Kesinambungan belajar berbasis IPE pada tahap akademik dan penerapannya pada tahap profesi Diantha Soemantri Koordinator Kurikulum Terintegrasi Rumpun Ilmu Kesehatan Universitas Indonesia “ It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be interprofessional “ (WHO, 2010, p.36) PRESENTATION OUTLINE Main concepts of IPE IPE in academic stage (current implementation) IPE in profession stage (future plan) MAIN CONCEPTS OF IPE The need for an interprofessional education Educational and Health System according to WHO (2010) Collaborative practice Perbaikan patient care & safety Perbaikan outcome pada pasien penyakit kronik Peningkatan kepuasan pasien Penurunan angka clinical error Compliance terhadap terapi yang lebih baik WHO (2010). Framework for Action on Interprofessional Education and Collaborative Practice Interprofessional education Sargeant (2008): “Contact … is not enough to build an effective team. Teamwork is a sophisticated social activity requiring cognitive (knowledge), technical (skills), and affective (attitude) competencies and education for developing these” How to organize an interprofessional education Components of Interprofessional Education Program (WHO, 2010) “International environmental scan” Only 38% reported that IPE is MANDATORY Only 66% reported that the students know the LEARNING OBJECTIVES of IPE program Only 37% reported that the learning objectives are ASSESSED Only 31% reported that there is a TRAINING for staff involved in IPE program 30% reported that IPE program is not EVALUATED Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91 Current implementation IPE IN ACADEMIC STAGE in Universitas Indonesia… • A learning module in which students sit together listening to the same lecture or reading the same book is not adequate Multiprofessional education • Informally, students can interact with each other in this module, most probably superficially in Universitas Indonesia… • Therefore, multiprofessional education must be accompanied with interprofessional education • Interprofessional education specifically aims to equip students with the ability to collaborate and work in a healthcare team effectively in Universitas Indonesia… Medicine Public health Nursing Health sciences Dentistry Pharmacy • Resource sharing • Efficiency of resource use • Closer relationship and more effective communication between professions • Added competency: the ability to collaborate and work in a team in providing health care services Structure of Health Sciences Faculties curriculum Study program (profession specific) modules Faculty compulsory modules University compulsory modules Multiprofessional & interprofessional learning modules Shared learning modules COMPETENCY MODULE CREDIT (in SKS) Ethics and Law Ethics and law in health profession 2 Basic biomedical sciences Basic biomedical sciences 3 (theory) + 1 (practical) Communication Effective communication in healthcare services 2 Disaster management Disaster Management 2 Research Research IPE Teamwork and collaboration of Teamwork and collaboration of healthcare team healthcare team (preclinical and clinical) MPE 3 2 (preclinical) + 1 (clinical) Interprofessional competency domains in the “Teamwork & Collaboration of Healthcare” Module Universitas Indonesia (2013) Canada (2010) IPEC (2011) Group dynamics Interprofessional communication Interprofessional communication practices Concept of collaboration and healthcare service system Patient/client/family/comm Roles and responsibilities unity-centred care Conflict management Role clarification Values and ethics Interprofessional communication & leadership Team functioning Interprofessional teamwork & team based practice Roles of each profession Collaborative leadership Obstacles & strategies for interprofessional collaboration Interprofessional conflict resolution Module: Teamwork and collaboration of healthcare team Teaching methods – – – – – Introductory lecture Collaborative learning Question based learning Case based discussion Plenary presentation Assessment system • • • • Self reflection Tutor & peer assessment Written exam (in group) Group project 80 70 60 50 40 30 20 10 0 Input from students: “Continuity of program from academic to professional stage” “Real world application of interprofessional collaboration principles” hospital? community? 