AHC
Transcription
AHC
Facilitating Interprofessional Clinical Learning: Interprofessional Education Placements and other Opportunities Authors Lynne Sinclair, MA(Ad Ed), BScPT Director of Education, Toronto Rehab Mandy Lowe, MSc, BSc(OT) Interprofessional Education Leader, Toronto Rehab Tracy Paulenko, BScPT Interprofessional Education Project Manager, Toronto Rehab Aleksandra Walczak, MA, BA Education Coordinator, Toronto Rehab Corresponding Author Mandy Lowe, MSc, BSc(OT) Interprofessional Education Leader Toronto Rehabilitation Institute [email protected] This project was funded by: The Ministry of Health and Long Term Care’s Interprofessional, Mentoring, Preceptorship, Leadership and Coaching (IMPLC) Fund. Suggested Citation Sinclair, L., Lowe, M., Paulenko, T. & Walczak, A. (2007) Facilitating interprofessional clinical learning: Interprofessional education placements and other opportunities. University of Toronto, Office of Interprofessional Education: Toronto. Copyright © Office of Interprofessional Education, University of Toronto, 2007 D O C U M E NT N AV I G AT I O N TIPS The following icons are used throughout this document to assist the user in accessing many related websites and resources: = Follow the HYPERLINK to a SECTION of this IPE Resource for related information = Follow the HYPERLINK to a WEBSITE by clicking on the blue highlighted text = Follow the HYPERLINK to an APPENDIX in the current SECTION by clicking on the blue highlighted text. USING ACROBAT READER: To return to the previous screen after following a HYPERLINK, BOOKMARK or using the automated TABLE OF CONTENTS, press [Alt + ] (Alt and back arrow together) on your keyboard OR click on the “Previous View” Button on the NAVIGATION Toolbar. (To add the NAVIGATION Toolbar: go to the “View” menu ~ select “Toolbars” ~ select “Navigation”). Facilitating Interprofessional Clinical Learning: Interprofessional Education Placements and other Opportunities Lynne Sinclair, MA(Ad Ed), BScPT Director of Education, Toronto Rehab Mandy Lowe, MSc, BSc(OT) IPE Leader, Toronto Rehab Tracy Paulenko, BScPT IPE Project Manager, Toronto Rehab Aleksandra Walczak, MA, BA Education Coordinator, Toronto Rehab July 2007 Acknowledgements We gratefully acknowledge The Ministry of Health and Long Term Care’s Interprofessional, Mentoring, Preceptorship, Leadership and Coaching Fund (IMPLC) project “Catalyzing and Sustaining Communities of Collaboration Around Interprofessional Care”, a University of Toronto and Toronto Academic Health Sciences Network Partnership. Preceptorship Arm Co-Leaders: Lynne Sinclair, MA (Ad Ed), BScPT Director of Education Toronto Rehabilitation Institute Mandy Lowe, MSc, BSc(OT) Interprofessional Education Leader Toronto Rehabilitation Institute IPE Project Manager: Tracy Paulenko, BScPT Toronto Rehabilitation Institute Education Coordinator: Aleksandra Walczak, MA, BA Toronto Rehabilitation Institute Overall Project Administrative Lead: Ivy Oandasan, MD, MHSc, CCFP, FCFP Director, Office of Interprofessional Education University of Toronto The Toronto Rehabilitation Institute established the first student clinically-based Interprofessional Education (IPE) placement program in Toronto, Ontario in 2004. Since that time, the IPE student placement program has evolved based largely on the experiences and feedback of the many students, clinical faculty, program service managers, and IPE Facilitators who have participated in this innovative program to date. We would like to both acknowledge and thank the many individuals and groups who have contributed to the success of the IPE placement program. The development of this innovative educational program would not have been possible without the strong support provided by the senior management team at Toronto Rehab. We would also like to take this opportunity to thank our senior sponsors for both their initial and ongoing support and mentorship, in particular, Dr. Karima Velji, VP Patient Care & Chief Nursing Executive at the Toronto Rehabilitation Institute. We would also like to acknowledge and thank our partners at Bloorview Kids Rehab. Through this grant, we have been fortunate to pilot our processes and materials with Bloorview Kids Rehab in the development and implementation of their own IPE Placement Program. We have learned much from our colleagues at Bloorview Kids Rehab and look forward to our continued collaboration. We hope you find this manual a helpful guide in your own interprofessional collaboration and education journeys. Lynne, Mandy, Tracy and Aleks Toronto Rehab/University of Toronto Contents SECTION 1 Getting Ready for IPE Placements SECTION 2 Leading and Coordinating IPE Placements: A Resource for Education Leaders and Coordinators SECTION 3 Hosting IPE Placements: A Resource for IPE Facilitators SECTION 4 Developing IPE Facilitator Skills: Workshop Resources SECTION 5 Supporting Other Interprofessional (IP) Learning Opportunities: A Menu of Options for All Types of Placements SECTION 6 IPE Websites and Key References Contents Introduction��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Understanding IPE: Background and Context��� ��� ��� � 1 Planning for an IPE Placement Program��� ��� ��� ��� ��� ��� � 2 Getting Ready for IPE Placements Preparing Teams and Staff��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 3 Successes and Benefits ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 4 Lessons Learned ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 4 Enhancing Interprofessional Learning Opportunities for all Leaners��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 5 Appendices - References��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� 7 - IPE Placement Program Description� ��� ��� ��� ��� ��� ��� ��� 8 - IPE Placement Program Overview ��� ��� ��� ��� ��� ��� ��� � 10 - IPE Leader Business Case and Role Description � 11 Section 1 A B C D Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 1: Getting Ready for IPE Placements Introduction There are many factors to consider in preparing and planning for IPE clinical placements. This section provides a brief overview of the main elements to consider and will guide the reader to additional resources found in other sections of the toolkit: “Facilitating Interprofessional Clinical Learning: Interprofessional Education Placements and Other Opportunities”. Understanding IPE: Background and Context What is Interprofessional Education (IPE) and Collaboration (IPC)? Interprofessional Education: “Members (or students) of two or more professions associated with health or social care, engaged in learning with, from and about each other” (CAIPE, 2002) Interprofessional Collaboration: “…an interprofessional process of communication and decisionmaking that enables the separate and shared knowledge and skills of health care providers to synergistically influence the client/ patient care provided” (Way, Jones & Busing, 2000) Is there a framework for planning interprofessional education initiatives? http://www.ipe.utoronto.ca/Educators/framework.htm Health Canada Model (D’Amour & Oandasan, 2005): Refer to Section 6 “IPE Websites and Key References” “ ...the separate and shared knowledge and skills of health care providers to synergistically influence the client/patient care provided. ” (Way, Jones & Busing, 2000) Why is IPE important now? Focus of, Policy Support for and Theoretical Foundations of IPE: http://www.ipe.utoronto.ca/tools/foundations.htm