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CanMEDS Collaborator Role

CanMEDS Collaborator Role. Effective Patient Centred Care Through Teaching Collaborator Competencies. Ivy Oandasan MD CCFP MHSc FCFP Director, Office of Interprofessional Education

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CanMEDS Collaborator Role

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  1. CanMEDS Collaborator Role Effective Patient Centred Care Through Teaching Collaborator Competencies Ivy Oandasan MD CCFP MHSc FCFP Director, Office of Interprofessional Education Jodi Shapiro MD, MHSc, FRCSC Assistant Professor University of Toronto

  2. CanMEDS Collaborator role By the end of the workshop participants will be able to: • Identify key competencies related to the CanMEDS collaborator role. • Be sensitized to “teachable moments” for interprofessional patient centred care. • Become familiar with educational methods and assessments for teaching the collaborator role. • Recognize the need for faculty development to teach this role.

  3. Evolving concepts… 2000: • Consulteffectively with other physicians and health care professionals. • Contributeeffectively to otherinterdisciplinaryteam activities. 2005: • As Collaborators, physicians effectivelywork withina healthcare teamto achieveoptimal patient care

  4. Context We all work within Multiprofessional health care environments: • Different Health Professionals • Patient-Centred • Patients have a trajectory of care

  5. Impetus to Teach • Collaborative Practice improves Patient Outcomes in specific populations studied to date. • Geriatrics, ER care for abused women, STD screening, Adult immunization, fractured hips & neonatal ICU care (Zwarenstein et al, JIC Supplement 2005) • Collaborative Practice can Improve Cost Efficiency • D’Amour et al, JIPC 2005 Supplement • Collaborative Practice Improves Patient Safety • US Joint Commission on Accreditation of Health Care Organizations • Improved Health Professional Satisfaction • Cohen & Bailey (1997)

  6. Enhanced Patient Care Outcomes (Zwarenstein et al. JIPC Supplement1 2005) Improved Patient Safety (US Joint Commission on Accreditation of Health Care Organizations) Cost Efficiency (D’Amour et al, JIPC Supplement 1 2005) Improved Health Professional Satisfaction (Cohen & Bailey (1997)) Impetus to Teach

  7. Impetus To teach… • Accreditation 2007: Goals and objectivesmust be structured to reflect CanMEDS. • Ministry of Health HHR Division in Ontario prioritizing interprofessional education within our educational programs across faculties. • Federal Ministry – Health Canada – grounding initiatives in HHR with IPE as a key foundational piece

  8. Collaboration is NOTabout SUBSTITUTION

  9. COLLABORATION IS ABOUT Working together -Context Specific- Task Dependent

  10. Collaboration is the most common descriptor of teamwork in healthcare

  11. Health Professionals may work in defined TEAMS… but that does not necessarily mean that they are engaging in TEAMWORK!

  12. Is Teamwork the Same as Collaboration??

  13. What is a Team? A collection of individuals who are interdependent in their tasks, who share responsibility for outcomes, who see themselves and who are seen by othersas an intact social entity embedded in one or more larger social systems and who manage their relationships across organizational borders. Cohen & Bailey (1997) Journal of Management 23(4) 238-290

  14. Moreover…in healthcare due to the fluidity of membership of teams AND because of the lack of co-location of health professionals in many settings… defining the“TEAM” and hence WITH WHOM to engage TEAMWORK is challenging

  15. Collaboration is a PROCESS that requires relationships & interactions between health professionals regardless if they perceive themselves as part of a team Oandasan, Lemieux-Charles, Baker, D’Amour, Nasmith, Way, Jones, Tepper, Barker, Bosco (in print) CHSRF June 2006

  16. THE FLUIDITY OF COLLABORATION Oandasan, Lemieux-Charles, Baker, D’Amour, Nasmith, Way, Jones, Tepper, Barker, Bosco (in print) CHSRF June 2006

  17. 7 Essential Elements for Collaboration(Way & Jones 2001) Power & Hierarchy Conflict Resolution

  18. 7 Essential Elements for Collaboration (Way & Jones 2001) (Way & Jones 2000)

  19. Shifting towards a Patient-Centred Approach to Care

  20. Who Defines the Team? Patient trajectory Collaborative Patient-Centred Care

  21. Enhancing how health professionals work together

  22. Collaborative Practice Health Care Assessment Integrated Care Plan Shared care plan Individual Professionals Person With Health Issue

