INTERPROFESSIONAL
LEARNING OBJECTIVES
FOR
STROKE CARE
INTRODUCTION
Supporting Interprofessional Education
through
Shared Learning Opportunities
APRIL 2007
Interprofessional Learning Objectives for Stroke Care Introduction
© 2007, Heart and Stroke Foundation of Ontario and Hamilton Health Sciences.
All rights reserved. No portion of this resource may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise without prior written
permission from the Heart and Stroke Foundation of Ontario and Hamilton Health
Sciences.
Published by:
Heart and Stroke Foundation of Ontario
2300 Yonge, Street, Suite 1300
P.O. Box 2414
Toronto, ON M4P 1E4
Tel: 416-489-7100; Fax: 416-489-6885
E-mail: heartandstroke@hsf.on.ca
www.heartandstroke.ca
This resource was prepared with input from a number of health professionals
who have reviewed the information to ensure its suitability. However, the
information contained herein is for reference only and should not be relied upon
exclusively.
The Heart and Stroke Foundation of Ontario and Hamilton Health Sciences and
other contributing organizations and health professionals assume no
responsibility or liability arising from the reader’s failure to become informed
about the practice guidelines applicable to their area or profession. In addition,
the Heart and Stroke Foundation of Ontario and Hamilton Health Sciences
assume no responsibility or liability arising from any error in or omission from this
publication or from the use of any information or advice contained in this
publication. No endorsement of any product or service is implied if other
agencies or persons distribute this material.
Funding for the development of this Guide was provided by the Ministry of Health
and Long-Term Care and the Heart and Stroke Foundation of Ontario. The
development and pilot testing phases of the project were completed by the
Regional Stroke Program of Hamilton Health Sciences, in Central South Ontario.
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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Why would the Interprofessional Learning Objectives for Stroke Care be of
interest to you?
•
If you are a registered health professional working with stroke survivors who
wishes to identify what knowledge, skills, attitudes, and values are important
to the provision of best practice stroke care…
OR
•
If you are interested in identifying learning areas of interest/priority that may
inform a professional development learning plan or interprofessional team
learning activity…
OR
•
If you are an educator with interest and/or responsibility for providing
continuing education for staff who work with stroke survivors…
OR
•
If you are a manager of health care services that provide care to stroke
survivors and support continuing education and interprofessional education in
your program…
…you may find the Interprofessional Learning Objectives for Stroke Care Tools
essential to guiding your personal learning and continuing education activities.
The objectives of the Interprofessional Learning Objectives for Stroke Care
resource are to:
• Give healthcare professionals working with stroke survivors a framework for
learning.
• Establish guidelines for knowledge and skill development related to stroke
care for all eight regulated health professionals.
• Form the foundation for learning plans for ongoing individual professional
development.
• Support self-directed learning.
• Support interprofessional education and collaborative practice through shared
learning opportunities.
• Support knowledge translation and the integration of best available evidence
into practice.
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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A number of tools have been developed to assist individual practitioners and
clinical teams, educators and managers with using the Interprofessional Learning
Objectives for Stroke Care. For more information on the development of the
learning objectives, the process undertaken, evaluation findings and
recommendations, see the Interprofessional Learning Objectives for Stroke Care
Report.
The tools include:
•
•
•
•
•
Shared Learning Objectives
Discipline-Specific Learning Objectives
Self-Evaluation Tool: an assessment tool to help users gauge their progress
in each learning area.
Learning Plan Template: a tool for tracking/monitoring CE activities and
informing managers of educational goals.
PowerPoint Presentation: provides an overview of the project, the Learning
Objectives, and recommendations for use based on the pilot experience.
Intended to assist educators or identified facilitators with introducing the
resource to clinical teams and key stakeholders.
All of these tools are available at www.heartandstroke.ca/profed .
SECTION 1: INTRODUCTION
The Interprofessional Learning Objectives for Stroke Care are learning objectives
related to stroke across 16 key learning areas and relevant to eight regulated
health disciplines. The Shared Learning Objectives identify the knowledge,
skills and values that are important to all health professionals who provide care to
stroke survivors in various settings across the continuum of care, regardless of
discipline. The Discipline-Specific Learning Objectives identify the knowledge,
skills and values that are important for each of the health professions. The eight
professional groups include: nursing, physiotherapy, occupational therapy, social
work, speech-language pathology, registered dietetics, registered respiratory
care and pharmacy.