5.75 5.88 30.47 30.48 37.68 38.27 Pre-module Post-module Roles and responsibilities Professional identity Teamwork and collaboration Mean score comparison of RIPLS (Readiness for Interprofessional Learning Scale) in year 1 Health Sciences students Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague Future Plan IPE IN PROFESSION STAGE 1 ROLE MODEL • Interprofessional team in hospitals/clinics • Examples of interprofessional collaborative practice in hospitals/clinics • Healthcare practitioners understand the roles of each profession, and aware of the importance of interprofessional, collaborative healthcare services • Minimizing negative stereotyping and hierarchy of profession 2 INSTITUTIONAL SUPPORT • Adjustment of the curriculum • Time allocated for interprofessional education • Allocation of human and physical resources, including a number of main/affiliated hospitals, satellite/family clinic, community health centers, etc. • Training for teaching staff 3 ORGANIZATION • Module management • Organization of a high number and diverse students and teachers • Individual preparedness: students, teachers • Student-centered active learning Some examples of IPE in profession stage (pre-qualification stage) • Guest et al (2002) – Interprofessional placement – Pediatric ward in a large teaching hospital – 90 senior nursing students, 90 junior medical students ‘buddied’ – Discuss and reflect students’ ward-based interprofessional learning experiences Some examples of IPE in profession stage (pre-qualification stage) • Van der Horst et al (1995) – Interprofessional community placement – Medicine, nursing, occupational therapy, physiotherapy, social work – Activities: observation of community interprofessional health teams, interviews with local community experts, interviews with the users of community health services Some examples of IPE in profession stage (pre-qualification stage) • Ker et al (2003) – Simulated ward environment in a clinical skills centre – Medical and nursing students interprofessional teams – Responsibility for the ward for a shift prepare a joint report discuss and receive feedback from tutors the way forward… • Designing an instructional design for IPE program in professional (pre-qualification) stage by an interprofessional teaching team – – – – Explicit learning objectives Relevant activities Valid assessment methods Feasible timing • Formation of interprofessional team of students – Medicine, nursing, dentistry, pharmacy and public health – 1 group 10 students max? the way forward… • Choices of placements: – Community placement • Students are given a patient/family who needs an interprofessional healthcare approach, that they have to monitor and intervene during a particular period – Clinical ward placement • Students team-up to observe and experience an interprofessional approach in treating patients in the ward – Simulated ward environment • Similar to the clinical ward placement, but in a simulated environment simulated patients. More opportunities for hands-on experience the way forward… • In each placement: – Tutors’ guidance and supervision – Discussion and reflection upon the experiences – Tutor assessment and feedback – Peer assessment and feedback • Evaluation (program) – Level 1: students, teachers satisfaction – Level 2: students’ learning achievement to sum up…. • IPE is a must, preferably both at academic and profession stage (continuum of the early and advanced stage of education) • Classroom-based teaching main activities at the academic stage • Community/hospital ward placement main activities at the profession stage • Specifically at the profession stage: IMPORTANT not only the instructional design of the IPE program, but also the ROLE MODELING from healthcare practitioners References • • • • • • • • • • Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework. February 2010. Guest C, Smith L, Bradshaw M & Hardcastle W (2002). Facilitating interprofessional learning for medical and nursing students in clinical practice. Learning in Health and Social Care 1: 132-138 Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core competencies for interprofessional collaborative practice: report of an expert panel. Washington, DC. Interprofessional Education Collaborative. Ker J, Mole L & Bradley P (2003). Early introduction of interprofessional learning: a simulated ward environment. Medical Teacher 37: 248-255 Modul Kolaborasi dan Kerjasama Tim Kesehatan. Rumpun Ilmu Kesehatan, Universitas Indonesia, 2012 Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91 Sargeant J, Loney E & Murphy G (2008). Effective interprofessional teams: “contact is not enough” to build a team. Journal of Continuing Education in Health Professions 28(4):228-234 World Health Organization (2010). Framework for action on interprofessional education and collaborative practice. Geneva: WHO Press Van der Horst M, Turpie I, Nelson W et al (1995). St Joseph’s Community Health Centre model of community-based interdisciplinary health care team. Health and Social Care in the Community 3: 3342 Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague