Methods for teaching interprofessional education in social work schools.

1. IPE Nuts and Bolts:
Development, Implementation and Evaluation
of Sustainable Interprofessional Programming
IPE

2. Introduction to IPE
Here are my ideas about introduction to
IPE/IPCP and Collaborative Practice – SCK
[This slide will be deleted]

3. Definitions
Interprofessional Education occurs when two or
more professions learn about, from and with
each other to improve collaboration and the
quality of care.
Collaborative Clinical Education promotes the
active participation of students, educators, and
workers in teaching relevant cross-disciplinary
person-centered care.
Center for the Advancement of Interprofessional Education (2002)

4. Interprofessional Practice
Multiple health workers from different professional
backgrounds providing comprehensive health
services working with patients, their families,
caregivers and communities to deliver the highest
quality of care across settings.
Framework for Action on Interprofessional Education & Collaborative Practice WHO, 2010.

5. Interprofessional Collaboration
“… the process of developing and maintaining
effective working relationships with learners,
practitioners, patients/clients/families and
communities to enable optimal health outcomes.
Elements of collaboration include respect, trust,
shared decision-making, and partnerships.”
Canadian Interprofessional Health Collaborative, 2010

6. Why IPE? Why Now?
Since 1999 the Institute of
Medicine (IOM) has urged the
practice of IP team-based care
to prevent medical errors.
In 2013 the Journal of Patient
Safety reported that between
210,000 and 440,000 patients
each year suffer some type of
preventable harm when
receiving hospital care. If the
Centers for Disease Control
were to include preventable
medical errors as a category,
these conclusions would make
it the third leading cause of
death in America.
James, J. T. (2013) . A new, evidence-based estimate of patient harms
associated with hospital care. JPS, 9(3), 122-128.
• Integration of primary,
behavioral and oral care
(PCMH; ACA)
• Demographic Changes, e. g.
aging population; chronic
health conditions
• Increase in dual diagnoses
• Technological advances;
saving lives
• Patient Safety & Quality
agenda
• Workforce pressures and
gaps
• Healthcare and payment
reforms

7. Interprofessionality is not
• Learners hearing a lecture about or by another profession
• Reporting out following interdisciplinary activities (e. g. service
learning; poster sessions)
• Co-location without intentional collaboration (e. g. events;
simulation lab)
• Talking about rather than with other professions/clients

8. Core Competencies
http://www.aacn.nche.edu/education-resources/ipecreport.pdf

9. Social workers:
• Articulate their roles and
responsibilities as well as
accurately and fairly represent
the qualifications and
obligations of colleagues from
other disciplines
• Demonstrate a variety of
approaches to achieve desired
outcomes
• Acknowledge professional
strengths that enhance the
interdisciplinary team process
and contribute to positive
client outcomes
• Identify and seek common
ground with your
interdisciplinary colleagues
IPEC Core Competencies:
Roles & Responsibilities: Know one’s
own role and those of team
members
Ethics & Values: Recognize and
respect the unique cultures, values,
roles/responsibilities and expertise
of other health professions
Teamwork: Integrate knowledge and
experience of other professions to
inform effective/ethical decisions
Communication: Listen actively,
encourage ideas and opinions;
express knowledge and opinions to
team members with confidence,
clarity, and respect, and work to
ensure common understanding.

10. Change is Hard

11. Implementation
• Give specific examples of “how” each of us
have offered our IPE courses
• Provide details to help a participant who may
not have developed an IPE course before
• Convey the message - there is no cookie cutter
approach

12. No “One Size Fits All”
• Promote ideas that are
meaningful to your faculty &
identify common goals
• Form an Inclusive coalition of
faculty, students, staff &
community partners
• Create a common vision, clear
message, and attainable goals
• Walk the Talk – reach out to
colleagues
• Begin with small successes and
build on them
• Remove obstacles & sidestep
barriers
• Sustain momentum – establish
a domino effect
• Anchor change
(Adapted from Kotter, 8-Step Change Model)

