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Office of Interprofessional Education and Practice

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Title: Office of Interprofessional Education and Practice


1
Office of Interprofessional Education and
Practice

Integrating Health Sciences Across the Continuum
Advancements in Interprofessional Education
C. Schroder, A. Aiken Health Sciences Education
Rounds March 6, 2008
2
Overview of presentation
  • Language definitions
  • Linking education and practice
  • Proposed benefits
  • Historical context
  • Theories grounding IP education and practice
  • Implications for Queens

Office of Interprofessional Education and
Practice
3
Language
SUFFIXES Professional, Disciplinary Discipline
subject that is taught, field of
study Profession a calling requiring
specialized knowledge and often long and
intensive academic preparation the use of
Professional makes it clear that individuals
from different health professions are included
Office of Interprofessional Education and
Practice
4
Language
PREFIXES Multi, Inter, Trans Multi
partners working independently or in parallel
towards a purpose Inter partners from different
domains work collaboratively towards a common
purpose Trans role blurring/doing tasks outside
normal professional role OR IP teams functioning
at high level of synergy
Office of Interprofessional Education and
Practice
5
Interprofessional Education (IPE)
DEFINITION occasions when two or more
professions learn with, from and about each other
to improve collaboration and the quality of
care (CAIPE, modified)
Office of Interprofessional Education and
Practice
6
Interprofessional Education
7
Continuum of learning
  • UNI MULTI INTER
  • (separate) (in parallel)
    (between)


Evolves toward integration of all components of
with, from and about into learning experience.
8
Interprofessional Care (IPC)
DEFINITION The provision of comprehensive health
services to patients by multiple HCPs who are
trained to work collaboratively to deliver the
best quality of care in every health care
setting. (Summit Document, 2006)
Office of Interprofessional Education and
Practice
9
Linking IPE and IPC
  • Interprofessional Education for Collaborative
    Patient-Centred Practice (IECPCP) Framework
    (DAmour Oandasan, 2004)
  • Two linked circles (2 CD model)
  • Education factors that affect HCP learners
    capacity to become a competent collaborative
    practitioner
  • Practice processes and factors that affect
    patient care outcomes in collaborative practice
    settings

Office of Interprofessional Education and
Practice
10
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11
Linking IPE and IPC
Distinction in the framework between the two
fields provides an opportunity for stakeholders
like the government, licensing bodies, hospital
and academic institutional leaders, educators,
learners, health professionals, and the public,
to examine the factors that influence specific
outcomes of both fields while acknowledging their
interdependence.
Office of Interprofessional Education and
Practice
12
Proposed Benefits IPE IPC
  • Improved patient care/outcomes/satisfaction
  • More efficient work/practice environment
  • Better health care resource utilization
  • Reduction in clinical error
  • Improved provider satisfaction
  • Reduction in staff shortages

Office of Interprofessional Education and
Practice
13
IPE Effects on professional practice and health
care outcomes
  • Scott Reeves et al. 2007 Cochrane review
  • Update to 1999 review
  • 6 studies 4 RCT, 2 CBA
  • 4 positive outcomes ER culture, patient
    satisfaction, collaborative team behavior,
    clinical error rate management care delivered to
    domestic violence victims mental HP competencies
    related to deliver patient care
  • 2 mixed (positive neutral), 2 no impact

Office of Interprofessional Education and
Practice
14
IPE Effects on professional practice and health
care outcomes
  • CONCLUSIONS
  • 6 studies compared to none in 1999
  • Some positive outcomes but not possible to draw
    generalisable inferences because of small
    numbers, heterogeneity of interventions,
    methodological limitations
  • Need more rigorous studies that include data
    collection strategies that provide insight into
    how IPE affects changes in health care processes
    and patient outcomes

Office of Interprofessional Education and
Practice
15
IPE Historical Perspective
  • INTERNATIONAL CONTEXT
  • World Health Organization
  • 1973 Expert Committee reviewing medical
    education
  • IP and traditional programs complementary
  • 1978 IPE entrenched in WHO strategy to promote
    Health for All by the year 2000

Office of Interprofessional Education and
Practice
16
IPE Historical Perspective
INTERNATIONAL CONTEXT United Kingdom 1970s IPE
initiatives developed in response to emphasis
on community care and development collaborative
models of delivery 1987 Centre for the
Advancement of Interprofessional Education
(CAIPE) founded
Office of Interprofessional Education and
Practice
17
IPE Historical Perspective
CANADIAN CONTEXT National 2001 Caring for
Medicare Sustaining a Quality System
(Fyke) 2002 Study on the State of the Health Care
System in Canada (Kirby) 2002 The Commission on
the Future of Health Care (Romanow)
Office of Interprofessional Education and
Practice
18
IPE Historical Perspective
CANADIAN CONTEXT National if health care
providers are expected to work together and share
expertise in a team environment, it makes sense
that their education and training should prepare
them for this type of working arrangement