International B Growing number of IPE programs and research initiatives – e.g. UK, USA National B Romanow Report, 2002: B http://www.hc-sc.gc.ca/english/care/romanow/hcc0086.html B Health Canada – Interprofessional Education for Collaborative Patient-Centred Care (IECPCP ) http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index_e.html Provincial/Local B Health Force Ontario’s Interprofessional Health Education Innovation Fund B “Regulation of Health Professions in Ontario: New Directions” (HPRAC, 2006) Section 1 University of Toronto (U of T) Office of IPE; research, practice, curricula http://www.ipe.utoronto.ca Enhance patient care B Collaborative practice improves patient outcomes in specific populations B What is the history of IPE? Where are the future directions for IPE? Historical overview B http://www.ipe.utoronto.ca/tools/research.htm Building on the Foundations of IPE in Toronto – An Agenda for the Future B http://ipe.utoronto.ca/about_us/mtcusub.pdf What is the research evidence for IPE? http://www.ipe.utoronto.ca/Educators/research.htm What are key references regarding IPE Clinical Learning Opportunities? • Refer to Section 6 “IPE Websites and Key References” Planning for an IPE Placement Program What does a Student IPE Placement look like? Refer to Appendix B “IPE Placement Program Description” and Appendix C “IPE Placement Program Overview” What are some key elements for a successful Student IPE placement program? Strong administrative and practice support Ability to build upon strong interprofessional teams, education programs Partners (Academic, leaders in other facilities) Recognition, support and mentorship of local champions Starting small and celebrating successes Being prepared to creatively address challenges (e.g. scheduling) Leadership that explicitly supports IPE and collaborative practice Allocation of resources for leadership roles (e.g. IPE Leader) How to build corporate support for an IPE Leader Allocate resources for leadership roles, e.g. funding for an IPE Leader Refer to Appendix D “IPE Leader Business Case and Role Description” What is the role of an IPE leader? Section 1 For details regarding IPE placements refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators” For details regarding IPE Leader role refer to Section 2 “Leading and Coordinating IPE Placements: A Resource for Education Leaders and Coordinators” Section 1: Getting Ready for IPE Placements What is the process for leading IPE placements? Refer to Section 2 “Leading and Coordinating IPE Placements: A Resource for IPE Leaders and Coordinators” B For example: selecting students and health care teams, curricula and scheduling, and academic contacts ([email protected]) How are IPE placements evaluated? A range of tools are available and are listed on the University of Toronto IPE Office website: http://www.ipe.utoronto.ca/Educators/evaluation.htm Refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators” for details of evaluation Preparing Teams and Staff What are some resources to prepare staff for the role of student supervisor? Many resources are available, for example: B http://www.preceptor.ca B http://www.cfd.med.utoronto.ca/ B connect with your own professional resources, e.g. academic partners What are some resources that may assist teams to build their own interprofessional collaboration competencies? Team building resources are available at: http://www.ipe.utoronto.ca/tools/groups.htm Orchard, C.A., Curran, V. & Kabene, S. (2005). Creating a culture for interdisciplinary collaborative professional practice. Medical Education Online, 10:11. Available from http://www.med-ed-online.org Teamwork in Healthcare: Promoting Effective Teamwork in Canada – a report funded by the Canadian Health Services Research Foundation http://www.chsrf.ca/research_themes/pdf/teamwork-synthesis-report_e.pdf What are some resources to help individuals develop IPE Small Group Facilitator skills? Refer to Section 4 “Developing IPE Facilitator Skills: Workshop Resources” For a series of Interprofessional Education DVDs on interprofessional collaborative care and learning which includes “Facilitating Interprofessional Collaboration with Students” (a companion tool to this guide), contact the U of T Office of IPE at http://ipe.utoronto.ca/tools/dvd.htm 5 Day Interprofesional Education Leadership Course – contact the Office of IPE ([email protected]) for additional information regarding course availability Section 1 Successes and Benefits What have been some of the successes of hosting IPE placements at Toronto Rehab? As of July 2007, 17 IPE placements with 99 students from 15 professions, including research, have been hosted since 2004 Seventeen IPE trained small group Facilitators from 8 professions have participated in the IPE placements Improved recruitment and retention is seen with 36% of graduated IPE students currently employed at Toronto Rehab (2006 data) Emphasis on collaboration and teamwork seen as foundation of all clinical practice Increased placement and teaching activity Preparing for unique practice demands of the future (e.g. Local Health Integration Networks, Primary Care, Family Health Centres) Increased research dollars ($4.7 M) Lessons Learned What has Toronto Rehab learned in hosting IPE placements since 2004? Section 1 Start small (e.g. pilot one IPE student clinical placement). Work with teams that are interprofessional and collaborative (team members that work well together on a unit or in a program of care and exhibit collaborative competencies or as reported from staff and patient satisfaction scores). Educate the IP team (managers, hosting team, clinical supervisors, Corporate Professional Leaders, Clinical Educators, etc.) about IPE and IPC (e.g. definitions, objectives, benefits, components of IPE Student Placements, roles and responsibilities of IP team members) at in-services, Team Rounds, Business Meetings, Grand Rounds Build excitement, enthusiasm and support across the organization B recognize, support and mentor local IPE champions (e.g. meet and share information, establish an interest/steering group) B partner with Marketing and Public Affairs/Communication (e.g. add an IPE section on the intranet) B include IPE initiatives in the organization’s strategic plans Celebrate and share your IPE successes B Local newsletters/ invitations to presentations on IPE B One student IPE group wrote an article re: their IPE placement experiences B Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional education: The student perspective. Journal of Interprofessional Care, 20 (3): 246-253. The facilitation of interprofessional education and collaborative patient-centred practice (IECPCP) with healthcare professional students provides meaningful learning opportunities for students and allows the teams themselves to reflect on and work toward further developing their own interprofessional collaborative competencies Section 1: Getting Ready for IPE Placements Enhancing Interprofessional Learning Opportunities for all Leaners What other IPE clinical learning opportunities are there? For a range of Interprofessional Learning Opportunities, please refer to Section 5 “Supporting Other IP Learning Opportunities: A Menu of Options for All Types of Placements” http://www.ipe.utoronto.ca also has suggestions re: promotion of interprofessional learning We hope that you have found this resource useful and that