IPE Update: How to Infuse IPP/IPE Into Your Curriculum - CAPCSD InterProfessional Education (IPE) Committee
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IPE Update: How to Infuse
IPP/IPE Into Your Curriculum
CAPCSD InterProfessional Education (IPE) Committee
Austin, Texas
April 2018
Committee Members • John McCarthy, Ohio University* • Jennifer Watson, Texas Christian University • Julie Estis, University of South Alabama • Laura Karcher, Indiana University* • Karen McNealy/Pam Holland, Marshall University* • Carolyn Wiles Higdon, Chair, University of Mississippi* • Ann Eddins, CAPCSD VP for Academic Development, University of South Florida
Yesterday, Today, Tomorrow • Where did IPP and IPE come from? Who are we? Why is interprofessional practice so important in the lives of SLPs and Audiologists? • What are we seeing today? • What does the future hold for us? Is it time for us to stop being the last one invited to the dance?
Laura Karcher Clinical Professor Speech-Language Clinic Director Indiana University The speaker has no relevant financial or non-financial relationships to disclose
Indiana University Center for Interprofessional
Practice & Education (CIPHEP)
• Created in 2014
• One of 8 National Center for
Interprofessional Practice &
Education Nexus Innovations
Incubators
• University Clinical Affairs Schools
• Dentistry, School of Health and Rehabilitation
Sciences, Medicine, Nursing, Optometry, Public
Health–Bloomington, Public Health at IUPUI, Social
Work
• *College of Arts and Sciences –
Speech and Hearing Sciences
https://ipe.iu.edu/
Program Goals • Three foundational pillars 1) curriculum development and integration 2) faculty development and leadership training 3) outcomes evaluation and scholarship • Implement, integrate and evaluate IPE education programs • Innovate team practice models • Impact Hoosier’s health & health care outcomes.
TEACH Curriculum • Team Education Advancing Collaboration in Healthcare (TEACH) • Systematic preparation • Base on Core Competencies for Interprofessional Collaborative Practice released by the Interprofessional Education Collaborative (IPEC) • 6 interprofessional learning anchors – flexible choice points • Co-emphasis on faculty development
https://ipe.iu.edu/wp-content/uploads/2017/01/TEACH-2.0-Curriculum-Plan.png
Faculty Development in IPE • Conceptual Framework for faculty development and leadership – 3 tier approach • Individual level (micro) • School or program (meso) • Campus/university level and beyond (macro) • Departmental Faculty roles • TEACH Anchor facilitators - # based on participants • TEACH Anchor content leaders
• IPE Curriculum (TEACH) participation since 2016 • Current student cohort - 39 • Anchor #1 fall, 2017 (133 total learners; 3 SPHS faculty) • Anchor #2 fall, 2017 (131 total learners; 3 SPHS faculty) • Anchor #3 spring, 2018 (4 SPHS faculty) • Anchor #4* spring, 2018 (6 SPHS faculty) • Anchor #5* & #6* – during externships?
What are we learning?
• Positives
• Student communication improves, understanding of role and advocacy for the
profession, work with standardized patients (SP’s)
• Faculty collaboration with other disciplines, intradepartmental collaboration
and understanding of other methods of student training
• Other IPE opportunities
• Fall community-based IPE teams working with clients post-brain injury
• Challenges
• Scheduling!
• Finding space in a packed curriculum
• Time for pre and post discipline specific briefing
• Faculty recruitment, representing this work in promotion and tenureSPHS IPE Goals • Build faculty capacity and sustainability • Infuse across the SPHS curriculum • Incentivize participation for faculty • Build IPE opportunities in pediatrics
John McCarthy Ohio University Communication Sciences and Disorders
• Logistical – How do you make sure every
student has an experience with another
profession?
• Scheduling conflicts
What is the main
• Quality – How do you make sure the IPE
challenge for IPE? experiences are meaningful for
students?
