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Strategies for Integration of IPE into Didactic and Clinical Education Anthony Breitbach PhD, ATC Saint Louis University Missouri Athletic Trainers Association 5th Annual Educators and Athletic Training Student Leadership Conference


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Strategies for Integration of IPE into Didactic and Clinical Education

Anthony Breitbach PhD, ATC Saint Louis University

Missouri Athletic Trainers’ Association 5th Annual Educator’s and Athletic Training Student Leadership Conference Fayette, Missouri - February 4, 2017

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Learning Objectives

  • At the end of this presentation, participants

will be able to:

– Describe how IPE prepares athletic trainers for collaborative patient-centered care. – Describe how inclusion of Athletic Training faculty and students can enhance IPE initiatives. – Describe specific examples of how Athletic Training programs have included IPE into the professional preparation of their students.

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Definition of IPE

  • “Interprofessional education (IPE) occurs

when students (learners) from two or more professions learn about, from, and with each

  • ther to enable effective collaboration and

improve health outcomes” (WHO, 2010)

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Individual Clinical Skills Effective Teamwork Skills

Consistent Quality Outcomes

Factors Impacting Outcomes

Effective Systems & Processes

SOURCES: SLU Model of Interprofessional Practice. Pole, D. Rottnek, F. 2014 Riley, et.al. 2010, Journal of Nursing Management 18, 556-563

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Definitions of IPCP

  • Interprofessional Collaborative Practice (IPCP) helps strengthen

the health care system and improves outcomes

  • When multiple health workers from different professional

backgrounds work together with patients, families, care givers, and communities to deliver the highest quality of care

  • Collaboration-ready members of interprofessional health care

teams are able to optimize the skills of team members, share in care management, and provide better health services to patients and communities – become change agents

SOURCE: WHO Framework for Action on Interprofessional Education & Collaborative Practice , 2010

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WHO Framework for Action

  • 3 levels of implementation

– Advancing IPE for improved health outcomes. – Advancing IPCP for improved health outcomes. – Supporting IPE and IPCP at the systems level

SOURCE: WHO Framework for Action on Interprofessional Education & Collaborative Practice , 2010

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WHO Framework for Action

  • Wide range of

stakeholders

– Patients/clients – Health professionals – Researchers – Administrators – Government officials – Communities

  • Levels of Engagement

– Contextualize – Commit – Champion

SOURCE: WHO Framework for Action on Interprofessional Education & Collaborative Practice , 2010

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IPEC Core Competencies & Collaboration Ready

  • Focus on transformation of health professions

education

  • Interactive learning outside one’s profession

(about, from, with)

  • Prepare health professions for deliberate work

together to improve care and outcomes

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Interprofessional Collaborative Practice Competency Domains

SOURCE: Interprofessional Education Collaborative (IPEC) Expert Panel. Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington DC: Interprofessional Education Collaborative; 2011.

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Learning Continuum

SOURCE: Owen and Schmitt, 2013. The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

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IPCP in AT

  • AT’s have been engaged

in IPCP for decades.

  • The traditional

Intercollegiate Athletic Health Care facility functions like a Patient Centered Medical Home.

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Professional Socialization

  • AT students often do not know where they “fit”.

– Their professional preparation and practice standards are that of health care providers. – They identify with the coaches and athletes with whom they interact daily. – Unless this conflict is resolved, it will carry on into clinical practice. – Peer professions are socialized as health care providers beginning with their admission process to their programs.

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Interprofessional Pedagogy Matrix

Time/Resource Demands Intra-curricular Extra-curricular LOW IPE Competencies Included in Individual Program Courses One-time Interprofessional Workshop or Orientation IPE Modules Embedded into Individual Program Courses Interprofessional Grand Rounds Sessions Cross-listed Courses with IPE Content Interprofessional Simulation Activities MEDIUM Single IPE-prefix Introductory Course Regularly Scheduled Seminars, Workshops, etc. Multiple IPE-prefix Core Content Courses Interprofessional Capstone Projects, Portfolios, etc. Academic Curriculum Including Practicum Mentored Interprofessional Service Learning Activities HIGH Academic Concentration, Major or Minor Established Clinical Practice Utilizing IPP Teams

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IP Team Seminar (IPTS)

  • Separate experience at

the post baccalaureate level.

