Integrated Interprofessional Education in Veterinary Medicine. Laura Molgaard Associate Dean for Academic and Student Affairs

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Integrated Interprofessional Education in Veterinary Medicine Laura Molgaard Associate Dean for Academic and Student Affairs

Agenda Framework and Background IPE at Minnesota, Western U, and Oregon State Interprofessional Interactions of Veterinarians

Definitions Interprofessional Education: IPE Occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes (WHO) The WHO framework for action on interprofessional education and collaborative practice states need to prepare "collaborative practice-ready" health workforce that is better prepared to respond to local health needs

Interprofessional Education Collaborative: IPEC Goal: to prepare all health professions students for deliberatively working together with the common goal of building a safer and better patient-centered and community/population oriented U.S. health care system Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative

IPEC Competencies Structured to yield collaboration ready trainees Domain 1: Values/Ethics for Interprofessional Practice Domain 2: Roles/Responsibilities Domain 3: Interprofessional Communication Domain 4: Teams and Teamwork

Interprofessional Professionalism Collaborative: IPC Interprofessional professionalism, when practiced by all health professions: enhances quality healthcare outcomes for patients promotes a culture that values and fosters individual competence improves practice and academic environments

Background The case for IPE is not new in human health professions Institute for Healthcare Improvement Triple Aim Improving the patient experience of care (including quality and satisfaction); Improving the health of populations; and Reducing the per capita cost of health care.

Background Canada and UK are leaders in IPE ACPE now requires IPE and other human health professions are moving in that direction One Health initiative supports IPE for veterinary students

IPE in Veterinary Medicine Talking Walls RVC resource to introduce Interprofessional Skills in context of veterinary team Communication Understanding and respecting roles (including misconceptions) Teamwork

IPE in Three Academic Health Centers with CVMs University of Minnesota (2008 / 2010) Western University of Health Sciences (2009) Oregon State collaboration with Western U (2011)

Minnesota Academic Health Center with Colleges/Schools of: Dentistry Medicine Nursing Pharmacy Public Health Veterinary Medicine and Center for Allied Health Programs Long-standing interest in team approach student desire for interprofessional interaction and learning 2010 commitment to 1Health and three phase model Phase I: Orientation Phase II: Necessary/Essential Skills Phase III: Expertise in Practice

Minnesota Phase I (2010) = Foundations of Interprofessional Communication and Collaboration (FIPCC) with 6 modules on Training, roles, responsibilities, stereotypes Ethics Teamwork Inteprofessional decision making Phase II (2012) = Electives to build the toolkit Phase III (2013) = and is intended to happen in the healthcare setting as a capstone experience Exemplary Interprofessional Learning Environments (EILE) National Center for Interprofessional Practice and Education

Western U Phase I: inter-institutional IPE program all first year students from 9 health professions at Western U, 8 health professions at Oregon State and Linn-Benton CC in an. facilitated small groups in a PBL format clinical cases emphasize interprofessional communication, collaboration, teams & teamwork in healthcare, scope of practice, and one health. Phase II: second year students small groups, throughout the academic year Phase III: pilot stage of development brings students from various professions working in clinical environments and with standardized patients and standardized clinicians

Western U One Health emphasized as a core competency throughout all 3 phases of the IPE curriculum, weighs heavily in written assessments of students from 13 health professions. Based on student outcomes and feedback, the perception of veterinary medicine as a healthcare profession is changing.

Oregon State Part of the inter-institutional IPE program with Western U Together with the Pomona campus, students are enrolled in an inter-institutional IPE course with a total of 13 health professions represented, including veterinary medicine on all campuses 2011-2012 pilot to replace veterinary integrative course (basic/clinical integration) with IPE One Health concept strong motivator Challenges that led to 2012-2013 hiatus Distance and time required Cases role of vet med perceived as contrived although the cases used in the curriculum were factual, real cases where veterinarians had roles. Planning to re-join in 2013

Lessons Learned Political and logistical challenges are significant Good facilitators are critical Cases need to be realistic Opportunities to educate others about veterinary medicine are never-ending

Research: Interprofessional Interactions of Veterinarians Margaret Root Kustritz, Laura Molgaard (MN) and John Tegzes (Western U) Survey of 4000 AVMA members using AVMA employment functions (self-reported) 18.6% response rate 15% <10 years 39% 10-25 years 41% 26-45 5% >45 years

Frequency of interactions with professions by employment type (1 = never, 2 = rarely, 3 = regularly, 4 = frequently) 3.5 3 2.5 2 1.5 Practice Teaching Industry Other 1 Root Kustritz M, Molgaard L, Tegzes J, unpublished data

Veterinarians should promote interaction to enhance patient care and growth Physicians, PhDs, biomedical engineers, researchers - promote animal models of disease and collaborate on research Social workers or psychologists - how to work with clients and in how to manage own personal stress Physical therapists, chiropractors, and acupuncturists - provide non-traditional care and rehabilitation (balanced with concerns) Law enforcement officers role in identifying abuse situations, work with animal rights groups, adherence to regulations Physicians, public health officials, etc. - disaster preparedness Attorneys - medical record documentation, legal issues Accountants or business professionals - practice management

Professions veterinarians could most positively affect Physicians and nurses - zoonotic diseases Physicians and nurses - in parasitology Pharmacists - in physiology of domestic animals, pharmacokinetics, administration (routes and challenges), contraindications Physicians - in prudent use of antimicrobial agents. Physicians and public health officials - in food animal production (animal welfare, food safety, and antimicrobial resistance) Physicians, PhDs, and other researchers - animal models of disease for research Teachers and other educators - promote veterinary medicine and interest in science in young people

Conclusions While DVMs do not frequently interface with human health care professionals in practice, greater interaction may benefit veterinary medicine as well as human health

Questions and Comments