you and your IP student teams will benefit from it. Lynne, Mandy, Tracy, Aleks Toronto Rehab/University of Toronto Section 1 Section 1 Section 1: Getting Ready for IPE Placements Appendix A: References Freeth, D., Hammick, M., Koppel, I., Reeves, S. & Barr, H. (2002). A critical review of evaluations of interprofessional education. Available from http://www.health.ltsn.ac.uk/publications/occasionalpaper/occasionalpaper02.pdf Way, D., Jones, L. & Busing, N. (2000). Implementation Strategies: “Collaboration in Primary Care -Family Doctors and Nurse Practitioners Delivering Shared Care”: Discussion Paper written for The Ontario College of Family Physician. Available from http://www.eicp-acis.ca/en/toolkit/management-leadership/ocfp-paper-handout.pdf Section 1 Appendix B: IPE Placement Program Description Sample from Toronto Rehabilitation Institute Students from Medicine, Nursing, Occupational Therapy, Physical Therapy, Social Work, Pharmacy, Speech Language Pathology, Psychology, Therapeutic Recreation and other professions have the opportunity to participate in interprofessional education (IPE) clinical placement experiences. The IPE placements will run in January/February and May/June this year. Students with a keen interest in interprofessionalism will be selected to participate in these student interprofessional teams. Once selected, students will be placed as an interprofessional team within one clinical care unit at Toronto Rehab. They will participate in one or two facilitated introductory tutorials and then continue to meet as a group on a regular basis for patient-themed tutorials. At some point during the later stages or on completion of their clinical experience, they will be asked to offer a group presentation. IPE Placement Program Goals The goals for this interprofessional placement program include: opportunity for students from various health care disciplines to develop an increased understanding of the expertise that each discipline brings to the solution of health problems provision of opportunities for students to learn and develop clinical expertise together opportunity to develop an understanding of team dynamics, communication skills within the team, and conflict resolution within the context of a well-functioning team Introductory Tutorials One or two introductory tutorials will be held at the beginning of the IPE placement. These tutorials will be held in the late afternoon to facilitate attendance. Students will have the opportunity to learn about each other, explore common professional interests, knowledge, experiences, and individual learning styles and needs. Students will have the opportunity to develop an understanding of team roles and responsibilities, conflict resolution, and any specific information related to the clinical skills required in the particular clinical placement. Patient-Themed Tutorials During the IPE placement, students will meet in facilitated tutorials on a regular basis. Students will take leadership in exploring learning issues pertaining to their clinical experience, the health system, and the delivery of health care services within the team. As well, students will have the opportunity to discuss issues related to interprofessional roles and collaborative practice. Shadowing experiences will be encouraged to supplement their clinical experiences. Presentation Throughout the IPE placement, students participate in the preparation of a joint interprofessional student presentation, which they will deliver at the end of the IPE placement. Section 1 Section 1: Getting Ready for IPE Placements Debriefing and Wrap-up Following completion of their clinical experience, students will meet for a final tutorial to provide a final evaluation, an opportunity for the synthesis of knowledge, and personal reflections. Student Learning Outcomes (adapted from McMaster University Health Sciences North Interprofessional Education Pilot Project.) increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services to patients/clients (e.g. similarities, differences and potential areas of role overlap and conflict) increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions. increased knowledge and understanding of the importance of interprofessional collaboration in the delivery of health care (e.g. team building, team functioning, communication, conflict resolution) enhanced skills in building interprofessional relationships and maximizing team function. Evaluation of Student Learning Outcomes The Interprofessional Education Perception Scale (Luecht, et al.1990) will be administered prior to and upon completion of the clinical experience to determine what changes in attitudes, if any, occurred throughout the placement. If you have any further questions regarding this innovative and exciting learning opportunity, please contact the Interprofessional Education Leader. Section 1 Appendix C: IPE Placement Program Overview Welcome to the IPE placement program. We are delighted that you have opted to participate in this innovative learning experience! This learning experience requires your participation and leadership; it is a self-directed, collaborative learning experience. The Facilitators are there to assist the group and facilitate your learning rather than as content experts themselves. This handout is a summary of the key elements of the placement program and expectations. What does the IPE placement consist of? IPE Placement Component A team of students are placed in the same clinical area (e.g. a common unit) Introductory Tutorials Weekly Patient-Themed Tutorials Presentation Details Students from as many professions as possible; students reflect make up of team 2 introductory tutorials (2 hours each) Once per week 1.5 hours in length Includes patient-themed discussion and feedback Last week of the placement Prepared and presented as a group Refer to detailed handout regarding presentations When do specific learning activities occur in the IPE placement? Patient Discussion Introductory Tutorials Review patient for week 1 tutorial Presentation Review details of presentation expectations Section 1 10 Week 1 Week 2 Week 3 Discuss week 1 patient in tutorial Discuss week 2 Discuss week patient in tutorial 3 patient in tutorial Prepare for Prepare for week 2 patient discussion Confirm presentation date and time week 3 patient discussion Final date and time of presentation - Discuss group confirmed presentation - Presentation topic topic confirmed Week 4 Discuss week 4 patient in tutorial Prepare for Final placement week 4 patient debriefing occurs discussion in last weekly tutorial Prepare for Presentation presentation occurs Finalize evaluation Section 1: Getting Ready for IPE Placements Appendix D: IPE Leader Business Case and Role Description Business Case for Creation of an Interprofessional Education Leader Background: As a fully affiliated teaching hospital of the University of Toronto (U of T), there is a critical need to have an Education Leadership position created with the mandate of enhancing, supporting, and initiating the integration of student and professional education scholarship into practice across all clinical disciplines. This position will lead in the development, coordination and evaluation of innovative education models, programs and strategies including the Interprofessional Education placement program for students and the clinical faculty development program for professionals. Health