  • Six team sessions with

faculty facilitator

– Same core experiences – Maps objectives to activities and IPEC Competencies – Applied, experiential, shared learning, critical reflection, application to clinical experiences

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IPE 1100 – Introduction to Interprofessional Health Care

Designed to provide students in health care professional programs with introductory knowledge of interprofessional teamwork within an evolving health care system.

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Teamwork Communication and collaboration Roles and responsibilities Health literacy Evidence based

Course Objectives

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Teaching Team Goals

  • Leverage technology to

decrease instructional support demands

  • Create structure where

students get guidance and practice using teamwork skills

  • Focus on team activities

in class and individual work outside of class

  • “Walk our talk” through

team teaching

  • Design course to

explicitly communicate schedule and course expectations

  • Emphasize interaction

through a relevant learning continuum

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Organization

Class Plans:

  • Serve as a guide to the learning activities and assignments

for the class and will be available for most class sessions

Blackboard:

  • This course will utilize Blackboard Learning Management

System.

  • Students are responsible for the content presented on

Blackboard and should view the course Blackboard site frequently for announcements and new postings.

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Communication

Contact IPE Office at ipe@slu.edu for the following issues:

Blackboard problems including inability to access information, difficulty or lack of access to submit assignments, you submitted the wrong assignment, etc. Attendance issues, questions, concerns, or letting us know you will not be in class. Scheduling missed quizzes or exams.

Contact IPE 1100 Course faculty for the following issues:

Course content questions or concerns Issues regarding a grade you received Notification of absence and approvals

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Learning Experiences

In Class Lectures and Activities

  • Lectures, discussions and presentations
  • Team Reports

Out of class Preparation

  • Readings
  • Assignments and project
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Learning Experiences

  • Team Reports:

– Posted on Blackboard before each class session. – Teams download the blank team report, complete as a team, and resubmit on Blackboard electronically at the end of each class session. – Each team member participating that day must be listed on the team report. – Make-up assignment available for missed team reports

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Learning Experiences

  • Individual Assignments

– “My Profession” Assignment – “Interprofessional Grand Rounds” Assignment

  • Instructions

– Posted on Blackboard with instructions regarding the completion and submission of the assignment. – Must be uploaded on Blackboard by the due date posted on the Assignment

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Learning Experiences

  • Team Video Project

– Each team develops a 1 minute video to serve as a “Public Service Announcement” regarding an assigned health topic. – Material presented must be based on scientific research which must be cited in written assignment – SAMPLE VIDEO

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Opening Activity

  • Week 1 Team Report more structured to allow students to get to know

each other and discuss expectations.

  • Team Expectations

– Write a mini-bio for each of your team members: – What do you most have in common? – What are unique attributes that each of you bring to your team? – Respond to the questions below for your interprofessional team in this class:

  • How you will communicate with each other?
  • How you will evaluate if your team is working well together?
  • Course Expectations (list 2 each)

– As STUDENTS….we have the following expectations of this course and the teaching team: – If you were an INSTRUCTOR….we would have the following expectations of the students

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Schedule

CONTENT ACTIVITIES (RD = Readings due before class) Introduction to Course/Meet your Team Team Report in class Interprofessional Education RD: “Cowboys and Pit Crews” Team Report in class Interprofessional Collaborative Practice RD: “The Triple Aim: Care, Health, and Cost” Team Report in class Evidence Based Medicine/Academic Searching Searching Assignment in class

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Evidence Based Searching Assignment

  • Led by Liaison Librarian, designed to introduce academic

searching and use of proper evidence.