13. Teaching and Learning Opportunities
Core Curriculum IPEC Event Series CLARION Competition
IPE Student-led Clinics Global IPE Learning IPE and the Arts

14. More Opportunities
Simulation Symposia IP Courses
Student –led Research Shared Field Experience Service Learning
ACA impact: http://youtu.be/6JAEKmNFTyA; Shared rotation: http://youtu.be/2zkQ0f3sluk

15. Tools & Methods
• Handout (see slide #16)
• Facilitation
• TeamSTEPPS

16. Tools - Handout
• Shared didactics – integrated curriculum; required &
elective courses; designed & implemented by IP faculty
• Shared assignments – case study presentations;
literature reviews; posters
• Shadowing – other professions; community workers;
patients
• IP Case conferences – intentionally designed with
actual clients/patients; Clarion Root Cause analysis
• Reflective journaling with prompts – use in field
placements; activities; ethnographies
• Shared field placements – IP placements
• Service learning – deliberately designed IPSL
• IP Scholarship & research – mini-grants; IP research

18. Group Exercise Idea
• Which of the teaching and learning tools fits
your IPE goals for the coming year
• Break into small groups with facilitator to
teach process and methods for activity
• Come back into large group and share

19. Facilitation
IP facilitators are:
• Responsive to students as they interact with
one another, surface ideas, and ask questions.
• Encourage reflection, circumspection, and
critical thinking
• Guide group process and draw out the natural
elements of group dynamics
• Comfortable with different views and indeed,
solicit them
• Patient, agile, process-oriented yet able to
manage conflict

20. Facilitation Goals
• Orient learners to goals of the session
• Prompt learners to discuss their observations
• Encourage a non-judgmental environment
• Make interprofessional learning explicit (e. g. let’s
get the [discipline] view of client’s needs)
• Inquire about what is missing and where might
we find it?
• Capture teachable moments
• Prompt self-reflection
• Encourage closure and final case/topic
determinations

21. Role Modeling
• Role model collaborative competencies in
everyday practice
• Share your own process – what were your
misperceptions of other professions
• Orient learners to interprofessional principles
and values
• Facilitate introductions
• Clarify your role and have learners identify
theirs

22. Facilitation Video Exercise

23. What is TeamSTEPPS™
• A teamwork system designed for
healthcare professionals and workers.
• Developed by Department of Defense's
in collaboration with the Agency for
Healthcare Research and Quality
(AHRQ).
• Provides attitudes, knowledge and skills
for improving patient safety and quality
within health and health-related
settings.
• Informed by evidence-based research
aimed at improving communication and
teamwork skills among healthcare
professionals and workers.

24. "Your spoken word, your courage to challenge, your
will to engage in teamwork, and your determination
to ensure no harm can all be pivotal in determining
if a patient lives or dies.“ Sue Sheridan
http://www.ahrq.gov/professionals/education/curriculum-tools/
teamstepps/instructor/videos/ts_Sue_Sheridan/Sue_Sheridan-400-
300.html

25. A Shared Mental Model Is...
The perception of, understanding of, or
knowledge about a situation or process that is
shared among team members through
communication.
"Teams that perform well hold shared mental models."
(Rouse, Cannon-Bowers, and Salas 1992)

