A Model for Interprofessional Education
Through Case Study Roles
Dianne Cameron, PhD
Collaborative Health Initiatives
Faculty of Science & Engineering
Northern Health Research Conference
Timmins, June 4-6, 2015
Conflict of Interest Declaration:
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Presenter:
Dianne CameronNothing
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Title of Presentation:
A Model for Interprofessional Education
Through Case Study Roles
I have no financial or personal
relationships to disclose
Introduction
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IECPCP:
“interprofessional education for collaborative patient-centred care”
(Health Canada. Interprofessional Education for Collaborative, PatientCentred Practice. Discussion Paper & Research Report Request for
Proposal. October 2003)
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Interprofessional Education:
“occasions when two or more professions learn from and about each
other to improve collaboration and the quality of care”
(Centre for Advancement of Interprofessional Education (CAIPE), 1977,
revised)
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Collaboration:
“an interprofessional process of communication and decision-making
that enables the separate and shared knowledge and skills of health care
providers to synergistically influence the client/patient care provided”
(Way & Jones, 2000)
Introduction …
Interprofessional education (IPE) leads to
interprofessional care (IPC)
How do we get there?
Many valid ideas: short courses, seminars,
workshops, focus groups, …
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A quick search on Health Canada finds >10,000 references on IPE/IPC
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How to prepare large numbers of students in many educational
programs/disciplines for fulfillment of interprofessional practice in
their professions ???
Relevant IPE/IPC issues:
excerpts from IECPCP report
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Little literature for educators on facilitating IPE: urgent need for
faculty development
Evaluation methods for program and student assessments
relevant to IPE are needed
Most successful collaborative practice initiatives were in service
or mixed settings (92%), rarely in higher education settings (7%)
Opportunities for IPE in transcultural perspectives are lacking or
inadequate in most professional programs and do not address
how to provide culturally sensitive care
Learners entering their training programs already have preexisting stereotypes developed about other health professionals
IPE/IPC issues from IECPCP report…
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Professional schools should include clinical experiences where students
from different professions work collaboratively in teams providing care
to culturally diverse populations.
Students in health care need to be aware of the contributions of all health
care providers, particularly non-traditional health care providers, and
how to work more collaboratively with them.
An interprofessional collaborative approach among professionals, health
care providers (traditional/non-traditional) and the community is
desirable and possibly the only feasible way in which health care can be
delivered in Canada's northern native communities and remote settings
Successful implementation of interprofessional education will require
both individual and collective learning
Challenges for undergrad IPE
Incorporation of IPE into undergraduate curricula has been slow,
and faces numerous challenges:
•
Professional programs need to focus on discipline specific
education
•
Little room in busy timetables for IP courses
•
“Silos” remain intact in many institutions
Administrative support is lacking
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Courses not shareable across disciplines
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Faculty assigned to one department or one program, one
instructor per course
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Class times & clinical time across programs conflict
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No “credit” for extra-curricular IPE
Examples: Possible
Interdisciplinary Courses
Interdisciplinary Pathophysiology
Clinical Research Methods in Interdisciplinary Practice
Interprofessional Practice and Cultural Competency
Interprofessional Practice and Patient Care
Common Elements:
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Team taught – instructors from various disciplines, faculties,
institutions
Case based, patient centred
Combination of individual learner and team projects
Students from different disciplines
Health care role exploration and role play
Pathophysiology
- Interdisciplinary Practice
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Uses the vehicle of common subject material in
pathophysiology, illustrated in patient case studies
Stresses a team approach to patient care to integrate
learners from different professional disciplines
Case studies explore a variety of episodic and complex
health challenges from an individual, family and
community perspective, cultivating an understanding of
interprofessional practice
Team taught by faculty from radiation therapy, oncology,
midwifery, neuroscience, human biology, radiology,
nursing, forensic science… some from Laurentian, some
from Hôpital régional de Sudbury Regional Hospital
Pathophysiology - Interdisciplinary
Practice…
Example Learner Activities (individual and team work):
• Each student is assigned a preliminary case study patient
and a health care role NOT matching his/her discipline
• Stage I case study report includes researching the role,
scope of practice, licensure, interaction with patient, case
based questions on pathophysiology, patient background