– Teams are given their Video Project topics prior to class

  • Team Assignment:

– Teams use PubMed features and tools to efficiently search their topic. – Teams select 3 relevant citations and provide rationales for selecting those citations. – Teams Copy/Paste their search terms and any Filters they used (e.g. English language, publication dates): – For each article, teams copy and paste the citation information (title of article, authors, journal info, etc.) and the abstract in the area indicated.

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Schedule

CONTENT ACTIVITIES (RD = Readings due before class) Health Professional’s Roles and Responsibilities RD: “Expectations and Obligations: Professionalism and Medicine’s Social Contract with Society” Team Report in class Exploring Specific Health Professions My Profession assignment due before class Team Report in class Teamwork and Collaboration RD: “Duke's Coach K: Healthcare Leaders Should Set the Standards, Ditch the Excuses” Team Report in Class Communication RD: “Professional Communication and Team Collaboration” Team Report in class

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“My Profession” Assignment

  • As novice learners, many
  • f the students do not

fully understand their profession.

  • This activity is designed

for them to research their profession that they can present in their team.

  • The in-class session

involves a panel of health professionals/faculty in various professions.

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“My Profession” Assignment

  • The assignment is designed to encourage students to think about

the different health professions, including the one they have selected for your future career.

  • Students use the Occupational Outlook Handbook from the US

Bureau of Labor Statistics found at http://www.bls.gov/ooh/ to answer the following questions about their chosen field of study.

– How does the occupation fit your skills and interests? – What will you be doing in the occupation? – What is the necessary education and/or training? – How many jobs are there in the occupation currently? – Is the occupation projected to grow, decline, or remain unchanged? Why? – How much does this occupation pay? What do the top 10 percent earn? The bottom 10 percent?

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Schedule

CONTENT ACTIVITIES (RD = Readings due before class) Addressing Conflict RD: “The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives.” Team Report in class Health Literacy RD: “Quick Guide to Health Literacy” Review AHRQ Health Literacy Toolkit (link in Blackboard) Team Report in class Teamwork in Health Care RD: “Collaborative Caring: Stories and Reflections on Teamwork in Health Care” Team Report in class

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Medical Readers Theater

  • Honors students read a

medical readers theater script of their choice

  • Discussion and team

report highlights theme

  • f health literacy from

the patient perspective

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Teamwork in Health Care

  • Utilize “Frontline for

Hope” episode, which shows teamwork in action

  • After the video, the

patient, his mother and his Physical Therapist talk about teamwork and the voice of the patient in health care.

http://www.childrensforhope.com

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Schedule

CONTENT ACTIVITIES (RD = Readings due before class) Interprofessional Grand Rounds RD: Review case for Interprofessional Grand Rounds. Advocacy RD: “Narrative and Medicine” Grand Rounds Assignment due before class Video Project Review Video Project Assignment due before class Team Report in class

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Interprofessional Grand Rounds

  • Standardized “parent of a patient” simulates a

meeting of a family member with an interprofessional team of health professionals.

  • Culminating activity where students can see

the basic tenets of the course “in action”.

  • The students then write an individual

structured reflection on the activity.

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Student Outcomes

  • Improved appreciation for person-centered

collaborative health care

  • Increased confidence in collaboration and

teamwork (SACS)

  • Readiness to engage in upper level IPE and

professional coursework

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Learning Activity

  • Design an Opening Activity

– Sets the stage for the teamwork as they move forward in the course – Helps them get to know each other – Helps them understand each other

  • Common interests/traits
  • Unique contributions

– How will they communicate? – How will they be held accountable?

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Learning Activity

  • Design an Simulation Activity

– Write a short scenario that is interactive and authentic

  • What type of roles are needed?
  • Will actors be needed? Can faculty fill roles?
  • Is teamwork demonstrated?
  • Is interaction/conflict possible?

