IPE Presentation CAPCSD 2018 FINAL PDF HANDOUT · 4/9/18 1 IPE/IPP Integration into the Curriculum CAPCSD Conference, Austin, 2018 John W. McCarthy Ohio University Jeffrey J. DiGiovanni

4/9/18

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IPE/IPP Integration into the Curriculum

CAPCSD Conference, Austin, 2018

John W. McCarthyOhio University

Jeffrey J. DiGiovanniUniversity of Cincinnati

McCarthy/DiGiovanni CAPCSD 2018 1

Disclosures

• The authors received partial salary support from the Ohio Department of Medicaid, Medicaid Technical Assistance and Policy Program (MedTAPP) Healthcare Access Initiative ODM Federal Funding: G-1415-07-0060; ODM201409.• John McCarthy, Jeffrey DiGiovanni have no

relevant nonfinancial disclosures.


Knowing your team…• Introductions

SpeakersAudience



PREVENTABLE MEDICAL ERRORS


“…particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles.”

-Commonwealth Fund


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The Continuum of

InterprofessionalEducation

Area an experience falls on IP continuum: Low Mid High

Typical characteristics of experience:

Classroom-basedEmphasis on text (books, articles, etc)

Interprofessionalcompetencies may be incidental and typically not assessed

May satisfy curricular course requirement for 2+ programs

Mix of class-based and clinical site learning

Mid- and high-fidelity simulations

Team-based learning

Content and assessments built around the IP competencies

Emphasis on team-based clinical practice in a health facility

Team-based meetings occur regularly

Experiences augmented with high-fidelity simulations, standardized patients, and other related, IP content

Grand rounds experiences common

Assessments a blend of clinical skills evaluations and team-based performance


What do you think of?

What do you think of when you hear… Interprofessional Education?


IPE Competencies in Accreditation Standards

9

• Graphic in presentation

McCarthy/DiGiovanni CAPCSD 2018

IPE

• Interprofessional education (IPE): Occasions when two or more professions learn from, with and about each other to improve collaboration and the quality of care (Freeth, Hammick, Reeves, Koppel, & Barr, 2005. p15)

McCarthy/DiGiovanni CAPCSD 2018 10 McCarthy/DiGiovanni CAPCSD 2018 11

Competency Area DescriptionValues/Ethics Work with individuals of other professions to maintain a climate of

mutual respect and shared values

Roles/Responsibilities Use the knowledge of one’s own role and those of other professions to appropriately assess and address the healthcare needs of patients and to promote and advance the health of populations

Interprofessional Communication Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.

Teams and Teamwork Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population-centered care and population health programs and policies that are safe, timely efficient, effective, and equitable.


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Competency Based

• How to take core competencies into instruction and outcomes… • Classroom• Clinical Settings


Demonstration of Core Skills Example AdvantagesWritten Assignment Design a brochure, web-

page, tweet, post, blog describing your profession to different audiences

Draft, edit, rewrite cycle to improve skills

Archived for use in other contexts

Shared via social mediaFace-to-Face Conversation Practice introducing

yourself and what to do to students in the class, related professionals when you have a short, medium, or extended time

Repeated practice makes for a smooth, professional introduction in a variety of contexts

Recorded Video/Audio Do an “elevator speech”, or record a longer introduction of yourself for different audiences to embed on a webpage

A chance to edit for not only content, but also presentation

Video allows for students to critique themselves

Roles/Responsibilities


Variable Opportunities in Large Environments Opportunities in Small Environments

Types of Students Wide variety of health disciplines lead to a wide breadth of interactions where students are exposed to many roles

Smaller variety of health disciplines offer chances for depth in repeated interactions with a select few groups

Class Size Large classes allow maximum number of students to have an IPE experience

Small classes allow for more discussion between different professions

Group Size Large groups (6 or more health disciplines per group) allow for multiple viewpoints and dealing with complex cases

Small groups allow for discussion of co-treatment and complementary practices

Setting Large hospitals offer a variety of floors and ward experiences

Smaller hospitals allow for closer relationships with staff at sites

Technology Large universities might have simulation spaces, a pool or standardized patients, and Virtual and Augmented Reality opportunities

Technology can allow individuals in smaller satellites to connect and learn from each other or supplement expertise


What is the main challenge for IPE?