• What are the activities?Area an experience falls
Interprofessional Education on IP continuum: Low Mid High
Classroom-based Mix of class-based and Emphasis on team-
Emphasis on text clinical site learning based clinical practice in
(books, articles, etc) a health facility
The Continuum of
Mid- and high-fidelity
Typical characteristics Interprofessional simulations Team-based meetings
of experience: competencies may be occur regularly
incidental and typically Team-based learning
not assessed Experiences augmented
Content and with high-fidelity
May satisfy curricular assessments built simulations,
course requirement for around the IP standardized patients,
2+ programs competencies and other related, IP
content
Grand rounds
experiences common
Assessments a blend of
clinical skills evaluations
and team-based
performance• In building our IPE Curriculum, we turned to the
Student students
• Build, Use, Edit, Re-Build, Use…
Centered,
Student • Initial Group of Scholars to build materials
Driven • Critical mass of materials…• Get a number of activities
• Activities are rated for number of hours
• Advantages
• Balance student involvement
IPE Implementation: • Student control
Activity Approach • Disadvantages
• Logistics
• Still need to have someone
coordinateActivities… Represent Tour and Demonstrate Patient/Client Encounters Classroom Simulation Community
Approach Role of Instructor Role of Students
Problem Based Learning Guides/Facilitator as students work Identify, rank, and allocate resources
through process to working on problems
Allow students to drive own learning
and don’t dictate the process
Case Based Learning Strategically choose cases to Apply own knowledge to aspects of
illustrate particular points or achieve case and other problems/decisions
a curricular end to be made in practice
Collaborate with students
Team Based Learning Design in-class and out of class Work in teams throughout the
assignments semester
Design readiness assessments Complete readings and study
outside of class
Form diverse teams
Contribute to team work in class
Provide frequent feedbackLet’s Discuss…
Future • Do we want IPE to be
Directions represented at the professional
level?
• Is IPEC where members
come together or do we
want to learn about, with
and from each other as
professional organizations
too?Karen McNealy/Pam Holland Marshall University
Marshall University Inter-professional Education: Past, Present, Future CAPCSD, 2018
Karen McNealy Chair-Graduate Program Director Department of Communication Disorders The speaker has no relevant financial or non-financial relationships to disclose.
3 Key Principles
• Principle #1. IPE/IPP is not a replacement
for rigorous education specific to each health
care profession. This indicates that
interprofessional identity complements—but
does not replace—professional identity.
• Principle #2. IPE/IPP represents one
solution—not all solutions—to the problems
of the health system.
•Principle #3. Experiential and team-based
learning are the hallmarks of IPE/IPP.
This is the basis of how we structure the
IPE program at MUWorld Health Organization (WHO) Framework for Action
Principle #1
IPE/IPP is not a Each of the 8 disciplines involved have a
unique, individualized and rigorous
replacement for rigorous
program:
education specific to College of Health Professions:
each health care Communication Disorders –first year
profession. This indicates graduate
that interprofessional Dietetics – fourth year
identity complements Nursing – fourth year undergraduate
but does not replace Social Work – first year graduate
professional identity. School of Physical Therapy
School of Medicine –first year
School of Pharmacy –first year
College of Liberal Arts
Psychology –fourth yearPrinciple #2 IPE/IPP represents Students are presented with one solution—not all a paper case and charged solutions—to the with developing ONE problems of the interprofessional solution. health system.
Principle #3
Experiential and Students are brought
team-based learning together for 2-3 sessions
are the hallmarks of (MU has done both) to
IPE/IPP. practice collaboration and
learning togetherInterprofessional Education at Marshall University History, Updates and Data Students are ready to achieve the 2015- 2025 Challenge!
