Multiprofessional medical education

Experience and future development

at KAROLINSKA INSTITUTE, Stockholm

Sweden

Anna Kiessling, MDHead at Centre for Clinical EducationDanderyd University Hospital

Why interprofessional teamwork?

• Paradigm shift in clinical care

• Results in more comprehensive and ”sensible” clinical desicions

• Results in mutual learning

Kiessling A, Participatory learning – a swedish perspective. Heart (2004)

“The KI history of Interprofessional Education”

• 1997 - Merge of Karolinska Institute and the former Stockholm College of Health Sciences

• 1998-2001 - “The Centre of Clinical Education project” at the four major hospitals with clinical education in Stockholm

• 2002 Centre of Clinical Education become permanent units at all four hospitals

Aims

• To bridge professional borders - aiming at an interdisciplinary view of clinical education

• To co-ordinate undergraduate studies and clinical reality

• To combine education in primary and secondary care

• To further integrate theoretical and practical knowledge

Cornerstones

• Clinical Education Ward (or Educational Open Clinic)-learning by working together

• Clinical Training Centre-specially equipped unit for training of manual, communication and collaboration skills

• Faculty for interprofessional teaching -provide meeting and creative energy to create an interdisciplinary view of clinical education

Danderyd UniversityHospital

KarolinskaInstitute

CEW

CTC

Medical libraryUnit for health care

development

SophiahemmetUniversity College

of Nursing

CCE

CPR and ACLS

Interprofessionalfaculty

Director of studiesfor assistant physicians

Coordinator forstudent work placement

in the hospital

Primary Care

Orthopedic ward

Routine clinical setting

Eight patients

Six to seven students

Two teams

Two week rotation

Tutors from all programmes

CEW

The students´object

• To care independently for the patients´ medical treatment, nursing and rehabilitation

• To develop professional competence

• To increase knowledge of other professionals´ competence

• To practice communication and teamwork

Individual professional identity (Median before and after training period

unclear - clear, 0 - 10)Spring 2004

0,01,02,03,04,05,06,07,08,09,0

10,0

Med stud n = 26

PT n = 13

Stud nursen = 45

OT n = 10

Before

After

Individual competence in communication and teamwork

Median before and after training period (0-10; low extent-high extent)Spring 2004

0123456789

10

Med stud n = 26

PT n = 13

Stud Nursen = 45

OT n = 10

BeforeAfter

Student comments”It´s been great with own responsibility and

problembased learning”

”Very rewarding! It strengthens my wish to become a nurse. I made the right decision!”

”It´s so important to co-ordinate the work with the patient and with other professionals and to

have the same goals”

”Communication. How difficult it can be and how wonderful it can be when it works”

”Trust other professions´ competences!”

Student comments”Early mobilisation is very important!”

”It has been unbelievable pleasant, fun, instructive, messy and sometimes stressful. Great to work with other professions”

”I learned a lot about other professions and realized that we complement each other very well. We became true friends”

”I felt like a real doctor for the first time”

”I dared to be responsible”

”I got an increased self confidence”

Outcome levels in clinical educational reseach and development

Educational process(attitude, satisfaction)

Knowledge(perceived or objectively examined)

Behaviour(perceived or objectively measured improvement of behaviour)

Quality of care at patient level

Kiessling A, Henriksson P. BMJ 2002;325:877-880

Key notes in interprofessional teamwork

• Language

• Knowledge

• Communication

• Aim

Conclusion

Learning by working together is an efficient method to increase collaborative and professional

competence

Future trends at KI

• Interprofessional education and teambuilding for tutors in the work place

• To reach a balance between:

Competence separation

Competence integration