• Logistical – How do you make sure every student has an experience with another profession?• Scheduling conflicts

• Quality – How do you make sure the IPE experiences are meaningful for students?• What are the activities?


Student Centered,

Student Driven

• In building our IPE Curriculum, we turned to the students• Build, Use, Edit, Re-Build, Use…

• Initial Group of Scholars to build materials• Critical mass of materials…


Common Discussions…


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IPE Implementation: Activity Approach

• Get a number of activities• Activities are rated for number of hours• Advantages• Balance student involvement• Student control

• Disadvantages• Logistics• Still need to have someone

coordinate


Activities…

Represent

Tour and Demonstrate

Patient/Client EncountersMcCarthy/DiGiovanni CAPCSD 2018 20 McCarthy/DiGiovanni CAPCSD 2018 21

What I think I do

What my mom thinks I do What my patients think I do

What my friends think I do

What society thinks I do

What I really do think I do

Your Profession


Audiology

WhatmyfriendsthinkIdo

WhatmymomthinksIdo

WhatsocietythinksIdo

WhatmypatientsthinkIdo

WhatIthinkIdo WhatIactuallydo


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https://blog.asha.org/2016/06/09/a-day-in-the-life-of-an-acute-care-slp/


Classroom Work


Patient Safety/QI Activities



Spaces…


Open Educational Resources…


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Learning About Each Profession


Acute Care Setting


Role Playhttps://www.dropbox.c

om/sh/p82cpktrh09vtcl

/AAA227HO90b6v9lKKc

vpbozva?dl=0


IPE Case Study Modules


IPE Case Study Modules…


https://www.dropbox.com/sh/p82cpktrh09vtcl/AAA227HO90b6v9lKKcvpbozva?dl=0

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MedEdPortal

https://www.mededportal.org/collection/interprofessional-education/

Other Open Resources: MedEdPortal


Exercise #1- What’s happening now? -

Part 1: Programs• Name “high connection”

programs in your college/university• Note:

• if they are within our outside your college

Part 2: Current Activities• List current efforts, such as:

• Annual IP conferences• Mixed-enrollment courses• IP specific courses• Grand rounds events

• Note: • Are they ongoing or one time events?• How many programs involved?• How are these driven? (by dept,

college, university?)

McCarthy/DiGiovanni CAPCSD 2018 38 39

IP Training Model

Faculty Development

Team Interactions

Built around

Competencies

Variety of Settings

Assess, Assess

Resources and Tools

Commonalities

Our Enabling factors

Internal to College• Desire from College for IP

opportunities• Freedom to operate

• Numerous programs• Standards giving IP a nod

External• Willing regional facilities• Grassroots faculty interest with

follow through• Colleges desire collaboration• Available funding• Facilities value IP


Barriers we experienced

Internal to College• Programs “mixed” in their interest• College-level support not well

articulated• Providing supervision • Interest followed money

• Students and programs

• No coordination across programs to allow curricular space (time/credits/requirements)

External• Need to invest in local facilities• No formal coordination across

Colleges• Interest followed money

• Students and programs

• Another area where power struggles manifest• Facilities need non-$$ support


Exercise 2- Your own analysis -

Part 1: Strengths / Weaknesses• List the strengths and weakness

of your department and/or college as they relate to IP development and execution• Think about all types of resources

Part 2: Opportunities / Threats• List the opportunities and

threats outside your college (i.e., include the university and community organizations, etc)


https://www.mededportal.org/collection/interprofessional-education/

4/9/18

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Debriefing• Where the learning takes place!• Facilitate do not lead• Allow self-identification of both good and

not so good• Provide prompts if needed


Exercise 3- Your next steps -

Ideas for development• Consider• Available resources (people,

financial, space, facilities)• Partners: who’s on the same

page?• Activities: what’s already

happening?• Outcome: what’s the desired next

step?

