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Shriners Hospital for Children

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  1. Shriners Hospital for Children Liliane Asseraf-Pasin & Elaine Laflamme The McGill Educational Initiative on Interprofessional Collaboration: Partnership for Patient and Family Centered Practice Faculty of Medicine McGill University

  2. Definitions Why Interprofessional Education? Literature Review (Freeth et al., 2005) How To? Discussion Overview

  3. Multiprofessional Education: Is when members (or students) of two or more professions learn alongside one another: parallel rather than interactive learning. (Freeth et al., 2005) Students learn by tackling together a common problem, but from the perspective of their own discipline. (Areskog, 1994) Definitions

  4. Interprofessional Education: Learning arising from interaction between members (or students) of two or more professions. This may be a product of interprofessional education, happen spontaneously in the workplace, or in educational settings. (Freeth et al., 2005) Students from each profession look at the subject from the perspective of other professions as well as their own. (Harden, 1998) Definitions

  5. Active participation of different professional groups in decision making; delivery of patient & family-centered care Responsive to patient & family goals, opens mechanisms for continuous communication & fosters mutual respect among professionals Interprofessional Patient-Centered Practice

  6. The Nature of Collaboration

  7. Mounting evidence that Collaborative Practice improves outcomes in a number of patient populations studied to date: Geriatrics, ER care for abused women, STD Screening, Adult Immunization, fractured hips and neonatal ICU care, depression care, and in simplifying medications (Zwarenstein et al., 2004) Why Interprofessional Education?

  8. Modify negative attitudes & perceptions(Carpenter, 1995) Remedy failures in trust & communication between professions(Carpenter, 1995) Reinforce collaborative competence(Barr, 1998) Secure collaboration implement policies (Department of Health, 2001) improve services (Wilcock and Headrick, 2000) effect change (Engel, 2000) Cope with problems that exceed the capacity of any one profession(Casto & Julia, 1994) Enhance job satisfaction & ease stress(Barr et al., 1998; McGrath, 1991) Create a more flexible workforce(Department of Health, 2000) Why Interprofessional Education? (as cited in Barr, 2002)

  9. Why Interprofessional Education? • Complexity of care • Rising expectations • Professional proliferation • Students want to know • Community based care • Teamwork • Interprofessional conflict • New models of practice • Legislation & redefinition of professional roles • Effectiveness of interprofessional practice

  10. Studies that EVALUATED Interprofessional Education: 10, 495 abstracts 884 papers 373 studies 107 “robust” evaluations = 3+ on quality criteria Literature Review (Freeth et al., 2005)

  11. Inclusion criteria for studies: Evaluation design was appropriate to the research aims/questions Selection of participants was based on clear criteria Validity & reliability or authenticity & trustworthiness well considered Results and context clearly described Literature Review (Freeth et al., 2005)

  12. Quality: reported information Clear rationale Good contextual information Sufficient information on sampling, ethics and possible bias Analysis described in sufficient detail Literature Review (Freeth et al., 2005)

  13. Literature Review (Freeth et al., 2005)

  14. Findings by Outcome – collapsed (Freeth et al., 2005)

  15. Key messages with examples: Wide range of positive outcomes associated with IPE: Richardson, Montemuro, Cripps, Mohide, & Macpherson (1997) Mixed, neutral and negative reactions provide useful lessons Clinebell & Stecher (2003) McCallin (2001) Literature Review (Freeth et al., 2005)

  16. Literature Review • Key messages: (Freeth et al., 2005)

  17. Effective Collaborative Interventions implemented in Pediatrics

  18. Effective Collaborative Interventions implemented in Pediatrics

  19. Effective Collaborative Interventions implemented in Pediatrics

  20. Effective Collaborative Interventions implemented in Pediatrics

  21. Team Building is important Team Development is necessary Regular Interdisciplinary Rounds Interdisciplinary Assessments Maintain Collaborative Quality Design Improvements to your Practice Practice by Reviewing Performance Data Take Home Message:

  22. Foster IPP Skills, Attitudes and Behaviors within your team and Model to & Mentor Students. Provide didactic information package to students prior to their clinical placement. Orient students to Spina Bifida Team Members early on in the rotation Set clear, achievable & measurable goals Have students Identify Roles & Tasks of each professional involved in the team and compare them to actual R & T. i.e.: what do you think is the role of the Social Worker/Nurse… on this team? Where do you see their intervention within this client’s plan of care? What do you see as your role on this team? How To Teach IPP to Students

  23. Use Simulation to present a typical case to all students as a group exercise. Map out process from admission to discharge Allow them to practice as an IP team & come up with a plan Facilitate their discussion and redirect if necessary Prepare a list of typical questions and answers (Q & A) parents may have about your team functioning, process and expected outcomes. Have students pretend to be another professional and prepare a Mock Team Meeting. How To Teach IPP to Students

  24. Shadowing (walking through the day of another professional) Scaffolding (breaking-up tasks into smaller parts) Situated Learning Principles (beginning at the edge & moving towards the center) Peer Coaching/Enhancing Metacognition (K/KDK/DKDK) Simulation Real Case Studies Small Group Discussions (IP) Peer discussions (intra) Videotaping sessions Provide time for students to meet prior to next clinic to share & discuss issues Sample Methods

  25. Definitions Why Interprofessional Education? Literature Review (Freeth et al., 2005) How To? Discussion Summary

  26. Areskog, N. H. (1994). Multiprofessional education at the undergraduate level. In K. Soothill, L. Machay, & C. Webb (Eds.), Working together?: Interprofessional relations in health care. London: Edward Arnold. Barr, H. (March, 2002). Interprofessional Education: Today, Yesterday and Tomorrow. Published as Occasional Paper No1, The UK Centre for the Advancement of Interprofessional Education (CAIPE). Freeth, D., Hammick, M., Reeves, S., Koppel, I., Barr, H., & Ashcroft, J. (2005). Effective interprofessional education: Development, delivery & evaluation. Malden, MA: Blackwell Publishing Inc. Harden, R. M. (1998). Effective multiprofessional education: a three-dimensional perspective. Medical Teacher 20, 5, 402-408. Zwarenstein et al., (2004) http://www.ktp.utoronto.ca/aboutTheKTP/projects/ References

  27. For a copy of any article please email us: elaine.laflamme@mcgill.ca liliane.asseraf.pasin@mcgill.ca