INTERPROFESSIONAL EDUCATION (IPE)

1. INTERPROFESSIONAL EDUCATION (IPE) Dr Vimmi Passi, Course Director, Masters in Medical Education Institute of Clinical Education, Warwick Medical School

2. LEARNING OUTCOMES • Description • Importance • Principles of IPE • WHO Framework for IPE • IPE in Practice • Designing Effective IPE • Challenges of IPE

3. CAIPEThe Centre for Advancement of Interprofessional Education DESCRIPTION IPE occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. Multiprofessional Interprofessional Uniprofessional

4. Ct • The education ensures that learning has taken place • Requires active learning as there is exchange of ideas, skills and knowledge • Aims at collaboration

5. Interprofessional Education

6. Multiprofessional Education • One or more students or professionals learn alongside one another. • The learning may be around acquisition of a clinical skill or knowledge, learners may occupy the same physical space and use the same learning materials.

7. Uni Professional Learning This is in which students learn together as a single group e.g. doctors, nurses, dentists, midwives etc and do not learn with or alongside other professional groups.

8. Collaboration An interprofessional process of communication and decision making that enables the separate and shared knowledge and skills of healthcare providers to synergistically influence the ways client/patient care and broader community health services are provided.

9. The Importance of IPE Thistlewaite J and Nisbet G. Interprofessional education Clinical Teacher : 2007 (4) : 67-72

10. CAIPESeven Principles of Interprofessional Education • Works to improve the quality of care • Focuses on the needs of service users and carers • Involves service uses and carers • Encourages professions to learn with, from and about each other • Respects the integrity and contribution of each profession • Enhances practice within professions • Increases professional satisfaction

11. Communities of Practice Teams can be seen as Communities of Practice • Group who work together to achieve a common goal • Trainees learn from each other • Junior medical staff • Nursing colleagues Lave J, Wenger E ( 2003) Situated Learning : Legitimate Peripheral Participation, Cambridge University Press.

12. Ct • Community health workers • Projects • politicians

13. ORGANIZATIONAL STRUCTURE

14. SCENARIO 1 • Mrs Z reports to the Labour ward in second stage of labour and progressed to delivery of a live full term baby with good apgar’s score. As you attempt to deliver the placenta, she starts bleeding profusely and the placenta appears to be stuck. Discuss the management • Consider the following • who are involved in the care (Active players) • What are the activities to be done • Who will do what (Sharing responsibilities) • Reflection

15. SCENARIO 2 • 15 year old mother is admitted in the postnatal ward following uneventful 1st, 2nd , 3rd and 4th stages of labour. She looks depressed and is mute. She is refusing to eat and her breast are tender to touch. • Consider the following • who are involved in the care (Active players) • What are the activities to be done • Who will do what (Sharing responsibilities) • Reflection

16. SCENARIO 3 • Mrs T has delivered a flat baby due to meconium aspiration. Apgar score at 1 minute is 2/10. Manage baby T • Consider the following • who are involved in the care (Active players) • What are the activities to be done • Who will do what (Sharing responsibilities) • Reflection

17. SCENARIO 4 • Mimi a 19 year old girl reports to the antenatal clinic with history of blurred vision and severe headache. Her blood pressure is 170/120. On admission she starts fitting. How would you manage Mimi • Consider the following • who are involved in the care (Active players) • What are the activities to be done • Who will do what (Sharing responsibilities) • Reflection

18. Rationale for IPE IMPORTANCE

19. Framework for Action on Interprofessional Education and Collaborative Practice : WHO : 2010 ‘ After almost 50 years of inquiry, there is now sufficient evidence to indicate the IPE enables effective collaborative practice which in turn optimizes health services, strengthens health systems and improves health outcomes.’

20. WHO : Collaborative Practice Can Improve • Access to and coordination of health services • Appropriate use of specialist clinical resources • Health outcomes for people with chronic diseases • Patient care and safety

21. WHO : Collaborative Practice Can Decrease: • Total patient complications • Length of hospital stay • Tension and conflict among caregivers • Staff turnover • Hospital admissions • Clinical error rates • Mortality rates

22. IPE in Practice Interprofessional Education in Practice

23. Interprofessional Education in Practice

24. Learning Outcomes for IPE • Teamwork • Roles/Responsibilities • Communication • Learning/Reflection • The Patient • Ethics/attitudes Thistlethwaite et al 2010 : Learning outcomes for IPE : Literature review and synthesis.

25. How to Design Effective IPE ?

26. Designing Effective IPE Key Principles • The perceived relevance of the learning opportunity • The perceived demands of the learning context • The relationship of current learning to prior learning • The learners’ self concepts

27. How to Design Effective IPE • Be aligned with anticipated participants’ current concerns, priorities, knowledge and expertise. • Respect participants’ self concepts as successful learners and members of particular professions • Restrict itself to a manageable level of diversity so that everyone can contribute and gain from IPE • Aim to challenge learners in a supportive way that guides and scaffolds their learning, adjusting the level of challenge as experience and confidence grows.

28. Management of Interprofessional Groups • Encourage learning from one another • Ensure adequate, diverse and equal mix • Topic is of relevance to all participants • Use knowledge, skills and expertise of all participants • Do not let one group dominate ideas • Challenge stereotyping and negative views

29. The Contact Hypothesis The Contact Hypothesis

30. The Contact Hypothesis • Each group should have equal status. • Interaction should be conducted in a co-operative atmosphere. • Participants should be working towards common goals and experience successful joint working. • The Authorities should support the initiative. • Participants should be made aware of group similarities and group differences. • Participants should have positive experiences. • Participants from different groups should perceive one another as typical members of their group.

31. What Makes a Good Facilitator ? • Self aware and open minded attitude • Good communication skills, listening, use of diffusing language • Question • Challenge • Balance discussion • Learn within group • Appropriate learning resource

32. Ct • Build in diversity: Insensitivity and bias to be avoided • Keep the group on track and manage dynamics • Be mindful of power to ensure equality • Creates a safe space • Handles negative behavior immediately • Promotes transformation as experience is used during the teaching • Has caring attitude • Provides effective feedback

33. Ct • Personal emotional control • Facilitates reflection • Criticize ideas not people • Has every one can learn spirit

34. MODELS TO EMBRACE DIVERSITY • Recognize the situation • Express yourself Speak up! • Acknowledge underlying feelings of frustration • Clarify reasons for the comment • Talk meaningful interventions

35. Ct • Halt discussion and consider the comment, reflect on it • Engage with the issue, discuss, observe behaviour • Allow trade opinions people to express their thoughts • Learn: Listen and learn from other people’s experiences • Synthesis: Why is this discussion matter, how did this process of discussion work

36. Ct • Diversity should be included: Teaching resources and modes of assessment • Cultural humility crucial

37. Your own scenario • In your teams develop a short scenario based on your own clinical experience • Who were are active player • What were the tasks • How was responsibility shared • What were the leadership qualities you used in your team?

38. What are Challenges of IPE ?

39. Challenges of IPE The Challenges of IPE • Differences in language and jargon • Differences in schedules and professional routines • Varying levels of preparation, qualifications and status • Differences in requirements, regulations and norms of professional education • Fears of diluted identity • Concerns regarding clinical responsibility. Headrick LA, Wilcock PM, Batalden PB (1998) Interprofessional Working and Continuing Medical Education. BMJ 316((7133): 771-4.

40. Develop and IPE Session

41. QUESTIONS