Canada, the Ministry of Health and Long-Term Care of Ontario and the U of T have moved to a direction of IPE practice/learning with a focus on both academic and clinical curriculums. Toronto Rehab requires an IPE Leader to be the corporate contact, liaison and coordinator of all IPE activities. Implementation Plan: There are at least three options available: 1. A Full-time IPE Leader (1.0 FTE) working with the Director of Education and other Education positions across the organization. Toronto Rehab can be a leading provincial teaching organization with a fully developed IPE Placement Program. In addition, all students on any type of placement at Toronto Rehab will have opportunities to participate in IPE activities/learning. To fully support these programs, this role includes the development, coordination, implementation and evaluation of a Clinical Faculty Development program. With the Director of Education, the IPE Leader will also provide educational leadership to other internal departments on corporate issues (e.g. Conference Services, Human Resources, Infection Control, and Occupational Health/Safety etc.) Please see attached job description for further details on this role. 2. A Part-time IPE Leader (0.5 FTE) working with the Director of Education and other Education positions across the organization. Lead all aspects of the IPE Placement Program and the Clinical Faculty Development programs. 3. A Part-time IPE Leader (0.2 FTE) reporting directly to the Director of Education to coordinate the IPE Placement Program. Measures of Success (for established Full-time IPE Leader): Develop and lead IPE student placement program (e.g. 8 IPE placements per academic year) Clinical IPE learning opportunities for all students on any type of placement Develop and lead Clinical Faculty Development program (e.g. 4 Clinical Faculty Development sessions per academic year) Presentations and publications on Toronto Rehab’s IPE initiatives Funding for Educational Research from external granting agencies Budget requirements: Patient care professional practice portfolio will have the IPE Leader role fully funded in base budget at a salary comparable to other Leadership positions within the organization. 11 Section 1 Role Description Interprofessional Education Leader (1.0 FTE) Reports to: Director of Education Primary Function: To enhance interprofessional learning corporately Requirements: Masters degree in related health field and/or education (PhD preferred in Adult Education) Experience with development, implementation and evaluation of interprofessional education programs Excellent interpersonal and leadership skills Demonstrated expertise in collaborative professional practice, including interprofessional practice Demonstrated advanced facilitation and coordination abilities Able to foster and participate in research activities related to education and evaluation Experience and expertise in clinical education, continuing professional education and development Able to develop partnerships and collaborative structures to enhance education Eligibility for cross-appointment to the University of Toronto with preferred academic experience Key Responsibilities: The Interprofessional Education Leader is a leadership position at the Toronto Rehabilitation Institute, with the mandate of enhancing, supporting, and initiating the integration of student and professional education scholarship into practice across all clinical disciplines. This position will interact closely with other positions that have an education focus. Section 1 12 Lead in the development and evaluation of innovative education models, programs and strategies including IPE placement program and clinical faculty development programs Facilitate/provide expert consultation to others in the area of education scholarship and methodology, e.g., conducting needs assessments, developing education philosophies and approaches, program implementation and evaluation With Director of Education, provides educational leadership to other internal departments on corporate issues (e.g. Conference Services, Human Resources, Infection Control, etc.) Provide leadership in the development of curricula with education institutions for Interprofessional Education in Rehabilitation and Complex Continuing Care Serve as an expert resource for fostering a best practice approach to all educational endeavors Collaborate with others to develop a further research focus in education programs, including research in knowledge translation and use of information in clinical management Seek funding from agencies to support research in the evaluation of education programs Contents Introduction��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 IPE Placement Planning ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 2 IPE Leader Role Once Placement Confirmed � ��� ��� � 8 IPE Leader Role During Placement��� ��� ��� ��� ��� ��� ��� ��� � 9 Leading and Coordinating IPE Placements: IPE Leader Role After Placement��� ��� ��� ��� ��� ��� ��� ��� �� 10 Appendices - Sample Contacts for Student Clinical Placements��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Overview Presentation Handout��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Sample Agenda for IPE Facilitator Orientation Meetings��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Leader Checklist��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Program Evaluation for Clinical Faculty��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Program Description� ��� ��� ��� ��� ��� - IPE Placement Program Overview ��� ��� ��� ��� ��� ��� - IPE Placement Presentation Overview ��� ��� ��� ��� ��� �11 ��� �13 ��� �15 ��� �16 ��� ��� ��� ��� Section 2 A B C D E F G H A Resource for Education Leaders and Coordinators �17 � 19 � 21 � 22 Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 2: Leading and Coordinating IPE Placements Introduction This resource supports the Interprofessional (IPE) Leader/Coordinator in his/her role. It should be used in conjunction with Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators” as this guide builds on the foundation established in that resource. As the IPE Leader is responsible for the overall development and implementation of the IPE placement program, additional resources have been included to assist in guiding the overall program. In this document, we have shared what has worked well in our experiences at Toronto Rehab since the implementation of our IPE student placement program in 2004. Central to this success has been the establishment of the IPE Leader (role outline below): IPE Leader: coordinates planning of IPE placement including determination of which placement opportunities will be offered, liaises with appropriate academic faculties and provides relevant information regarding IPE placement to academic institutions orients clinical faculty to IPE placement philosophy, goals and processes with Facilitators, orients students to IPE placement learning opportunities and expectations, orients and supports IPE placement Facilitators, clinical faculty and students in each of their respective roles acts as a resource for interprofessional education responsible for overall evaluation and ongoing development of program This resource specifically addresses the following areas: IPE Placement Planning B Selecting the Timing of the Placement B Selecting the Clinical Team B Selecting Students B IPE Facilitators