interprofessional education (ipe)

INTERPROFESSIONAL EDUCATION (IPE)

Dr Vimmi Passi, Course Director, Masters in Medical EducationInstitute of Clinical Education, Warwick Medical School

LEARNING OUTCOMESDescriptionImportancePrinciples of IPEWHO Framework for IPEIPE in PracticeDesigning Effective IPE Challenges of IPE

CAIPEThe Centre for Advancement of Interprofessional Education

DESCRIPTION IPE occurs when two or more professions learn

with, from and about each other to improve collaboration and the quality of care.

MultiprofessionalInterprofessionalUniprofessional

CtThe education ensures that learning has

taken placeRequires active learning as there is exchange

of ideas, skills and knowledgeAims at collaboration

Interprofessional Education

Profession X

Profession Z

Profession Y

Multiprofessional Education

One or more students or professionals learn alongside one another.

The learning may be around acquisition of a clinical skill or knowledge, learners may occupy the same physical space and use the same learning materials.

Uni Professional Learning

This is in which students learn together as a single group e.g. doctors, nurses, dentists, midwives etc and do not learn with or alongside other professional groups.

Collaboration

An interprofessional process of communication and decision making that enables the separate and shared knowledge and skills of healthcare providers to synergistically influence the ways client/patient care and broader community health services are provided.

The Importance of IPE

Improved Interprofessional Education

IPE

Improved Interprofessional Practice

IPP

Improved Health

Outcomes

Thistlewaite J and Nisbet G. Interprofessional education Clinical Teacher : 2007 (4) : 67-72

CAIPESeven Principles of Interprofessional Education

Works to improve the quality of careFocuses on the needs of service users and carersInvolves service uses and carersEncourages professions to learn with, from and

about each otherRespects the integrity and contribution of each

professionEnhances practice within professionsIncreases professional satisfaction

Communities of Practice

Teams can be seen as Communities of PracticeGroup who work together to achieve a common

goalTrainees learn from each otherJunior medical staffNursing colleagues

Lave J, Wenger E ( 2003) Situated Learning : Legitimate Peripheral Participation, Cambridge University Press.

CtCommunity health workersProjectspoliticians

ORGANIZATIONAL STRUCTURE

HEALTH CENTRE IN CHARGE

NURSING OFFICER

NURSE IN CHARGE

NURSE

WARD ATTENDANT

ENVIRONMENTAL HEALTH OFFICER

HEALTH SURVEILLANCE

ASSISTANT

HSA

VILLAGE HEALTH

COMMITTEE

CLINICAL OFFICER

MEDICAL ASSISTANT

PATIENT ATTENDANT

GROUND LABOURERS

SCENARIO 1Mrs Z reports to the Labour ward in second

stage of labour and progressed to delivery of a live full term baby with good apgar’s score. As you attempt to deliver the placenta, she starts bleeding profusely and the placenta appears to be stuck. Discuss the management

Consider the following who are involved in the care (Active players)What are the activities to be doneWho will do what (Sharing responsibilities)Reflection

SCENARIO 215 year old mother is admitted in the

postnatal ward following uneventful 1st, 2nd , 3rd and 4th stages of labour. She looks depressed and is mute. She is refusing to eat and her breast are tender to touch.

Consider the following who are involved in the care (Active players)What are the activities to be doneWho will do what (Sharing responsibilities)Reflection

SCENARIO 3Mrs T has delivered a flat baby due to

meconium aspiration. Apgar score at 1 minute is 2/10. Manage baby T

Consider the following who are involved in the care (Active players)What are the activities to be doneWho will do what (Sharing responsibilities)Reflection

SCENARIO 4Mimi a 19 year old girl reports to the

antenatal clinic with history of blurred vision and severe headache. Her blood pressure is 170/120. On admission she starts fitting. How would you manage Mimi

Consider the following who are involved in the care (Active players)What are the activities to be doneWho will do what (Sharing responsibilities)Reflection

Rationale for IPE

IPE

Healthcare

Teamwork

Learning

IMPORTANCE

Framework for Action on Interprofessional Education and Collaborative Practice : WHO : 2010

‘ After almost 50 years of inquiry, there is now sufficient evidence to indicate the IPE enables effective collaborative practice which in turn optimizes health services, strengthens health systems and improves health outcomes.’