26. ISBAR
Introduce Situation Background Assessment Recommendation
A Shared Mental Model for Communication

27. Patient
• Sally Hinton is a 55 year old single women who lives on her own, receives
MaineCare and SSI disability. She previously worked for 30 years as a school
bus driver and continues to do volunteer work in the schools.
• Sally was discharged a week ago after 2 days in the hospital being worked
up for angina. Her diagnoses include insulin dependent diabetes, obesity,
depression, and hydradenitis suppurativa (i.e., the development of cysts in
the breasts, arm pits, neck and groin which require occasional draining). She
takes nine different medications.
• During a routine office visit today Sally seems uncharacteristically
disoriented. She denies using alcohol or other intoxicating substances. You
ask if she’s taking her medication appropriately to which she replies that
she thinks so. When you ask to see her medications she tells you that they
are stored in their vials in a kitchen drawer. She cannot however tell you
which medications she takes, when she takes them or their dosages.
• Sally also describes two falling incidents that occurred last week during the
night. Although nothing was apparently broken, she shows you large bruises
on her hip and forearm. She also has an open injury on her shin that she
says is painful and not healing properly.
• What are your thoughts about Sally’s health and well-being?
• Describe how you would use ISBAR when transferring or referring Sally’s
care.

28. 28
Briefs, Huddles & Debriefs
Brief
Who is on the team?
Agree on Goals
Roles & Responsibilities
Understood
Plan of Care
Availability
Access
Resources
Huddle
Problem-solving
Review situation
Discuss new &
emerging events
Anticipate outcomes &
possibilities
Assign resources
Express Concerns
Debrief
Communicate clearly
about event
Go over details
Were roles &
responsibilities
understood?
What went well
What should change
Can we improve?

29. Check-Back Is when Practitioners…

30. Racial & Ethnic Disparities
• IOM’s Unequal Treatment
highlighted evidence of
racial and ethnic disparities
in health care
• Language barriers are less
well documented
• The root causes of patient
safety events for non-
English speaking patients in
are: (1) poor
communication and (2)
insufficient use of qualified
medical interpreters and
cultural navigators
http://www.youtube.com/watch?v=
ABn0sE1aiGo

31. Case Study
Mr. Morales is a 45-year-old car mechanic with type 2 diabetes.
He was born in Mexico, speaks English as a second language,
and has an eighth grade education. He just learned that he must
transition to insulin therapy to manage his illness. His attempts
at weight loss were challenged by desire to show appreciation
for his wife and mother’s cooking. His PCP sent him to a
dietician, who in turn provided him with an 1800 calorie-count
diet plan.
Written materials given to Mr. Morales were not helpful because
he does not read English. He has also heard that insulin causes
blindness and is thus fearful of starting this new medication
delivery method. For now Mr. Morales chooses to use Mexican
remedies such as prickly pear, offered by his mother.

32. Risks in Translation
• Not using a professional interpreter or
community health worker
– Using family members or hospital/clinic staff
as interpreters
– “Getting by” with provider’s or patient’s poor
language skills
– Interpreter only present for part of the
encounter

33. Community Health Outreach Workers
Community health outreach
• Culturally relevant health
workers (CHOWs): trusted
education
• Mediate between community
members of their communities
who provide vital links between
health systems and
communities and play critical
roles on the health team.
members and services providers
• Case management, systems
navigation & insurance
enrollment
• Medical interpretation
• Health promotion
• Conduct surveys, collect
community and health related
data.
• Contribute information on
community needs and needed
resources.
• Educate health professions
Whitley et al (2006). Measuring return on investment of outreach by
community health workers. J of Health Care for the Poor and
Underserved, 17, 6-15.

34. Teach-Back Is…
• Confirmation of understanding
• Opportunity to correct miscommunication
• Comprehensive
– “Tell me in your own words how you will take
this medicine when you get home…”

35. Equipping Patients & Families
• Quality care is a team effort
• Patients and families can
improve their care by taking
active roles in the process
• Invite patients to ask questions,
and evaluate their option
• Be culturally responsive to
patients
• Encourage shared decision-making
in their health care
• The AHRQ Web site
―www.ahrq.gov/questionsareth
eanswer/
Questions Your Patients Should
Ask
What is the test for?
When will I get the results?
Why do I need this treatment?
Are there any alternatives?
What are the possible
complications?
Which hospital is best for my
needs?
How do you spell the name of
that drug?
Are there any side effects?

36. 3 Things
Write down 3 things that you take away from
today’s teaching and learning time together.
Share one with the rest of the group.