  23. Key Competencies - Collaborator • Participate effectively & appropriately in an interprofessional healthcare team • Effectively work with other health professionals to prevent, negotiate and resolve interprofessional conflict

  24. KNOWLEDGE *roles of other health professionals SKILLS *communication *reflection ATTITUDES *mutual respect *willingness to collaborate *openness to trust Health Canada’s Collaborator competencies (IECPCP initiative) Conflict resolution Evolving Oandasan & Reeves JIC 2005

  25. Developed by Keegan Barker MEd Lynne Sinclair, Director of Education Toronto Rehabilitation Institute In conjunction with the Standardized Patient Program University of Toronto Video DemonstrationInternal Medicine DVD Clip

  26. Vignette - What learning opportunities do you see? - What might you need to do to facilitate learning about the collaborator role to learners? - Who might assist you in teaching the Collaborator Role?

  27. Recognize the need for faculty development

  28. The role modeling of collaboration cannot be an act – it must be lived… it must be seen

  29. THE IPE TRIAD – A Parallel Process FACULTY STUDENTS FACULTY DEVELOPMENT PLANNERS (FACILITATORS) Ivan Silver, 2005

  30. Planning Framework • What are the external/internal drivers influencing the development of your educational initiative? • Who are your potential partners and how will you convene them? • What is the overall goal and vision of this program at the interprofessional and profession-specific levels? ie. attitudes, skill development, team building.

  31. Curriculum Goals If goal is to teach collaborative practice ... Content must be on interdisciplinary knowledge, skills & attitudes. Do not confuse teaching medical content foci with the primary goals of collaborative practice. (Reeves & Freeth, 2002/ Johnston & Banks, 2000)

  32. Planning Framework • What are the opportunities within the current learning/practice context: -the patient population/patient issues -the practice site(s) or situations -the learners/providers to participate within educational initiatives -the timing (scheduling, length of teaching activity)

  33. Look for Current & New Opportunities to Incorporate Collaborator Competencies Undergraduate Postgraduate In Practice Role Integration Socialization Pre-Licensure Post-Licensure Early Yrs: Community health/prevention, ethics, communications, critical appraisal, and epidemiology (Curran, 2004) Middle/late Yrs: Shadowing & Immersion Later Yrs: Problem Based Small Group Learning, Simulations, Real patient care – developing integrated care plans

  34. Planning Framework • What are the specific objectives of this program? -essential elements of interprofessionalism -content/context specific • What methods and tools will you use to operationalize these objectives?

  35. 7 Essential Elements for Collaboration(Way & Jones 2001) Power & Hierarchy Conflict Resolution

  36. Planning Framework • What barriers/difficulties do you anticipate and how can you overcome them? • Who are the key players in designing this program? -how will you involve them? -what will be their roles and responsibilities? -how will you build group trust and cohesiveness? -how will you ensure good communication? -how will you resolve conflict? -how will you build reflection into the process?

  37. Planning Framework • How will you evaluate the program: -reactions/satisfaction -knowledge and skills -behaviours and attitudes -outcomes (impact) • How will you ensure the sustainability of this program? -funding -changing the culture

  38. CanMEDS Collaborator role • Examples of what to observe? The resident is able to: • Define the roles, responsibilities and limits of self and others. • Act effectively as a team leader, moderator, participant. • Demonstrate a respectful attitude and good interpersonal relationships with others. • Help others – (content versus process). • Delegate appropriately. • Share medical expertise knowledge. • Communicate effectively. • Prevent, resolve conflicts with others.

  39. Resource Individuals • Molyn Lescsz, Dept. of Psychiatry • Denyse Richardson, Dept. of Physiatry • Ivan Silver, Associate Dean CE • Jodi Shapiro, Dept of Obs & Gyne • Lynne Sinclair, TRI • Anja Robb, Director Standardized Pt Prg • Scott Reeves, Scientist, WCRE

  40. Office of Interprofessional Educationopening June 1st 20063rd Floor MedWest Bldg750 Dundas St. WestUniversity Health Networkwww.ipe.utoronto.cai.oandasan@utoronto.ca

  41. References: Journal of interprofessional care, Supplement. May 2005 Special Issue: Interprofessional Education for Collaboration Patient-Centred Care Canada as a Case Study. Compiled by Ivy Oandasan and Keegan Barker. Edited by: Marilyn Hammick

  42. Thanks for Coming! i.oandasan@utoronto.ca jshapiro@mtsinai.on.ca

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