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Experiential Learning in Interprofessional Educa tion. Joe Schwenkler , MD Medical Director Physician Assistant Program School of Health Related Professions Rutgers Biomedical & Health Sciences. Experiential Learning. Reflection, critical analysis and synthesis

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experiential learning in interprofessional educa tion

Experiential LearninginInterprofessional Education

Joe Schwenkler, MD

Medical Director

Physician Assistant Program

School of Health Related Professions

Rutgers Biomedical & Health Sciences

experiential learning
Experiential Learning
  • Reflection, critical analysis and synthesis
  • Opportunities for students to take initiative, make decisions, and be accountable for the results
  • Opportunities for students to engage intellectually, creatively, emotionally, socially, or physically
  • A designed learning experience that includes the possibility to learn from natural consequences, mistakes, and successes

Source: Experiential Learning Center

University of Colorado

slide3

Established on February 12, 2013

  • Representatives from four schools:
    • Rutgers PA Program
      • Joe Schwenkler, MD- chair
      • Lori Palfreyman, PA-C
    • RWJ Medical school
      • Rob Zachow, Ph.D.
      • Joyce Afran, MD
    • Rutgers College of Nursing
      • Maureen Esteves, Ph.D., R.N.
    • Ernest Mario School of Pharmacy
      • Rolee Pathak Das, Pharm. D.
  • Students from each program participated in the planning sessions
principles of interprofessional education
Principles of Interprofessional Education
  • Longitudinal training, developing relationships with peers
  • Opportunities for collaborative problem solving
  • Explore how to function effectively on teams
  • Ensure that graduating students have the foundation for collaborative practice
  • On-going program evaluation
rutgers rwj interprofessional education initiative website
Rutgers/RWJ InterProfessional Education Initiative Website

http://moodle.rutgers.edu/course/view.php?id=4289

Moodle Course utilized for central storage of case info and suggested readings

2 013 2014 ipe seminars students

#

2013/2014 IPE Seminars (students)
  • IPE Patient Centered Medicine run by RWJMS
    • Geriatrics (250)
    • Caring for patients with limited English proficiency (180)
  • IPE Physiology Small Groups run by RWJMS
    • Asthma (250)
    • Nephrotic Syndrome (180)
    • Uncontrolled Hypertension (180)
  • IPE Case Conferences
    • CVA run by PA Program (350)
    • Medical Errors run by Pharmacy, Scheduled on 3/19/14 (400)
  • IPE Simulation Sessions run by the College of Nursing
    • To start with asthma case scenario April 3, 2014
    • Plan to expand to 48 students every other week
new ipe seminars planned for 2014 2015
New IPE seminarsplanned for 2014/2015
  • IPE Case Conference: The Hospice Team
    • To be coordinated by the School of Social Work
    • Modeled after the CVA Case Conference with the addition of New Brunswick Seminary students
  • PCM Shadow Experience
  • Nurse/PA Cadaver Lab
  • New simulation scenarios emphasizing IPE
ipe case conference cva 11 25 13
IPE Case Conference: CVA (11/25/13)
  • Seven programs participated (# students):
    • Robert Wood Johnson Medical School (130)
    • School of Health Related Professions:
      • Physician Assistant (45)
      • Dietetics (18)
      • Physical Therapy (30)
    • Rutgers College of Nursing (70)
    • Ernest Mario School of Pharmacy (25)
    • Rutgers School of Social Work (40)
case conference goals
Case Conference Goals
  • Realize the importance of patient care being provided by Interprofessional (IP) teams in the real world
  • Learning to work as a collaborative unit
  • Skill-building to be able to function as part of an IP collaborative team
  • Understanding the roles, strengths of IP colleagues and what each individual and discipline can bring to patient care
  • Develop relationships with colleagues outside of the student’s own discipline
research initiative
Research Initiative
  • Collected pre- and post-activity data using validated instrument (about 300 surveys completed)
    • Readiness for Interprofessional Learning Scale (RILS)
    • Paper-based, will use Qualtrics* for future activities
  • Looking at attitudes and perceptions about other disciplines and IPE
    • Assesses value of cooperative learning, trust, respect, professional limitations and professional identity
    • First step toward developing a comprehensive IPE curriculum
  • Identify real and perceived barriers to IPE

*Qualtricsis a web-based survey design and collection program

major challenges
Major Challenges
  • Scheduling
    • Several programs had limited student availability due to scheduling conflicts
    • Need to plan further in advance
  • Logistics
  • Case presentation
  • Facilitator training
  • Reflection
  • Data Collection and analysis
logistical challenges
Logistical Challenges
  • Getting over 350 students and 50 facilitators to the right place at the right time
  • Creating 30 small groups and finding enough rooms
    • About a dozen students did not show
    • Created an imbalance in several groups
  • Balance student representation in each small group
  • Ensure student educational levels are similar
logistical solutions
Logistical Solutions
  • Utilized Access Database to store data
    • This relational database allows for instantaneous queries and reports
    • Easy to create mailing lists
  • Each participant picked up a place card
    • Name, Program (color coded), and breakout room
      • Also received a list of students & facilitators in their small group
pa students served as the hosts
PA students served as the “hosts”
  • Enlisted PA students to organize the traffic flow, greet participants, and stand in the aisles
  • Red carnation identified the 45 students hosting the event
case discussion challenges
Case Discussion Challenges
  • Need to utilize a case that encourages collaboration
  • Need to have aspects of care that relate to all the disciplines involved
  • Need to present the case in a manner that promotes group problem solving
  • Need to emphasize the process taking place within the small group
case discussion solutions
Case Discussion Solutions
  • Build on a CVA case used by the PA faculty for 2nd year students
  • Utilize a comprehensive appendix for facilitators
  • Role-play the ER entrance of a “stroke patient” in front of the entire audience
    • Let the students take the history and ask for physical exam findings
case discussion solutions cont
Case Discussion Solutions (cont.)
  • Break out into thirty small groups with a mix of twelve students and one or two facilitators
    • Groups with the best balance “performed” the best
  • This “stroke team” follows the patient from the entrance to the ER until they return home
  • Build in challenges the team needs to deal with (i.e. acute delirium, dysphagia, falls, family issues)
facilitator t raining challenges
FacilitatorTraining Challenges
  • Bringing a heterogeneous group of about fifty clinicians up to speed on the case
  • Getting the information to the facilitators ahead of time
  • Getting the facilitators to preview the material
  • Getting all facilitators to attend a training session in advance of the case conference
facilitator training solutions
FacilitatorTraining Solutions
  • Distribute case discussion in advance
  • Comprehensive appendix
  • Postings on website
  • Train the facilitators via mailings
    • Working in an Interprofessional (IP) Group
      • Dr. Afran’s document distributed in advance
  • One hour case review over lunch
  • Debriefing for facilitators at the end of session
student reflection at the end
Student Reflection at the end
  • What do you feel you learned about the role of other professionals in the care of older patients in particular?
  • Were there any challenges to working as an IP group today?
  • Do you think these challenges come up when providing interdisciplinary care in the actual clinical setting?
  • What are some of the key factors in making IP care work?
  • How has IP communication and dialogue been facilitated?
ways to improve
Ways to improve?
  • Goal is to have equal # students per program
    • Ensure that all who sign up participate
  • Students should have similar level of education
  • Goal to have two facilitators per small group
    • Each program to supply at least 1 facilitator per 10 students
    • Enlist practicing clinicians:
      • speech therapy and occupational therapy
    • Invite top senior students from each program
  • Develop a webinar for facilitator training