(Romanow)
Office of Interprofessional Education and
Practice
19
IPE Historical Perspective
  • CANADIAN CONTEXT National
  • 2003 First Ministers Accord on Health Care
    Renewal
  • 2003 Interprofessional Education for
    Collaborative Patient-Centred Practice (IEPCPC)
  • National Expert Committee
  • 20 million dollars in funding through Health
    Canada
  • QUIPPED
  • EFPPEC
  • Canadian Interprofessional Health Collaborative
    (CIHC)

Office of Interprofessional Education and
Practice
20
IPE Historical Perspective
  • IECPCP Outcomes by March 31, 2008
  • Increased understanding of IP collaborative
    practice
  • Improved sharing of best practices
  • Increased use well functioning IP teams
  • Increased access to appropriate provider at
    appropriate time
  • Decreased wait times in critical areas of health
    care system

Office of Interprofessional Education and
Practice
21
IPE Historical Perspective
  • CANADIAN CONTEXT Ontario
  • 2006 Summit on Advancing IP Education and
    Practice
  • Priorities and actions within health care and
    education systems to ensure ready access to
    quality health care services and protect
    sustainability of system and its workforce

Office of Interprofessional Education and
Practice
22
IPE Historical Perspective
CANADIAN CONTEXT - Ontario We know that IP
collaboration is key to providing the best in
patient care. That means we need to ensure our
health and human services students gain the
knowledge and skills they need through IPE that
begins at the earliest stages of their schooling.
This is why Ontario has made IPE and IPC a
cornerstone of their new health human resources
plan. A cornerstone that will support health
providers and patient for years to come. (Dr.
Joshua Tepper , ADM MOHLTC)
Office of Interprofessional Education and
Practice
23
IPE Historical Perspective
  • CANADIAN CONTEXT Ontario
  • 2006 Funding through MOHLTC and MTCU for IPE,
    Mentorship, Leadership, Preceptorship and
    Coaching Fund
  • Mentoring MD/APN Dyads in PC
  • Seed funding Mental Health
  • Seed funding Ontario Collaborative
  • AHSC infrastructure funding- OIPEP

Office of Interprofessional Education and
Practice
24
IPE Historical Perspective
  • CANADIAN CONTEXT Ontario
  • 2007 Blueprint for Advancing IP Care in Ontario
    (MP)
  • 2007 Combined funding MOHLTC/MTCU ICEF
  • The Southeastern Interprofessional Collaborative
    Learning Environment (SEIPCLE)
  • The Ontario Collaborative
  • Mentoring IP Primary Health Care Teams in
    Collaborative Palliative Care Practice
  • Centre for Interprofessional Mental Health
    Education and Care
  • Primary Care Consulting Program (ID)

Office of Interprofessional Education and
Practice
25
Theories relevant to IPE IPC
  • Scott Reeves et al. 2007 Scoping Review
  • Funded by QUIPPED and Calgary Health Regions
    IECPCP project
  • Identified described 35 theories in literatures
    currently applied to IPE/C
  • Identified presented 33 additional theories
    with potential to inform IPE/C not as yet
    employed in IP context

Office of Interprofessional Education and
Practice
26
Theories used in IP literature
  • Perspectives
  • Social psychology (12)
  • Sociology (7)
  • Adult learning (4)
  • Systems (5)
  • Psychodynamic (3)
  • Organizational (3)

Office of Interprofessional Education and
Practice
27
Theories used in IP literature examples
  • Social psychology
  • Contact theory (Allport)
  • Sociology
  • Discourse, surveillance theories (Foucault)
  • Adult Learning
  • Reflective learning (Schön)
  • Experiential learning (Kolb)

Office of Interprofessional Education and
Practice
28
Theories used in IP literature examples
  • Systems
  • Complexity theory (Cooper)
  • Psychodynamic
  • Social defence (Menzies)
  • Organizational
  • Organizational learning (Argyris Schön)

Office of Interprofessional Education and
Practice
29
Theories suggested as relevant
  • Focus
  • Individual (9)
  • Team/group (13)
  • Organizational/system (11)

Office of Interprofessional Education and
Practice
30
Theories suggested as relevant examples
  • Individual
  • Active learning
  • Team/group
  • Collaborative/cooperative learning
  • Organizational/system
  • Unfreeze Change Refreeze

Office of Interprofessional Education and
Practice
31
IPE Key questions to address
What? When? How? Where?
Office of Interprofessional Education and
Practice
32
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33
IPE involves collaboration in the learning
process to
  • Socialize professionals in working together, in
    shared problem solving and decision making
    towards enhancing the benefit for patients, and
    other recipients of services
  • Develop mutual understanding and respect for the
    contributions of various disciplines
  • Instill the requisite competencies for
    collaborative practice (communication,
    negotiation, etc.)