Who, what, and when• Who do I need to involve?• What is the opportunity I’m

pitching• When will this be (first) offered?


OUTCO

MES

Teams & Teamwork Domain Pre Score M, SD

Post Score M, SD

P-value

Q1. Describe the process of team development

3.81, 1.13 4.35, 0.67 .017*

Q2. Describe the roles and practices of effective healthcare teams 3.92, 1.09 4.38, 0.57 .015*Q3. Engage other health professionals in shared problem-solving appropriate to the specific care situation

3.88, 1.14 4.69, 0.47 .001*

Q4. Inform care decisions by integrating the knowledge and experience of other professions appropriate to clinical situation

3.85, 1.90 4.58, 0.58 .003*

Q5. Apply leadership practices that support collaborative practice and team effectiveness

4.19, 0.85 4.50, 0.51 .070

Q6. Engage others to constructively manage disagreements that arise between healthcare professionals, patients, and families

3.92, 1.09 4.42, 0.47 .054

Q7. Share accountability with other professions, patients, and communities for outcomes relevant to prevention and health care

4.15,0.93 4.65, 0.58 .011*

Q8. Reflect on my individual performance for my improvement

4.62, 0.57 4.62, 0.51 1.0

Q9. Reflect on my healthcare team’s performance for my team’s improvement

4.38, 0.94 4.69, 0.70 .106

Q10. Use strategies that will improve the effectiveness of interprofessional teamwork and team-based care

4.19, 0.98 4.62, 0.49 .017*

Q11. Use available evidence to inform effective teamwork and team-based practices

4.19, 0.93 4.50, 0.65 0.88

Q12. Perform effectively on teams and in different team roles in a variety of settings 4.19, 0.85 4.70, 0.47 .009*

Roles/Responsibilities Domain Pre Score M, SD

Post Score M, SD

P-value

Q1. Communicate my roles and responsibilities clearly to patients, families, and other professionals

4.07, 1.0 4.41, 0.50 .058

Q2. Recognize my limitations in skills, knowledge, and abilities

4.44, 0.70 4.48, 0.51 .796

Q3. Engage diverse healthcare professionals with complementary professional expertise to develop strategies to meet specific patient care needs

3.74, 1.35 4.56, 0.64 .008*

Q4. Explain the roles and responsibilities of other care providers and how the team works together to provide care

3.56, 1.34 4.41, 0.64 .006*

Q5. Use the full scope of knowledge, skills, and abilities of available health professionals and healthcare workers to provide care that is safe, timely, efficient, effective, and equitable

3.70, 1.54 4.44, 0.70 .009*

Q6. Communicate with team members to clarify each member's responsibility in executing components of a treatment plan or public health intervention

3.93, 1.21 0.23, 0.45 .001*

Q7. Establish interprofessional relationships to improve care and advance learning 4.33, 0.78 4.74,0.45 .017*

Q8. Engage in continuous professional and interprofessional development to enhance team performance

4.30, 0.95 4.74, 0.45 .030*

Q9. Use unique and complementary abilities of all members of the team to optimize patient care

4.07, 1.27 4.56, 0.64 .035*McCarthy/DiGiovanni CAPCSD 2018 45

Interprofessional Communication Domain Pre Score M, SD

Post Score M, SD

P-value

Q1. Choose effective communication tools and techniques to facilitate discussions and interactions that enhance team function

4.19, 1.02 4.52, 0.50 .101

Q2. Communicate information with patients, families, and healthcare team members in a form that is understandable

4.23, 0.80 4.44, 0.57 .317

Q3. Avoid discipline-specific terminology when possible

3.74, 0.70 4.0, 0.73 .111

Q4. Express my knowledge and opinions to team members involved in patient care with clarity and respect

