Resultados de la evaluación inicial de la comunicación oral

A total of 25 individuals participated in interviews including 10 volunteer faculty clinicians and 15 students. Table 15 provides information on the participants. To protect anonymity, labels (e.g. FC1) have been used to replace all participant names and only brief information (gender and profession) is provided for individual participants. All other data will be shared as group information.

4.1.1. Faculty clinicians

The 10 faculty clinicians included 3 nurses, 2 physicians, 2 physician assistants (PA), a pharmacist, a physical therapist (PT), and a social worker. They represent one-third of the total faculty supporting the clinic and included five faculty clinicians who had been with the clinic from its inception and five who had joined after the first year when the clinic was established. The nursing faculty clinicians and students were recent additions as nursing was only added to the clinic that year. They were affiliated with a second university that had established a formal partnership with the SRC's host university. Social work was also a more recent addition and the social worker was recruited to participate by one of the nursing faculty clinicians. Social work is not a programme offered by the university that houses the SRC.

Five faculty clinicians including two physicians, a physical therapist, pharmacist, and one of the physician assistants, had been with the clinic from the beginning. This group provided valuable institutional memory regarding how the clinic was designed. The more recent faculty clinicians provided useful insight into how the clinic integrated two new professions.

Faculty Clinicians (FC) Student Leaders (SL) Student Volunteers (SV) FC1 Female Physician Assistant SL1 Female Medicine SV1 Female Physical Therapy FC2 Female Nurse SL2 Female Physical Therapy SV2 Female Physical Therapy FC3 Female Nurse SL3 Female Medicine SV3 Male Physical Therapy FC4 Female Nurse SL4 Male Podiatry SV4 Female Physician Assistant FC5 Female Physical Therapist SL5 Male Pharmacy SV5 Female Medicine FC6 Female Physician SL6 Female Psychology FC7 Male Physician Assistant SL7 Female Physical Therapy FC8 Female Social Worker SL8 Male Physical Therapy FC9 Male Pharmacist SL9 Female Physical Therapy FC10 Female Physician SL10 Female Medicine

Table 15: Study participants

4.1.2. Students

Of the student participants, 5 had served solely as clinic volunteers, and 10 had volunteered and served in student leadership positions. The student leaders included students from medicine (3), physical therapy (4), clinical psychology (1), podiatry (1), and pharmacy (1). All of these students had initially experienced the clinic as a volunteer and had then applied for a clinic leadership position. This group was relatively easy to recruit to the study and readily engaged in the discussion regarding the clinic.

The student volunteers represented physical therapy (3), physician assistant (1) and medicine (1). They were all in the first or second year of their programme. This was the most difficult group to recruit with those who participated describing some reticence in putting their names forward believing they had little to offer to the study as they had only volunteered in the clinic a few times, as exemplified on the following quotation from a student volunteer.

“ I wasn’t sure if I could be of help, I had only been in the clinic a couple of times, so I wasn’t sure if I would be able to help”. (Student Volunteer)

A disproportionate number of student volunteers were from physical therapy (3/5). Only one of the PT volunteer students had served on an IP primary care team with the other two

having worked in the physical therapy specialty clinic. The researcher's professional background as a PT may have been influential. Although they were careful to not explicitly identify themselves by their professional affiliation, in the call for participants,

communications via email and in the consent and information forms the researcher’s credentials were listed including the designation PT (State licensed physical therapist). Presenting such designation is required by the physical therapy practice act of the state in which the researcher is licensed.

4.2. Context

The following section describes the contextual setting for the interprofessional SRC including both the community and institutional settings.

4.2.1. Community setting

The clinic is located in the outer suburbs of a large metropolitan city in the Midwest region of the United States. The town in which it is situated has a population of around 35,000 and covers a geographical area of approximately 8,000 square miles. Historically, the town has had a large population of eastern European migrants, African Americans, and more recently Latinos, especially from Mexico. The US 2010 census showed a racial mix of 36.3%, white (Non-Hispanic) 29.92% Black or African American, and 26.8% Hispanic or Latino (11.29% White Hispanic, 15.9% Hispanic or Latino other race) (US Census Data 2010).

Both students and faculty described the local population as economically diverse. This economic diversity is supported by the US Census Data for 2010, which identified the county in which the clinic is situated as one of the 30 richest counties in the US. The same census reported the town in which the clinic is located as having 15.1% of the population with an annual income below the US poverty threshold of $11,770 for a single person under 65 and $24,250 for a family of four (US Census Data 2010).

Students and faculty identified health disparities as one of the main reasons for establishing the clinic and describe the local community setting as follows.

“We are kind of located right between, like, some pretty wealthy areas, and then some areas that have more financial challenges. So one of the reasons for the clinic is to address the growing health disparities in the area” (student leader).

“There was just a need in the area that our university is located in for people who do not have health insurance. And there is a very well economic area, with a pretty high health disparity population that is nearby. I mean like really wealthy on one side of the road and really poor on the other” (student leader).

“We are in such a wealthy area on the one hand, but we also have some very poor neighbours. They struggle to feed their families and don’t have access to

healthcare. We have a lot of working poor in the area who need the help the clinic offers” (faculty clinician).

4.2.2. Institutional setting

A private not-for-profit graduate health sciences university is the academic home of the SRC which operates out of the university health clinics. There is clear institutional support for interprofessional education, which is the focus of both the university mission and vision statements. The university's commitment is evidenced through the creation of an institute to support IPE, the appointment of IPE leadership roles throughout the organization, including within the provost's office, and by requiring all first-year students take a semester-long IPE class which is included in the core curriculum for all health professional programmes.