Improving education in wound care: crossing the boundaries of interprofessional learning

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• Improving education in wound care crossing the
  boundaries of interprofessional learning
• Caroline McIntosh
• Senior Lecturer, Podiatry
• Karen Ousey
• Principal Lecturer, Adult Nursing
• Centre for Health Social Care Research
• University of Huddersfield, UK

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Acknowledgements

• The authors would like to thank David Mowforth
  for all technical assistance and the School of
  Human and Health Sciences, University of
  Huddersfield, UK for funding this project

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Introduction

• Wound care represents a significant proportion of
  health care resources and makes up a substantial
  amount of contact time within clinicians daily
  schedules
• It is estimated that community based nurses spend
  25-50 of their time treating wounds in the UK
  (Bale 2004)
• The extended role of podiatrists now encompasses
  wound care, particularly in the management of
  lower extremity wounds

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Wound Care Knowledge

• A survey (n692) of nurses wound care knowledge
  undertaken primarily in Canadian provinces
  identified nurses perceptions on whether their
  basic nursing education was sufficient (Ayello et
  al 2005)
• 70 of nurses felt they had not received
  sufficient education on chronic wounds in their
  basic nursing education

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Knowledge Skills Gap

• Mitchell et al (2000) identified significant
  discrepancies in care provided by GPs and nurses
  in the management of diabetic foot disease
• Currently there is no evidence that specifically
  focuses on podiatrists knowledge and skills in
  wound care

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Collaborative Practice

• Collaborative practice is an essential component
  of modern wound care
• However the reality remains that there is often
  little collaboration between the two professions
  (McIntosh Ousey 2006)

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Interprofessional Learning (IPL)

• The concept of IPL is well established. Caipe
  (1997) offered the following definition for IPL
• Where two or more professions learn from and
  about each other to improve collaboration and
  quality of care

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Interprofessional Learning

• There is increasing emphasis on IPL as a strategy
  to improve interprofessional collaboration
  (Pollard 2004)
• NICE (2001) state that an interdisciplinary
  approach to the training and education of health
  care professionals should be adopted
• McNair et al (2005) suggest the responsibilities
  of health care educators extends beyond
  discipline specific competencies

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Barriers to collaborative practice

• Lack of awareness of each others roles
• Professional stereotyping
• Professional identity
• Inconsistent educational strategies
• No exposure to interprofessional education at
  undergraduate or postgraduate level
• (Mandy et al 2005 Xyrichis and Lowton 2007)

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Current Wound Care Education

• At the University of Huddersfield
• In Podiatry
• Wound care option module
• Clinical placements
• In Nursing
• Theory sessions
• Clinical placements
• No shared learning between nursing and podiatry

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Aim of the Project

• To develop an IT-based learning resource to
  convey evidence-based concepts of wound care to
  undergraduate nursing and podiatry students, that
  also encourages collaborative practice

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Objectives

• The CD-Rom will provide an innovative approach to
  wound care education that will
• Bridge the theory to practice gap
• Broaden perspectives beyond the students
  specialist area
• Highlight the importance of interdisciplinary
  working and raise awareness of each others roles

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Project Design

• This interactive CD-Rom utilises a problem based
  learning format in the style of three case
  scenarios centred on the assessment, diagnosis
  and management of commonly encountered wounds
• Diabetic Foot Ulcers
• Pressure Ulcers
• Infected Wounds

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Structure of the CD-Rom

• Initial quiz
• Scenario selection
• Assessment strategies
• Management strategies
• Repeat quiz

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Diabetic Foot Ulcer Scenario

• Caucasian male
• 65 years
• 15 year duration type 2 diabetes
• Poor glycaemic control (HbA1c 16)
• History of ischaemic heart disease
• Charcot foot

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Patient Assessment
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Problem-based learning

• Interactive element
• Encourages autonomy
• Allows students to make clinical decisions within
  a virtual environment
• Allows formative feedback
• Encourages learners to be self-directed, critical
  and reflective thinkers

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Interprofessional Practice

• Students will be encouraged to consider the role
  of the podiatrist and nurse in the patients care
• Qualitative statements from nurses and
  podiatrists involved in wound care are included

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Conclusion

• This initiative aims to introduce an
  interdisciplinary IT resource to encourage
• Evidence based practice
• Critical thinking and reflective practice
• Understanding of collaboration and a team
  approach
• Positive interprofessional behaviour which can be
  taken forward into professional practice
• The CD-Rom will be formally evaluated after 12
  months

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Thank you for your attention