2013: MU IPE started with 5 disciplines 2014: Added Dietetics and Social work 2015: Added Psychology
IPE-Marshall University
• They are gathered together for 2 - 3 Sessions
• Interprofessional Teams Created and assigned faculty
facilitators
• Utilized
Patient Cases
Preparatory activities and surveys
Post activities and surveys
Standardized patients/caregivers
How are the students learning about
IPE/IPP?IPE - Marshall University • Utilized “paper case” as a vehicle for interaction • Same teams / Same case • Cases evolved from session 1 (immediately after ER admission secondary to CVA to session 2 (2 weeks post CVA with plans for D/C) • First two years of the program we also utilized a pediatric case with the fish bowl activity for students to observe teams with opposite case Patient Cases
IPE – Marshall University
• YouTube Videos
• Assigned Readings (articles and books )
• The Spirit Catches You and You Fall Down
• UpStream Doctors
• Self Assessments via Qualtrics
• Interprofessional Attitudes Scale (IPAS)
• Readiness for Interprofesional Learning Scale (RIPLS)
• Faculty and Standardized patient / family Debrief
• Reflections
Preparatory Activities and SurveysIPE – Marshall University
• Purpose- To examine the attitudes of health and social care
students and professionals towards interprofessional learning.
• Description- 19 item tool with a 5 point Likert Scale
“strongly agree” to “strongly disagree”
• 3 Subscales
1. Teamwork and Collaboration
2. Negative and Positive Professional Identity
3. RolesLearning
Readiness for Interprofessional and Responsibilities
(RIPLS) Questionnaire9IPE – Marshall University • Students participate in team building and Icebreakers; explain their scope of practice in patient care • Group question/answer period. Students begin discussing and asking for any clarification of each disciplines roles and responsibilities. • Wrap Up with a Plan of Care during acute care stay Session 1 – Communication, Collaboration and Scope of Practice
IPE – Marshall University • Students review and discuss the case. Each student is to participate in the discussion. • Group question/answer period. Students begin discussing and asking for any clarification of each disciplines roles and responsibilities. • Wrap Up with a Plan of Care while in Acute Care Session 2 – Communication, Collaboration and Scope of Practice
IPE – Marshall University • Standardized Patient- (SP) “is a person carefully recruited and trained to take on the characteristics of a real patient thereby affording the student an opportunity to learn and to be evaluated on learned skills in a simulated clinical environment”.11 • Discharge Planning Meeting • Faculty facilitators and SP debrief Session 3 - Standardized Patients and Caregivers
IPE – Marshall University
1. Is there further discipline specific information you need?
2. Summarize your discipline specific priorities.
3. What other information would you like to have for this case from the other
disciplines?
4. Is there information presented in the case provided by other disciplines that you
don’t understand?
5. What are your thoughts on discharge location?
6. Can you predict any equipment needs or support this patient may need at
discharge?
Adapted from: Riley N., Frank L. Inter-Professional Clinical Reasoning Event. Academy of Neurological Physical Therapy, Inc.
DisciplinePhysical
American Specific Plan ofAssociation.
Therapy Care
Worksheet 10This is where the video will go.
RESULTS
Significant changes in
• Self-assessment of communication
• Understanding of roles and
responsibilities
• Ability to collaborate across
disciplines
No significant changes
• Attitudes towards interprofessional
healthcare (-)
• Knowledge of specific disciplinesAdditional break out IPE learning opportunities • PT and ST - Cases based on clients in MUSHC • ST and Dietetics –Dysphagia Diner • SOP and SOM – Use of SP and paper cases
Examples of Collaborative Clinical Practice • ALS Clinic: • Current Professionals: SLP, Dietetics, Neurology, PT • ASD Clinic: • Current Professionals: SLP, PT, OT, Social Work, Psychology • Feeding and Swallowing Clinic: • Current Professionals: SLP, PT, Dietetics, Psychology, Physician • KIDS Clinic (NAS follow up clinic) • Physicians, SLP, PT, Psychology, Social Work
Challenges • Faculty burn out • Limited time for data collection • Student scheduling • Variety of student levels • Space for all of the students We know what they are!
