PAST COHORT PANEL PRESENTATION + Q&A VIRGINIA COMMONWEALTH UNIVERSITY Alan Dow, MD, MSHA, Assistant Vice President, Center for Interprofessional Education and Collaborative Care and Seymour and Ruth Perlin Professor of Medicine and Health Administration Kelly Lockeman, PhD, Director of Evaluation and Assessment, Center for Interprofessional Education and Collaborative Care and Assistant Professor, School of Medicine TRAINING COLLABORATORS FOR THE FUTURE OF HEALTHCARE 2017 IPEC 1
OBJECTIVES Outline a developmental approach for planning and evaluating interprofessional education Describe some examples of large-scale experiences in interprofessional education Examine the purpose of interprofessional education VIRGINIA COMMONWEALTH UNIVERSITY 53 acre Health Science campus 5 health professional schools: allied health, dentistry, medicine, nursing, pharmacy Tertiary academic medical center 3200 clinical learners Monroe Park campus School of social work, departments of psychology and health & human performance Distant training sites: Inova-Fairfax (70 miles IPEC north) INSTITUTE UVA (70 miles MONDAY, west) JANUARY 13, 2014 2017 IPEC 2
COMPETENCY-BASED EDUCATION MODEL Health needs Health systems Competencies Outcomes Curriculum Assessment (Frenk et al., 2010) Professional Expertise Collaborative Expertise Khalili et al. JIC. 2013 2017 IPEC 3
Time-based Education X amount of training Y amount of more training Z amount of more training Competency-based Education Role Beginning Intermediate Advanced Competency-based Education Profession-specific Abilities Beginning Intermediate Collaborative Abilities Advanced Role Beginning Intermediate Advanced 2017 IPEC 4
CONCEPTUAL FRAMEWORK FOR PROFESSIONALIZATION PRACTIONERS: Context-Specific Experiences ADVANCED LEARNERS: Profession-Specific Experiences EARLY LEARNERS: Foundational Health Professions Experiences ENTERING STUDENT: Pre-curricular Experiences A DEVELOPMENTAL APPROACH Dreyfus Benner (and beyond) Novice Advanced Beginner Competent Proficient Expert New to area but motivated to learn more Learning basic steps in area; needs supervision Able to perform in area without supervision Able to perform in area across contexts Able to perform intuitively across contexts My daughter wants to make ice cream. My daughter can make ice cream with a recipe and my help. My daughter can make vanilla ice cream by herself. My daughter My daughter can make creates new different ways of kinds of ice making IPEC ice INSTITUTE cream by MONDAY, JANUARY cream. 13, 2014 herself. 2017 IPEC 5
Advanced Novice Beginner Competent Proficient Expert Recognize the value of shared problem solving Teams Domain Know principles of effective teams Engage in shared problem solving Adapt within a team framework Know the roles & responsibilities of your profession Roles & Responsibilities Domain Understand the perspectives of others (listening) Express views with clarity Communication Domain Know the roles and responsibilities of other professions Recognize your personal & professional limitations Form team goals Voice conflicting opinions Give feedback (individual & team) Fulfill your role & responsibilities on teams Use strategies to overcome your personal limitations Resolve conflict successfully Respond to feedback (individual & team) Solve problems interprofessionally Lead & follow in context Using QI methods to improve team performance Change systems of care to leverage interprofessional teams Integrative Domain INTERPROFESSIONAL CURRICULUM, ASSESSMENT, AND EVALUATION AT VIRGINIA COMMONWEALTH UNIVERSITY 2017 IPEC 6
PRIMARY LEARNERS Nursing (MS NP) 1 Nursing (BS RN) 4-5 Pharmacy (Pharm D) 3-4 Dental Hygiene (BS) 2 Medicine (MD) 3 Physical Therapy (DPT) 1 Dentistry (DDS) 2 Occup. Therapy (OTD) 1 Numbers in red = typical number of formal IPE courses and learning activities in which each program participates. Health Admin (MHA) < 1 Social Work (BSW/MSW) MONDAY, < JANUARY 1 13, 2014 FOUNDATIONAL LEARNING Classroom-based for 15 weeks, ~500 students each semester, required by participating programs, 1-credit, pass/fail grading IPEC 501: Foundations of Interprofessional Practice (Fall) IPEC 502: Interprofessional Quality Improvement and Patient Safety (Spring) 2017 IPEC 7
PROFESSION-SPECIFIC LEARNING Simulation-based, length varies, required by participating programs, embedded in discipline-specific courses but transitioning to IPEC Health Assessment Simulation: Practice evaluating patients and communicating patient data with an IP team Virtual Geriatrics Case: Practice collaborating to care for a complex geriatric patient as a member of an IP team ICCS: Practice critical care skills, communication, and escalation MONDAY, within JANUARY an IP team 13, 2014 CONTEXT-SPECIFIC LEARNING Immersion activities, offered as electives and/or volunteer opportunities where students can help enact positive change with support from faculty QI Projects Teams collaborate to tackle real QI projects in the health system Hotspotting Teams engage with complex patients in the community to improve health outcomes through care coordination support 2017 IPEC 8
EXAMPLE IN NURSING Context-Specific Experiences Richmond Health & Wellness BSN Graduate Profession-Specific Experiences IP Critical Care Simulations IP Geriatrics Virtual Case Foundational Health Professions Experiences IP Quality & Safety Foundations of IP Practice Pre-Curricular Experiences Entering Student INTERPROFESSIONAL COMPETENCE: THE STATE OF THE SCIENCE The need for improved assessment methods and tools is commonly recognized. The need for defined outcomes at the level of (a) individual learner, (b) team, and (c) program is also commonly recognized. (Blue, Chesluk, Conforti, & Holmboe, IPEC 2015) INSTITUTE 2017 IPEC 9
OUR APPROACH TO ASSESSMENT Learner Knowledge individual quizzes Skills/ Performance narrative reflections about learning self assessment peer assessment instructor assessment using activity-specific tools or rubrics Attitudes self assessment using validated tools (e.g., SPICE- R2, IPEC Competency Self- Assessment) Narrative reflections Team team quizzes team work products team work products aggregate responses to validated measures (e.g., Team Development Measure) narrative team reflections OUR APPROACH TO EVALUATION Course evaluations: student and faculty feedback after each course/activity. Aggregate analysis of learner and team assessment data for trends and group comparisons. Record maintenance for student and faculty activity tracking and network analysis. Regular engagement with program stakeholders. Feedback loop for planning and improvement of courses/activities. 2017 IPEC 10
SELECTED OUTCOMES Improvements in student attitudes about working interprofessionally Reduced stereotypes about other professions Correlation between quality of interprofessional student collaboration and patient care Faculty as an important key to learning Faculty participation from 55 to 90 over 3 years A Final Thought 2017 IPEC 11
FINAL CONSIDERATION: WHAT IS IPE? a) An instructional method? b) Curricular content? c) A professional identity construct? d) A lever for organizational change? e) All of the above? WRAP-UP AND DISCUSSION 2017 IPEC 12