4.04, 0.89 4.54, 0.56 .008*

Q5. Listen actively, and encourage ideas and opinions of other team members 4.48, 0.57 4.85, 0.36 .002*

Q6. Give timely, sensitive feedback to others about their performance on the team

4.12, 0.92 4.44, 0.79 .041

Q7. Respond respectfully to feedback from others about their performance on the team

4.33, 0.82 4.59, 0.56 .083

Q8. Use appropriate, respectful language in a given difficult situation such as interprofessional conflict

4.33, 0.86 4.70, 0.45 .032

Q9. Recognize how my experience and expertise contributes to communication, conflict resolution, and interprofessional working relationships

4.26, 0.80 4.56, 0.57 .070

Q10. Recognize how my position in the hierarchy of the healthcare team, contributes to communication, conflict resolution, and interprofessional working relationships

4.04, 1.0 4.44, 0.63 .032

Q11. Consistently communicate the importance of teamwork in patient-centered and community-focused care

4.04, 1.17 4.48, 0.57 0.038

Values/Ethics Domain Pre Score M, SD

Post Score M, SD

P-value

Q1. Place the interests of patients at the center of interprofessional health care delivery 4.41, 0.64 4.81, 0.40 .005*

Q2. Respect the privacy of patients while maintaining confidentiality in the delivery of team-based care

4.56, 0.64 4.81, 0.40 .094

Q3. Embrace the diversity that characterizes patients and the health care team

4.41, 0.64 4.70, 0.47 .021

Q4. Respect the unique cultures, values, roles/responsibilities, and expertise of other health professionals

4.33, 0.83 4.74, 0.53 .005*

Q5. Work in cooperation with those who receive care and those who provide support or care

4.22, 0.89 4.56, 0.58 .094

Q6. Develop a trusting relationship with patients, families and other team members

4.33, 0.88 4.59, 0.57 .070

Q7. Demonstrate high standards of ethical conduct and quality of care in my contributions to team-based care

4.44, 0.85 4.74, 0.53 .088

Q8. Manage ethical dilemmas specific to interprofessional patient centered care situations

4.04, 1.16 4.52, 0.51 .021

Q9. Act with honesty and integrity in relationships with patients, families, and other team members

4.60, 0.75 4.89, 0.32 .039

Q10. Maintain competence in my own profession appropriate to my scope of practice or level of training

4.52, 0.70 4.60, 0.57 .617

OUTCO

MES


Simulation Resources

• Formal Simulation Course: http://sirc.nln.org/mod/page/view.php?id=789• Storyboard and Template: https://collaborate.uw.edu/ipe-teaching-

resources/simulation-scenario-building/• IPE Simulations: http://www.ipe.uwo.ca/Administration/case.html• Competencies: http://qsen.org/a-template-for-simulation-scenario-

development-that-incorporates-qsen-competencies/• National Patient Safety

Goals: https://www.jointcommission.org/assets/1/6/2018_HAP_NPSG_goals_final.pdf


Acknowledgements

48

• ODM Federal Funding: G-1415-07-0060; ODM201409• Ohio University 1804 Fund• College of Health Sciences and Professions• Heritage College of Medicine• College of Education• Scripps College of Communication• College of Fine Arts

http://sirc.nln.org/mod/page/view.php?id=789

https://collaborate.uw.edu/ipe-teaching-resources/simulation-scenario-building/

http://www.ipe.uwo.ca/Administration/case.html

http://qsen.org/a-template-for-simulation-scenario-development-that-incorporates-qsen-competencies/

https://www.jointcommission.org/assets/1/6/2018_HAP_NPSG_goals_final.pdf

Documents

IPE Presentation CAPCSD 2018 FINAL PDF HANDOUT · 4/9/18 1 IPE/IPP Integration into the Curriculum CAPCSD Conference, Austin, 2018 John W. McCarthy Ohio University Jeffrey J. DiGiovanni