IPE Leader Role throughout all IPE placement phases This resource has been organized using frequently asked questions. Areas of key learning and additional resources and tools have also been highlighted throughout. Section 2 IPE Placement Planning What is an IPE student placement? Interprofessional education (IPE) has been defined as, “occasions when two or more professions learn with, from and about one another to improve collaboration and the quality of care” (UK Centre of Interprofessional Education, 1997). IPE placements provide students from a variety of professions, who are presently involved in their own profession-specific clinical placement, with the opportunity to participate in interprofessional placement experiences. IPE placements are described in detail in Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”. In brief, an IPE placement consists of 4 main elements: a group of interprofessional students are placed together on the same unit students participate in 2 introductory tutorials students participate in weekly patient-themed tutorials students prepare and deliver an interprofessional presentation What are the roles of those involved in IPE student placements? The various roles are outlined in detail in Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”. These roles include: IPE Leader, IPE Co-Facilitators, Clinical Faculty, Students, Academic Faculty, Program Service Managers and Senior Sponsor. Although IPE planning has been divided into 4 sections in this guide (selecting timing, clinical team, students and IPE co-Facilitators), the planning often occurs concurrently. However, the timing of the IPE placement should be selected first, since the Facilitator, clinical team and student availability will depend on the establishment of the IPE placement timing. IPE Placement Planning: Selecting the Timing of the Placement How should the timing of an IPE placement be determined? Students often participate in clinical placements at various times throughout their curricula. In planning for the ideal time, it is important to be mindful of the range of professions, the length of placements, the particular placement requirements (e.g. students from one profession may be available in the spring, but only able to participate in an orthopedic placement), the schedule of the placements (e.g. are students on placement full time? Part time? On shifts?), the type of placement (e.g. whether students are on a group or individual placement), the level of the students participating (e.g. first year, postgraduate, etc.) and other factors. Once you have developed a clinical placement schedule for the professions with whom you regularly work, it has been our experience that this needs to be updated as curriculum timing and contacts may change annually. The IPE placement time is set when students from at least 3 professions are involved in their profession-specific placements. For example, in looking at the table of student schedules below, the ideal timing appears to be January. Section 2 Section 2: Leading and Coordinating IPE Placements December January February March April Social Work Pharmacy Registered Nursing Physiotherapy Medicine As some professions schedule their clinical placements several months in advance, it is recommended to start planning approximately 6 months or more prior to an IPE placement. Who should I contact to learn more about the timing of clinical placements of the various professions? Developing partnerships with the professional leadership already in existence in our organization was critical. In an effort to continue to foster critical professional linkages with our academic partners, the IPE Leader collaborated with professional leaders and communicated primarily through them to academic partners. In addition to your own professional leaders, you may wish to consult the University of Toronto website (including the Office of IPE) for information regarding clinical placement curricula ( http://www.ipe.utoronto.ca). A sample listing of select contacts for a variety of professions (prepared for Toronto Rehab) has also been attached (refer to Appendix A “Sample Contacts for Student Clinical Placements”). IPE Placement Planning: Selecting the Clinical Team In planning for the first IPE placement, the choice of the pilot unit/team must be carefully considered and recommendations have been outlined below. Partnering with senior leaders, professional leaders and academic partners is critical. How do we know if we are ‘ready’ to develop and implement an IPE placement program pilot? In considering the range of factors that are important in developing and implementing an IPE placement program pilot, please refer to Section 1 “Getting Ready for IPE Placements” in addition to the points below. Selecting the first IPE Placement Team/Unit We recommend selecting a unit or clinical area that works well as an interprofessional and collaborative team to further build on their successes. This will provide the opportunity to pilot an IPE placement with a team that can role model interprofessional teamwork. You may also want to consider the following factors in selecting the first student IPE placement team/unit: teams that have high team patient satisfaction ratings teams that have high staff satisfaction ratings teams where the management and leaders are supportive of interprofessional learning teams where staff are keen to supervise students during the same time period teams widely felt to be leaders in collaboration in your organization recommendations from senior leaders Section 2 Helping clinical staff learn about the IPE placement program It is critical for the clinical team to both understand and be supportive of hosting an IPE placement. This often entails many strategies for helping the team to learn more about the IPE placement program itself (for a sample IPE placement presentation, refer to Appendix B “IPE Placement Overview Presentation Handout”). The clinical team will likely have many questions about what the IPE placement means for them and it is imperative that they have a very clear understanding about what is involved. Their role as clinical faculty should be highlighted. It is also highly advisable to invite the two IPE co-Facilitators (if confirmed) for that placement to the presentation. What are the benefits of hosting an IPE student placement for teams? Teams have reported benefiting in many ways. Clinical faculty report they have learned more about the professions they work with through discussing their students’ learning. As IPE students may develop an enhanced understanding of how the team works, clinical faculty have also reported that students demonstrate greater ease and confidence, in interacting with team members. Clinical teams have also benefited from students considering how to improve interprofessional collaboration for better patient care in key areas. For example, two previous student IP teams at Toronto Rehab have developed patient education materials and discharge safety checklists from an interprofessional perspective. Further, teams have reported enhanced awareness of interprofessional collaboration opportunities and challenges through working with the students. As part of the IPE placement includes an expectation for students to work together to prepare and deliver an interprofessional presentation, clinical teams may also offer various presentation topics for students to consider. Some