One last take away
IPE/IPP
• Professionals practicing and learning FROM other disciplines WITH
other disciplines and ABOUT other disciplines
• Professionals maintaining the Certificate of Clinical Competence
consider the CCCs: Why not consider….
• Consistently and Constantly Communicating
• Professionals practicing Patient/student-Centered, Non-
hierarchical Interprofessional ProfessionalismReferences
1. World Health Organization (WHO). Framework for action on interprofessional education and collaborative practice. Geneva: World Health Organization.
2010. Available at http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf. Accessed 03/01/17.
2. Grant RW, Finocchio LJ, and the California Primary Care Consortium Subcommittee on Interdisciplinary Collaboration. Interdisciplinary collaborative
teams in primary care: a model curriculum and resource guide. San Francisco, CA: Pew Health Professions Commission. 1995.
3. Centers for Medicare and Medicaid Services. Accountable Care Orgnizations. Cms.gov. 2015. Available at https://www.cms.gov/Medicare/Medicare-Fee-
for-Service-Payment/ACO/index.html Accessed 03/02/17.
4. American Family Physician, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint Principles of the
Patient-Centered Medical Home. 2007. Available at http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf.
Accessed on 03/02/17.
5. Fickenscher K. Accountable care organization and medical home differences. KevinMD.com. 2017. Available at
http://www.kevinmd.com/blog/2010/12/accountable-care-organization-aco-medical-home-differences.html. Accessed on 03/02/17.
6. Centers for Medicare and Medicaid Services. Bundled Payments for care improvement initiative: general information. CMS.gov. 2017. Availible at
https://innovation.cms.gov/initiatives/bundled-payments/index.html. Accessed 03/02/17.
7. American Physical Therapy Association. Expanded CMS bundling programs with payment incentives- ready to launch in 2017. PTinMotion News. 2016.
8. Norris J, Lassche M, Eaton J, Guo J, Preet M, Blumenthal D. The development and validation of the interprofessional attitudes scale: assessing the
interprofessional attitudes of students in the health professions. Academic Medicine. 2015, 90:1394-1400.
9. Curran V, Sharpe D, Forristall J, Flynn K. Attitudes of health sciences students towards interprofessional teamwork and education. Learning in Health
Science and Social Care. 7(3);146-156. 2008.
10. Riley N., Frank L. Inter-Professional Clinical Reasoning Event. Academy of Neurological Physical Therapy, Inc. American Physical Therapy Association.
11. Johns Hopkins Medicine. Standardized Patient Program. Available at
http://www.hopkinsmedicine.org/simulation_center/training/standardized_patient_program/index.html. Accessed on 03/08/17.
12. http://www.asha.org/uploadedFiles/2016-Interprofessional-Practice-Survey-Results.pdf
13. http://www.asha.org/Practice/Interprofessional-Education-Practice/
14. http://www.asha.org/uploadedFiles/IPE-IPP-Reader-eBook.pdfThank you
Carolyn Higdon: U of Mississippi • Purdue University Showcase: Barbara Solomon, Clinical Professor • President’s Excellence Award at the Great Lakes Athletic Training Association • Her IPP IPE work with SLP and Athletic Training and otolaryngology • University of Mississippi Project: What are the students saying? • Nursing • Communicative Sciences and Disorders • Pharmacy • Registered Dieticians • Social Work
Questions ???? • Committee’s Plan for 2018 • How are Programs addressing IPP and IPE in the 2017 CAA Standards? • Discussion Board versus IPP Blog…..or both? • ASHA’s Template • Webinars • ASHA National Convention in Boston, MA (November 2018) • CAPCSD 2019 • Resources • 2017 CAA Standards
Contact Us! • Carolyn: chigdon@olemiss.edu (cell: 678-296-0905) • John: mccarthj@ohio.edu • Julie: jestis@southalabama.edu • Laura: lkarcher@indiana.edu (work: 812-855-2912) • Karen: mchealy@marshall.edu • Ann: aeddins@usf.edu
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