– Develop detailed script for each role. – Develop structured reflection for students

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Learning Activity

  • Design an Culminating Activity

– Develop activity that, by design, requires teamwork to complete the project

  • Needs to be authentic and relevant to the course

content

  • Design for peer review of project in class

– Group paper that presents:

  • Scientific Foundation
  • How Teamwork Involved in Project
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NATA IPEP Interest Group

  • NATA has developed Member Interest Groups

– The NATA IPEP Interest Group is the first! – Based as a LinkedIn group, with a Twitter feed.

  • Provides a structure for:

– Many different groups to have a voice on IPEP. – Dissemination and exchange of information on IPEP. – Advocacy of AT involvement in IPEP initiatives.

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NATA IPEP Interest Group

LinkedIn: https://www.linkedin.com/grp/home?gid=8229902 Twitter: @NATA_IPEP

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Organizations

  • Canadian

Interprofessional Health Collaborative

http://www.cihc.ca/

  • American

Interprofessional Health Collaborative

http://www.aihc-us.org/

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Organizations

  • National Center for

Interprofessional Practice and Education

https://nexusipe.org/

  • Centre For The

Advancement Of Interprofessional Education

http://caipe.org.uk/

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Resources

  • Anderson ES, Thorpe LN. Early interprofessional interactions: does student age matter? J Interprof Care. 2008

Jun;22(3):263-82. doi: 10.1080/13561820802054689.

  • Breitbach AP, Sargeant DM, Gettemeier PR, Ruebling I, Carlson J, Eliot K, Kienstra K, Gockel-Blessing EA. From buy-

in to integration: melding an interprofessional initiative into academic programs in the health professions. J Allied

  • Health. 2013 Fall;42(3):e67-73.
  • Breitbach AP, Richardson R; National Athletic Trainers’ Association Executive Committee for Education;

Interprofessional Education and Practice in Athletic Training Work Group. Interprofessional Education and Practice in Athletic Training. Athl Train Educ J. 2015;10(2):170–182.

  • Interprofessional Education Collaborative Expert Panel (IPEC). (2011) Core competencies for interprofessional

collaborative practice: Report of an expert panel. Washington DC: Interprofessional Education Collaborative.

  • Owen and Schmitt, 2013. The Alliance for Continuing Education in the Health Professions, the Society for

Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  • Pole D, Breitbach A, Howell T. (2015) Using a Real-life Case Scenario to Integrate Additional Health Professions

Students into an Existing Interprofessional Team Seminar. Accepted for publication - Journal of Interprofessional Care.

  • Reeves S, Fletcher S, Barr H, et al. A BEME systematic review of the effects of interprofessional education: BEME

Guide No. 39. Medical Teacher. 2016/07/02 2016;38(7):656-668.

  • Ruebling I, Pole D, Breitbach AP, Frager A, Kettenbach G, Westhus N, Kienstra K, Carlson J. A comparison of student

attitudes and perceptions before and after an introductory interprofessional education experience. J Interprof

  • Care. 2014 Jan;28(1):23-7. doi: 10.3109/13561820.2013.829421. Epub 2013 Sep 3.
  • Thistlethwaite J. Interprofessional education: a review of context, learning and the research agenda. Med Educ.

2012 Jan;46(1):58-70. doi: 10.1111/j.1365-2923.2011.04143.x.

  • WHO. (2010) Framework for Action on Interprofessional Education and Collaborative Care. Geneva: World Health

Organization.

  • Zorek J, Raehl C. (2013) Interprofessional education accreditation standards in the USA: A comparative analysis.

Journal of Interprofessional Care, 27:123–130

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Acknowledgements

  • I would like to recognize Dr. Leslie Hinyard, Dr.

David Pole, Dr. Katie Eliot and Eileen Toomey from Saint Louis University for their assistance.

  • The author reports no conflict of interest in

this presentation.

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Questions?

  • Anthony Breitbach PhD, ATC

breitbap@slu.edu http://ipe.slu.edu