WHO : Collaborative Practice Can Improve

• Access to and coordination of health services• Appropriate use of specialist clinical

resources• Health outcomes for people with chronic

diseases• Patient care and safety

WHO : Collaborative Practice Can Decrease:

Total patient complicationsLength of hospital stayTension and conflict among caregiversStaff turnoverHospital admissionsClinical error ratesMortality rates

IPE in PracticeInterprofessional Education in Practice

Interprofessional Education in Practice

Learning Outcomes for IPE

• Teamwork• Roles/Responsibilities• Communication• Learning/Reflection• The Patient• Ethics/attitudes

Thistlethwaite et al 2010 : Learning outcomes for IPE : Literature review and synthesis.

How to Design Effective IPE ?

Designing Effective IPE Key Principles

• The perceived relevance of the learning opportunity

• The perceived demands of the learning context

• The relationship of current learning to prior learning

• The learners’ self concepts

How to Design Effective IPEBe aligned with anticipated participants’ current

concerns, priorities, knowledge and expertise.

Respect participants’ self concepts as successful learners and members of particular professions

Restrict itself to a manageable level of diversity so that everyone can contribute and gain from IPE

Aim to challenge learners in a supportive way that guides and scaffolds their learning, adjusting the level of challenge as experience and confidence grows.

Management of Interprofessional Groups

Encourage learning from one anotherEnsure adequate, diverse and equal mix Topic is of relevance to all participantsUse knowledge, skills and expertise of all

participantsDo not let one group dominate ideasChallenge stereotyping and negative views

The Contact HypothesisThe Contact Hypothesis

The Contact Hypothesis

Each group should have equal status. Interaction should be conducted in a co-operative atmosphere. Participants should be working towards common goals and experience

successful joint working.The Authorities should support the initiative.Participants should be made aware of group similarities and group

differences.Participants should have positive experiences.Participants from different groups should perceive one another as typical

members of their group.

What Makes a Good Facilitator ?

Self aware and open minded attitudeGood communication skills, listening, use of

diffusing languageQuestion ChallengeBalance discussionLearn within groupAppropriate learning resource

CtBuild in diversity: Insensitivity and bias to be

avoidedKeep the group on track and manage

dynamicsBe mindful of power to ensure equalityCreates a safe spaceHandles negative behavior immediatelyPromotes transformation as experience is

used during the teachingHas caring attitudeProvides effective feedback

CtPersonal emotional controlFacilitates reflectionCriticize ideas not peopleHas every one can learn spirit

MODELS TO EMBRACE DIVERSITYRecognize the situation Express yourself Speak up!Acknowledge underlying feelings of

frustrationClarify reasons for the commentTalk meaningful interventions

CtHalt discussion and consider the comment,

reflect on itEngage with the issue, discuss, observe

behaviourAllow trade opinions people to express their

thoughtsLearn: Listen and learn from other people’s

experiencesSynthesis: Why is this discussion matter, how

did this process of discussion work

CtDiversity should be included: Teaching

resources and modes of assessmentCultural humility crucial

Your own scenarioIn your teams develop a short scenario based

on your own clinical experience

Who were are active playerWhat were the tasksHow was responsibility sharedWhat were the leadership qualities you used

in your team?

What are Challenges of IPE ?

Challenges of IPE

Differences in language and jargonDifferences in schedules and professional routinesVarying levels of preparation, qualifications and

statusDifferences in requirements, regulations and norms

of professional educationFears of diluted identityConcerns regarding clinical responsibility.

Headrick LA, Wilcock PM, Batalden PB (1998) Interprofessional Working and Continuing Medical Education. BMJ 316((7133): 771-4.

The Challenges of IPE

Develop and IPE Session

QUESTIONS