teams have invited the IPE Student Groups to prepare a presentation about a shared clinical issue they would like to learn more about, and have therefore benefitted through receiving education tailored to the needs of the clinical team. IPE Placement Planning: Selecting the IPE Facilitators Who can be an IPE Facilitator? In our experience, clinical staff from across the organization and in various positions (e.g. clinician, manager, advanced practice leader, educator, professional practice leader and others) have been interested and successful in their IPE Facilitator roles. In facilitating IPE student small group processes, we use an interprofessional co-facilitation model (two Facilitators from different professions) to role model collaborative patient-centred practice. It is critical that the Facilitators are able to role model interprofessional collaboration and it is advantageous if they have prior small group facilitation experience. What is the role of the IPE Leader with respect to IPE Facilitators? The IPE Leader identifies potential IPE Facilitators, selects, orients, provides education, supports, mentors, and coaches IPE Facilitators throughout the placement. The IPE Leader also integrates feedback to inform future IPE placement development. What are the benefits of participating as an IPE co-Facilitator? In our experience, every person who has participated as an IPE co-Facilitator has enthusiastically and consistently agreed to participate in future IPE placements as a co-Facilitator. Co-Facilitators report many benefits to their involvement including: Section 2 Section 2: Leading and Coordinating IPE Placements opportunity to further develop: B small group facilitation skills B interprofessional facilitator skills B interprofessional knowledge and collaborator competencies strengthened relationships with co-Facilitators from other professions satisfaction and reward in being able to facilitate the development of their team and collaborator skills in an interprofessional manner How should IPE Facilitators be prepared? IPE Facilitators can gather information from a range of sources to determine if s/he is interested in enacting the role of IPE Facilitator (e.g. websites, articles, references listed in Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”), speak to previous IPE Facilitators, discuss with IPE Leader, etc.). In preparation, IPE Facilitators will also participate in orientation (led by the IPE Leader) and an IPE Facilitator Workshop (refer to Section 4 “Developing IPE Facilitator Skills: Workshop Resources”). How much time is involved in being an IPE Facilitator? In a 4 week IPE placement, Facilitators indicate that they have been able to integrate their roles as IPE Facilitators into their work. Facilitators report that, after the initial time investment, the workload diminishes greatly throughout the placement (refer to chart below prepared for first time IPE Facilitator). IPE Facilitators have reported spending approximately 25 hours over a total of 8 weeks preparing for, implementing and planning. A sample breakdown of the time has been included below. Experienced IPE Facilitators report progressively less preparation time as their experiences grows. IPE Facilitator Workshop Planning with co-Facilitator IPE Facilitator Orientation Meetings Pre IPE Placement 4 hours 3 hours 3 hours IPE Placement IPE Introductory Tutorials 3-4 hours IPE Patient-Themed Tutorials 6 hours (4 x 1.5 hours) IPE Presentation 1 hour (plus 1 hour for presentation rehearsal) Debriefing with IPE co-Facilitator 2 hours IPE Facilitator Mid and Post IPE placement 2 hours meetings How should the IPE co-Facilitators be paired? It is recommended that experienced IPE co-Facilitators be paired with novice IPE co-Facilitators wherever possible. Further, in an effort to role model interprofessional collaboration, partnering of individuals from two different professions has been effective. Section 2 Leading the IPE Facilitator Orientation Meetings The IPE Leader may draw from a sample agenda to guide the discussion (refer to Appendix C “Sample Agenda for IPE Facilitator Orientation Meetings”). IPE Placement Planning: Selecting Students How do we link with academic partners to ensure they support their students in the IPE placement program? Many of the professions with whom Toronto Rehab has partnered are aware of the IPE placement program as they have supported their students’ involvement in these learning opportunities. It is critical that all academic institutions be provided information about the IPE Placement Program for students to review. Using this process, students who select an IPE placement are then aware of the information in advance and can use it to inform their decision as to whether they would like to participate or not. It may also be helpful to connect with the academic partners and students in person via a short meeting or deliver a presentation to the students outlining the IPE placement program. We have found it helpful to partner with the professional leadership already in existence in our organization. In an effort to continue to foster critical professional linkages with our academic partners, the IPE Leader has collaborated with professional leaders and primarily communicated via these leaders to academic partners. Information about the IPE placement should be sent in advance and often includes the documents outlining the program description, sample schedule and IPE presentation (refer to Appendix F “IPE Placement Program Description, Appendix G “IPE Placement Program Overview, and Appendix H “IPE Placement Presentation Overview”). Numbers of students participating in the IPE placement Students from at least three professions are recommended as a minimum for creating an IPE tutorial group. The maximum number of students recommended is 10-12; we have found that 6-7 is an ideal group size. What levels of learners should be involved in an IPE placement? Any level of student can be involved as, although students may range widely in their academic preparation, they have many common areas for learning from an interprofessional perspective. As students in an IPE placement will be expected to speak to their roles, it is recommended that students have a well-established understanding of their own professional role regardless of academic level. For example, we recommend that IPE students have participated in at least one other clinical placement prior to an IPE placement. What if there are no clinical placement students from some professions available from the University of Toronto at the time of our IPE placement? We have partnered with many academic institutions in arranging our IPE placements. At this point, we have not found a time in the year where all of the professions have clinical placements at the same time. However, working with the professional leadership in our organization, we have secured linkages with several other academic partners (as the clinical placement scheduling often varies across academic institutions). For example, while we often host IPE placements in January to early February, there are no student Occupational Therapists (OT) on placement in January from the Section 2 Section 2: Leading and Coordinating IPE Placements University of Toronto. We have therefore invited student OTs from the University of Western Ontario to participate in the IPE placements with great success. What if there is more than