34
IPE What, when, how, where?
  • Core Competencies for IPC
  • Knowledge
  • Roles, responsibilities
  • Skills/Behaviours
  • Communication, Reflection, Cooperation, Conflict
    Management
  • Attitudes
  • Mutual respect, trust, willingness to collaborate

Office of Interprofessional Education and
Practice
35
IPE What, when, how, where?
  • Pre-licensure, post-licensure
  • Mandatory, elective
  • Content IP objectives together or IP objectives
    alone
  • Explicit, implicit
  • Classroom, Simulation, Practice setting

Office of Interprofessional Education and
Practice
36
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37
IPE Barriers, Challenges, Opportunities
  • MACRO Level - National/Political Organizational
  • Need for senior management and government
    political support
  • Accreditation, regulatory, and licensing bodies
  • University funding flexibility of finances and
    HHR
  • Professional associations - liability
  • Compensation for educators/clinicians

Office of Interprofessional Education and
Practice
38
Queens Enablers
  • MACRO Level - National/Political Organizational
  • Government support IECPCP, Blueprint,
    MOHLTC/MTCU
  • QUIPPED, 5 ICEF grants, OIPEP
  • Primary care reform (FHT)
  • Organizations CIHC, NaHSSA, Ontario
    Collaborative
  • Provincial work groups developing core
    competencies curriculum, accreditation

Office of Interprofessional Education and
Practice
39
IPE Barriers, Challenges, Opportunities
  • MESO Level University/Medical Organization
  • Administrative challenges for learners and
    faculty that affect teaching environment and role
    of local leaders
  • Scheduling e.g. timing of IPE approach (early,
    late)
  • Logistical obstacles inequality number of
    learners divergent learning/assessment styles
    different curricular periods limited resources
    space considered an add-on lack of
    administrative support lack of value

Office of Interprofessional Education and
Practice
40
Queens Enablers
  • MESO Level University/Medical Organization
  • FHS (Medicine, Nursing, Rehabilitation)
  • QUIPPED initiatives (learner, faculty) - momentum
  • OIPEP funded until March 2009
  • Adoption OIPEP vision statement at FHS Faculty
    Board administrator support, leadership
  • OIPEP management and steering committee broad
    stakeholder group - address logistical obstacles

Office of Interprofessional Education and
Practice
41
IPE Barriers, Challenges, Opportunities
  • MICRO Level Learner/Faculty
  • Attitudinal/behavioural hidden curriculum
  • Stereotypes
  • Learning environment individual, cooperative
  • Professional readiness for IPE

Office of Interprofessional Education and
Practice
42
Queens Enablers
  • MICRO Level Learner/Faculty
  • Student advocates readiness
  • Faculty champions
  • Faculty development IPTL
  • Model collaborative teams
  • Learning environment CEC, IP placements,
    simulation hospital, community, local, regional

Office of Interprofessional Education and
Practice
43
Implications for Queens
  • Need to sustain momentum created by QUIPPED
    initiatives, faculty development
  • Maintain infrastructure support for OIPEP to
    ensure its Vision is realized
  • All health professional schools promote and
    support Interprofessional Education (IPE).
  • Common IPE competencies have been identified for
    medicine, nursing and rehabilitation therapy.
  • IPE is integrated throughout the core curriculum
    .
  • All students have opportunities each year to
    participate in IPE activities through
    simulations, the Clinical Education Centre, or in
    clinical settings.

Office of Interprofessional Education and
Practice
44
Implications for Queens
  • Develop a IPE framework for Queens FHS that
    considers barriers, theories, and links education
    with practice
  • Develop variety of IPE opportunities including
    classroom, CEC, simulation lab, placements for
    learners
  • Develop variety of IPE opportunities for faculty
    specific to interests and education roles
  • Support/develop IP teams in all settings to model
    IPC
  • Highlight value of IPE space, student
    stipends, awards, faculty promotion, scholarship

Office of Interprofessional Education and
Practice
45
Implications for Queens
  • Support for Queens IPE leaders (students,
    patients, faculty) to continue their provincial
    national involvement on work groups, OC, CIHC,
    AHSC, NaHSSA
  • Mandate to contribute to the literature, share
    lessons learned, disseminate best practices

Office of Interprofessional Education and
Practice
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