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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The shared and discipline-specific learning objectives were developed across 16
Learning Areas related to stroke care:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Principles of Stroke Care
Anatomy and Physiology of Stroke
Cardiovascular and Respiratory Effects
Psychosocial Effects
Communication
Independence in Mobility and Prevention of Complications of Immobility
Routine Activities of Daily Living
Instrumental Activities of Daily Living
Cognitive, Perceptual and Behavioural Changes Following Stroke
Sexuality
Nutrition
Dysphagia
Skin Care
Continence Management
Primary and Secondary Stroke Prevention
Transition Management
SECTION 2: SHARED LEARNING OBJECTIVES FOR STROKE CARE
Shared learning objectives for stroke care are core learning objectives that are
intended to articulate the knowledge, skills and value base that is important to all
health professionals working with stroke survivors across the continuum,
regardless of discipline. These shared learning objectives form the foundation for
the development of discipline-specific learning objectives for regulated health
professionals.
This section provides a description of each of the 16 learning areas related to
stroke care as outlined above.
See Shared Learning Objectives for Self-Evaluation Tool to review the specific
shared learning objectives.
Learning Area 1: Principles of Stroke Care
Description
• Rehabilitation defined: impairment, activity and participation
• Enablement: principles and practice
• Client -centered care: principles and practice, setting client-centered goals
• Evidence-based practice
• Interdisciplinary team models
• Cultural competency
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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Learning Area 2: Anatomy and Physiology of Stroke
Description
• What is stroke
• Assessment and diagnostics
• How stroke affects the body: functions controlled by the brain
• Common effects of stroke
• Basics of medical management: medications, co-morbidities (e.g.,
hypertension, diabetes)
Learning Area 3: Cardiovascular and Respiratory Effects
Description
• Impact of stroke on cardiac and respiratory systems
• Cardiac conditioning
• Airway management
Learning Area 4: Psychosocial Effects
Description
• Initial reaction
• Common emotions experienced post-stroke
• Psychosocial issues faced by the stroke survivor and his/her caregiver
• Caregiver coping
• Depression and emotional changes post-stroke
• Social support programs (e.g., funding, caregiver relief)
Learning Area 5: Communication
Description
• Specific communication impairments: speech (apraxia, dysarthria), language
(aphasia), social interaction impairments, cognitive-communication deficits
• Communicating with a stroke survivor
• Essential characteristics of successful communication partners
• Post-stroke problems that make communication difficult
• Communication strategies (e.g., alternative/ augmentative strategies to
enhance communication ability)
Learning Area 6: Independence in Mobility and Prevention of
Complications of Immobility
Description
• Positioning
• Handling
• Moving the stroke survivor
• Functional mobility: transfers, wheelchair, bed, stairs
• Adaptive devices
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Learning Area 7: Routine Activities of Daily Living
Description
• Grooming: set up, physical guidance, encouraging use of the affected limb,
cueing, encouraging effort
• Bathing: assistive devices, set up, transfers
• Dressing: positioning, set up, cueing and guiding, adaptive devices and
clothing
• Toileting: using a commode, assistive devices
• Feeding and eating: positioning and assistive devices
• Environmental assessment/adaptations
Learning Area 8: Instrumental Activities of Daily Living
Description
• Financial management, banking
• Shopping
• Household management
• Meal preparation
• Medication management
• Driving, community mobility, reintegration
• Returning to work or leisure activities
• Environmental assessment/adaptation
Learning Area 9: Cognitive, Perceptual and Behavioural Changes Following
Stroke
Description
•
•
•
•
•
•
•
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•
•
•
•
•
Cognition defined
Attention and concentration impairments
Memory impairment
Executive functioning impairments
Impulsivity
Impaired insight and judgment: what you can do to help
Perseveration, inability to sequence and impaired problem-solving ability
Apraxia
Visual/perceptual problems: time awareness, visual and auditory neglect,
body neglect, body processing, body scheme neglect and apraxia
Vision problems
Changes in personality
Loss of emotional control, withdrawal, aggression, amotivation, frustration,
social judgment, confusion, disinhibition, uncooperative behaviour
Safety issues
Learning Area 10: Sexuality
Description
• Sexuality defined
• Changes in sexuality and relationships post stroke
