visit (4-week); three months after the training workshop

Secondary Outcomes

Changes in students' clinical practice in team and patient interaction

This outcome assesses changes in students' clinical practice during interprofessional education placements, focusing on interactions with both team members and patients. The 8-item Clinical Practice on Team and Patient Interaction Scale includes two subscales: Team Interaction (items 1-4) evaluates collaboration, communication, role understanding, and decision-making; Patient Interaction (items 5-8) assesses rapport-building, cultural sensitivity, health education, and professionalism. Each item is rated on a 5-point Likert scale from 1 ("Strongly Disagree" or "Not at all effective") to 5 ("Strongly Agree" or "Extremely effective"). Scores are summed, with higher scores indicating more effective clinical interactions.

Time frame: Prior to the training workshop; immediately after the follow-up home visit (4-week); three months after the training workshop

Changes in students' perceptions of interprofessional clinical education and collaborative practice

This outcome evaluates students' perceptions of interprofessional teamwork, roles and responsibilities, and patient outcomes following participation in the interprofessional education program. The 10-item Perceptions of Interprofessional Clinical Education (Revised) survey is used, with items divided into three domains: teamwork, roles/responsibilities, and patient outcomes. Each item is rated on a 5-point Likert scale from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). Higher total and subscale scores indicate more positive perceptions of interprofessional learning and collaborative practice.

Time frame: Immediately after the training workshop; immediately after the follow-up home visit (4-week); three months after the training workshop

Students' perceived usefulness and ease of use of the digital handover platform

This outcome assesses students' acceptance of the digital case management handover platform using the 12-item Technology Acceptance Model (Version 4). The instrument includes two subscales: Perceived Usefulness (items 1-6) evaluates how the platform supports productivity, job performance, and effectiveness, while Ease of Use (items 7-12) measures usability, clarity, control, and flexibility. Items are rated on a 7-point Likert scale from 1 ("Extremely Disagree") to 7 ("Extremely Agree"). Higher total and subscale scores indicate more favorable perceptions of the platform's usability and usefulness.

Time frame: Immediately after the follow-up home visit (4-week)

Changes in anxiety and depression symptoms among older adults

This outcome evaluates changes in older adults' mental health by measuring symptoms of anxiety and depression using the 4-item Patient Health Questionnaire-4 (PHQ-4). The tool includes two items for anxiety and two for depression. Each item is rated on a 4-point scale from 0 ("Not at all") to 3 ("Nearly every day"), producing a total score ranging from 0 to 12. Scores are interpreted as follows: normal (0-2), mild (3-5), moderate (6-8), and severe (9-12). Higher scores indicate greater psychological distress.