one student from a profession who wants to be involved in an IPE student placement group? We have found that having two students from one profession has worked well in the IPE student groups (as long as the total number of students in the group still allows for effective small group functioning). Inclusion of more than two students from one profession appears to adversely affect the function of the overall group in terms of equitable participation from each profession. If there are more than two students who would like to be involved, students can be encouraged to join other IPE placements occurring simultaneously. If there are no other IPE placements occurring, it is recommended that each profession decides who will be able to participate. Some professions have asked students to write a short paragraph about why they would like to be involved in the IPE placement program and others have opted for the selection of students with higher academic or clinical placement evaluation results. What if a student is not on the IPE unit but is assigned to another area – is it possible for him/her to participate in the IPE placement tutorials? Including a student from another area is possible and should be carefully planned in order to facilitate the most effective learning experience for all involved. The student will no doubt benefit from a thorough orientation to the area/unit where the IPE placement is occurring. Partnering the student with a professional from his/her same profession on the unit for this orientation and ongoing clinical involvement is critical to student learning. The structure of the IPE placement provides the students with a week’s notice prior to discussing a patient, thereby allowing the student to have sufficient time to plan for and prepare for the discussion. Key Learning: It is ideal if only one or two students are outside of the core IPE unit/area in order to facilitate maximal opportunity for working together in a common area with a shared group of patients. What if a non-clinical student would like to be involved in an IPE placement? We have had limited experience integrating research students into IPE placements. Success has been facilitated through careful communication of the goals of the IPE placement and critical and creative thinking around how to foster the participation of research students in IPE tutorial discussions. For example, research students have been encouraged to shadow clinical professionals and bring information back to the group. Research students have also assisted the clinical students to further their understanding of the role of research in a clinical setting and how they may interact with patients as well. Inclusion of administrative students may be another option to consider. Section 2 IPE Leader Role Once Placement Confirmed As there are many aspects to the development, implementation, planning and monitoring of the IPE placement, a checklist has been developed to assist IPE Leaders in coordinating activities (refer to Appendix D “IPE Leader Checklist”). Evaluation The IPE Leader should lead the analysis of the evaluation data (including pre/post student evaluations, feedback from IPE Facilitators, students, and clinical faculty). This analysis should inform recommendations and planning for subsequent IPE placements. There are many options for evaluation. Please refer to http://www.ipe.utoronto.ca for suggestions regarding available approaches and tools as well as Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”. What should be completed in preparation for the IPE Placement? The IPE Leader should gather the contact information (particularly email addresses) for the clinical faculty and the students. Once the student email addresses have been confirmed, they should be forwarded to the IPE Facilitators who will then communicate directly with the students to establish initial meeting times. IPE Facilitators should also provide the students and clinical faculty (supervisors) with the IPE Placement Program documents (program description, sample schedule and IPE presentation – refer to Appendix F “IPE Placement Program Description, Appendix G “IPE Placement Program Overview, and Appendix H “IPE Placement Presentation Overview”) in advance of the IPE placement. It is critical for the IPE Leader to address IPE Facilitators’ learning needs in preparation for the IPE placement. These learning needs can be addressed through sharing of resources (refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”), an IPE Facilitator workshop (refer to Section 4 “Developing IPE Facilitator Skills: Workshop Resources”), IPE Facilitator orientation meetings, etc. What should the IPE Leader do just before the IPE placement commences? The IPE Leader may consider confirming the date and time of the student IPE presentation just before the placement starts. Although the date and time can be changed after the placement begins, it is helpful for the IPE Facilitators to share the timing of the presentation with the students in their first meeting. The IPE Leader may consider mechanisms for preserving IPE student presentations (e.g. archived webcast) and make arrangements accordingly. Further, it is also helpful to establish the midway planning meeting timing with the IPE Facilitators and IPE Leader prior to the start of the IPE placement. After the IPE Facilitators Orientation meeting prior to the IPE placement (refer to Appendix C “Sample Agenda for IPE Facilitator Orientation Meetings” for sample agenda), IPE Facilitators may benefit from reminders about critical tasks before the placement commences. The IPE Leader may consider providing IPE Facilitators with reminders about documents to send to students, Section 2 Section 2: Leading and Coordinating IPE Placements pre-placement evaluations, confirmed dates and times of IPE presentations, etc. Refer to the IPE Leaders Checklist ( Appendix D “IPE Leader Checklist”) for details. IPE Leader: Meeting the IPE Students In the first or second introductory tutorial, the IPE Leader should meet the students briefly and provide some background information and acknowledgement for their contributions to the IPE student placement program. At Toronto Rehab, this consists of a brief 10 minute meeting at the beginning of the tutorial during which introductions are made. The IPE Leader also establishes connections for potential future interactions with students (e.g. support, recruitment, corporate opportunities, etc.). Feedback has indicated that both students and Facilitators appreciate this opportunity as it reinforces the importance of the placement, provides an opportunity to ask questions and engage in discussion, reinforces group members’ decisions to be involved and supports the Facilitators in their roles. IPE Leader Role During Placement IPE Leader Role: First Week of Placement In the first week, the IPE Leader may want to briefly connect with the IPE Facilitators to learn how the placement is progressing and follow up regarding any concerns. Topics for discussion may include: overview of introductory tutorials, student presentation topics suggested by clinical teams, sharing of group norms and learning objectives, planning to address group process, co-facilitation, discussion of challenges and successes, etc. IPE Leader Role: Mid Placement The IPE Leader should meet formally with the IPE Facilitators to learn about the progress of the IPE placement to date. Topics