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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•
Sensitivity to allow discussion of issues related to sexuality
Learning Area 11: Nutrition
Description
• Reducing the risk of dehydration and malnutrition after stroke
• Alternative feeding methods
• Therapeutic diet
Learning Area 12: Dysphagia
Description
• Dysphagia: defined
• Feeding strategies: proper positioning of the stroke survivor
• Reducing the risk of aspiration
• Dysphagia diet
• The importance of dental/oral hygiene
• Education regarding risks and dysphagia management
Learning Area 13: Skin Care
Description
• Risks of skin breakdown
• Preventing skin breakdown
Learning Area 14: Continence Management
Description
• Normal bladder/bowel function and age-related changes that affect
continence
• Continence problems
• Symptoms of bladder/bowel dysfunction
• Incontinence due to cognitive, language and mobility problems
• Psychosocial reaction to incontinence
• Bladder retraining/bowel management
• Reducing the risk of urinary tract infections
Learning Area 15: Primary and Secondary Stroke Prevention
Description
• Primary stroke prevention
• Secondary stroke prevention
• Five main warning signs of stroke
• Transient ischemic attacks
• Risk factors for stroke
• Lifestyle modification to prevent stroke: healthy eating, smoking cessation,
exercise
Learning Area 16: Transition Management
Description
• Transition management
• Stroke survivor care needs and the discharge planning process
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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•
•
Facilitating effective transitions along the continuum of care
Community services
SECTION 3: DISCIPLINE-SPECIFIC LEARNING OBJECTIVES FOR STROKE
CARE
Discipline-specific learning objectives were developed for 16 learning areas that
are important for eight regulated health professions working with stroke survivors
across the continuum. The professions, in alphabetical order, are:
• Nursing
• Occupational Therapy
• Pharmacy
• Physiotherapy
• Registered Dietetics
• Respiratory Therapy
• Social Work
• Speech-Language Pathology
Table 1 presents an overview of the interdisciplinary learning objectives for
stroke care by each of these regulated professions.
See Discipline Specific Self-Evaluation Tools to review the discipline specific
learning objectives.
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Table 1: Overview of Interprofessional Learning Objectives for Stroke Care by Regulated Profession
Learning Area
Nursing
Occupational
Therapy
Pharmac
y
Physiotherapy
Registered
Dietetics
Respiratory
Therapy
Social
Work
1. Principles of Stroke Care
No
No
No
No
No
No
No
SpeechLanguage
Pathology
No
2. Anatomy and Physiology of
Stroke
3. Cardiovascular and Respiratory
Effects
4. Psychosocial Effects
5. Communication
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
6. Independence in Mobility and
Prevention of Complications of
Immobility
7. Routine Activities of Daily
Living
8. Instrumental Activities of Daily
Living
Yes
Yes
No
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
9. Cognitive, Perceptual and
Behavioural Changes Following
Stroke
10. Sexuality
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
11. Nutrition
Yes
Yes
No
Yes
Yes
No
Yes
Yes
12. Dysphagia
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
13. Skin Care
14. Continence Management
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
Yes
Yes
No
15. Primary and Secondary Stroke
Prevention
16. Transition Management
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Interprofessional Learning Objectives for Stroke Care Introduction, 2007
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SECTION 4: TOOLS
Self-Evaluation Tool
The Self-Evaluation Tool incorporates all of the learning objectives across the 16
learning areas into one document.
There is a modifiable Self-Evaluation Tool for the Shared Learning Objectives
and one for each discipline for the Discipline-Specific Objectives. Individuals or
groups may print only the learning areas of interest to simplify the process and
time to complete. The tool is available at www.heartandstroke.ca/profed and can
be modified.
The Learning Plan Template
The results of the self-evaluation will enable professionals to identify their
learning needs and incorporate these into a learning plan. Using this learning
plan, individual professionals can regularly review their learning activities and
progress. This can be done in collaboration with an expert resource person, such
as a mentor/preceptor, educator, or clinical lead where possible.
Learning Plans may be incorporated into established evaluation activities, for
example, linked with professional college requirements, peer mentoring activities
and organizational learning evaluation processes.
The Learning Plan Template is available at www.heartandstroke.ca/profed .
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