• Stage II case study – identifies classmates with different
health care roles sharing same patient; team must pool
information and submit joint case report
• Stage III case study – includes pathophysiology lab with
tests/exploration related to each case
• Final Health Care Team report & oral presentation
Case Studies & Roles
Patient 1
Patient 2
Patient 3
Nurse Practitioner
Paramedic
Optometrist
Pathologist
Radiologist
Respiratory Therapist
Parasitologist
Emergency Physician
Chiropodist
Laboratory Technician
Dietician
Pharmacist
Social Worker
X-ray Technician
Family Physician
Nurse
Home Care Worker
Clinical Dietician
Aboriginal Elder
Physiotherapist
Lab Technician
Case Studies & Roles…
Patient 1, Mr. Minto
Patients 2, Gauthier
brothers
Patient 3, Annie
Armstrong
Aboriginal Cree trapper
near Hornepayne, pain in
Fragile elderly bachelor
brothers on farm near
Verner, attacked by rabid
cow & trapped on shed
roof, speak no English
Morbidly obese former
logging camp cook with
skin & visual problems,
sleep disturbance, always
hungry & thirsty
right side below the rib
cage, dark coloured urine,
reluctant to seek medical
help
Case Studies & Roles…
Patient 4
Patient 5
Patient 6
Nurse Practitioner
Oncologist
Obstetrician /Gynecologist
Social Worker
Radiation Therapist
Genetic Counsellor
Endocronologist
Naturopath
Spouse
Bariatric Surgeon
Clinical Psychologist
Midwife
Psychiatrist
Oncology Nurse
Ultrasound Technician
Nurse
Health Care Chaplin
Dietician
Case Studies & Roles…
Patient 4, Annie
Armstrong (2)
Patients 5, Mike Periera
Patient 6, Janet Simmons
Enters program for
bariatric surgery for
weight loss
Heavy smoker with
emphysema, now
terminal lung cancer;
palliative case
Pregnant in an isolated
rural area, lost previous
child to genetic disorder;
healthy but fearful
Measuring Effectiveness
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Each course uses an entry/exit assessment tool to
evaluate changes in knowledge and awareness of
IPE/IPC by students who have completed the course
Participating course instructors are asked for input
before, during, and after course completion
Students complete a course evaluation at the end of
each course
Final team case reports includes students’ evaluation
of pros/cons of IPC, IPE & what they learned
Still needed: longer term tracking to evaluate effect of
undergraduate IPE on patient outcomes in
professional practice
Measuring Effectiveness…
Student questionnaire responses on entry / exit
Measuring Effectiveness…
Three most changed responses from entry to exit
Measuring Effectiveness…
Sample from one team’s final report..
“We have learned that having a patient-centered health care team is essential in the
diagnosis and treatment of a patient. Each part of the team, whether or not they
actually interacted with the patient, played a part in Mr. Minto’s care and if one
was missing we could not have made our diagnosis. Working as a team allows each
person to focus on their job and be an expert in their field so that the patient
receives the best care possible. Health care team members whether they are nurse
practitioners, experts, or social workers seek out, and rely upon collaborative
interaction with each other to ensure that their patients receive effective and
seamless care. Care that is truly patient-centered considers patients’ cultural
traditions, their personal preferences and values, their family situations, and their
lifestyles. It makes the patient and their loved ones part of the care team. Overall,
using a team health care approach allowed for the best possible care for Mr.
Minto.”
References
1.
Barr, H., Koppel, I., Reeves, S., Hammick, M., & Freeth, D. (2005). Effective interprofessional education Argument, assumption and evidence. CAIPE London, United Kingdom: Blackwell Publishing.
2.
Commission on the Future of Health Care in Canada. (2002). Building on values: The future of health care in
Canada: Final report. Commissioner: Roy J. Romanow. Ottawa: Queen's Printer.
3.
Health Canada (2004). Interprofessional education for collaborative patient-centred care (IECPCP)
4.
Health Force Ontario (2007). Interprofessional Care: A Blueprint for Action in Ontario.
www.healthforceontario.ca/IPCProject
5.
Martin-Rodriguez, L., Beaulieu, M., D'Amour, M., & Ferrada-Videla, M. (2005). The determinants of successful
collaboration: A review of theoretical and empirical studies. Journal of Interprofessional Care, 19(1 Suppl), 132147.
6.
McNair, R., Brown, R., Stone, N., & Sims, J. (2001). Rural interprofessional education: Promoting teamwork in
primary health care education and practice. Australian Journal of Rural Health, 9(Suppl), S19-S26.
7.
Oandasan, I., Baker, G.R., Barker, K., Bosco, C., D'Amour D., et al. (2006). Teamwork in healthcare: Promoting
effective teamwork in healthcare in Canada. Policy synthesis and recommendations. Ottawa: Canadian Health
Services Research Foundation.
8.
Parsell, G., & Bligh, J. (1999). Interprofessional learning. Postgraduate Medical Journal, 74, 89-95.
9.
Parsell, G., Spalding, R., & Bligh, J. (1998). Shared goals, shared learning: Evaluation of a multiprofessional course
for undergraduate students. Medical Education, 32, 304-311.
10.
Purden, M. (2005). Cultural consideration in interprofessional education and practice. Journal of Interprofessional
Care, 19(1 Suppl), 224-234.
11.
Zwarenstein, M., Reeves, S., & Perrier, L. (2005). Effectiveness of pre-licensure interprofessional education and
post-licensure interprofessional collaboration interventions. Journal of Interprofessional Care, 19(1 Suppl), 148-165.
A Model for Interprofessional Education
Through Case Study Roles
Dianne Cameron, PhD
Collaborative Health Initiatives
Faculty of Science & Engineering
Northern Health Research Conference
Timmins, June 4-6, 2015