for discussion may include: patient-themed tutorial overviews, topics of discussion to date, group process observations and interventions, feedback for IPE Facilitators from students, etc. At this time, students should have finalized IPE presentation topics and the times and location of the IPE placement presentation. Once student presentation details have been finalized, the IPE Leader can lead the invitation of others in the organization (e.g. open to all staff) and academic faculty, thereby building capacity for future IPE placements. What if a student is struggling to meet his/her profession specific objectives? If a student is facing challenges in learning regarding his/her own professional role, it may be too difficult for the student to meaningfully participate in an IPE placement. The IPE Leader should draw on resources in the organization (e.g. practice leaders/educators) and from academic partners as appropriate. Although this has rarely occurred in our experiences to date (1%), it may be necessary for the student to leave the group to prioritize his/her own professional learning. What if an IPE Facilitator cannot meet his/her responsibilities? Unexpected events may preclude involvement of an IPE Facilitator at times. In this unlikely event, a discussion with the two co-Facilitators to problem solve is key. Depending on the progress of the placement, one Facilitator may continue alone to the end of the placement. Alternatively, the IPE Leader may be required to join the group as the other IPE co-Facilitator. Section 2 IPE Leader Role: End of Placement The IPE Leader should consider how to recognize and thank the many who have been involved in the student IPE placement program prior to the end of the placements (e.g. during the IPE student placement presentation). We have provided certificates of recognition to students and IPE Facilitators (or letters of thanks) and emails of thanks to clinical faculty and managers. Students may need to be reminded to complete post IPE placement evaluations at the end of their placement. IPE Leader Role After Placement The IPE Leader should coordinate a meeting of all the IPE Facilitators after the IPE placement has finished. In this meeting, IPE Facilitators can reflect on the strengths of the program and opportunities for further growth in subsequent IPE placements. We have found this critical to the success of our program as we have made modifications based on this invaluable feedback. The IPE Leader should also provide all staff involved with the IPE placement with the opportunity to provide feedback regarding the student IPE placement. This may include focus groups or surveys (sample survey provided in Appendix E “IPE Placement Program Evaluation for Clinical Faculty”). Sharing and Celebrating Successes The IPE Leader, in conjunction with senior sponsors, should consider how to share student IPE placement successes. Partnering with your organization’s marketing or public affairs departments will enable the stories to be shared or hosting annual recognition/award events may be another option to consider. Opportunities for celebrating successes should also be explicitly sought. It is critical for all involved to be celebrated and for others to share in the successes. We hope that you have found this resource helpful and that your interprofessional teams will benefit from this teaching and learning opportunity. We wish you the best in leading this exciting program. Lynne, Mandy, Tracy, Aleks Toronto Rehab/University of Toronto Section 2 10 Section 2: Leading and Coordinating IPE Placements Appendix A: Sample Contacts for Student Clinical Placements In Alphabetical Order, Effective July 2007 Nursing Prepared for Toronto Rehab Chaplaincy Kong Ng University of Toronto (RN) (416) 946-0279 [email protected] Dr. Gray Hughes Yorkville University (506) 451-8844 [email protected] Keri DeCiccio-Fernandes Ryerson University (RN) (416) 979-5000 Ext. 4252 [email protected] Chiropody Jennifer Cameron York University (RN) (416) 736-2100 Ext. 20172 [email protected] Christine Burton The Michener Institute (416) 596-3103 Ext. 3065 [email protected] Medicine For 3rd and 4th year clinical elective: Eva Lagan – for U of T (416) 978-0416 [email protected] Sheila Binns – for visiting electives (non University of Toronto) (416) 978-2691 [email protected] Donna Penstone Humber College (RN & RPN) (416) 675-6622 Ext. 4387 [email protected] Heather Blachford George Brown College (RPN – Full Time) (416) 415-5000 Ext. 3191 [email protected] Gayle Bradley George Brown College (RPN – Continuing Education & Internationally Educated) (416) 415-5000 Ext. 2872 [email protected] MaryBeth Hastings-Bedard Seneca College (RPN – Full time) (416) 491-5050 Ext. 5211 [email protected] Linda Silver Seneca College (RPN – Part time) (416) 491-5050 Ext. 2879 [email protected] 11 Section 2 Occupational Therapy Social Work Rachel Stack or Donna Barker University of Toronto Rachel: (416) 978-2679 [email protected] Donna: (416) 946-8782 [email protected] Barbara Muskat University of Toronto [email protected] Occupational Therapy Assistant/ Physiotherapy Assistant Sonia Deleo Humber College (416) 675-3111 [email protected] Pharmacy Andrea Cameron University of Toronto (416) 946-3623 [email protected] Physical Therapy Brenda Mori University of Toronto [email protected] Section 2 12 Speech Language Pathology Lynn Ellwood University of Toronto [email protected] Therapeutic Recreation - Internship Adrienne Gilbert University of Waterloo (519) 888-4567 Ext. 33015 [email protected] Therapeutic Recreation - Co-op Placement Colleen Phillips-Davis Co-operative Education & Career Services (416) 423-0660 [email protected] Section 2: Leading and Coordinating IPE Placements Appendix B: IPE Placement Overview Presentation Handout Interprofessional Education Student Placement Program Goals of IPE Placement Key Elements of IPE Placement Program Purposeful and coordinated planning of placement Search for times of overlap in the curricula B January/February and May/June 2. Two introductory tutorials Interprofessional students placed together in a shared practice area at same time One of two introductory tutorials Four weekly, patient-themed group discussion tutorials Shared preparation and delivery of a formal group presentation 1. Students in a shared practice area at the same time Increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services Increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions Increased knowledge and understanding of the importance of interprofessional collaboration in the delivery of health care Enhanced skills in building interprofessional relationships and maximizing team function Icebreakers Pre-placement assessments B Interdisciplinary Education Perception Scale (Luecht, 1990) and IPE Placement Survey What is IPE? Orientation to organization and program Group functioning and norms B What are the rules of conduct in this group? Group learning objectives B What do we as a group hope to learn together from this placement? 3. Four weekly, patient-themed group discussion tutorials Weekly group tutorials (1.5 hours) with IPE Facilitators Address student learning objectives in context of actual clinical cases Content expert at each tutorial 13 Section 2 Sample IPE Weekly Patient-Themed Tutorial (11:30-1:00) 11:30 – Team and individual check-in 11:40 – Patient for that week (Mr. X) discussed by group 12:20 – Content expert briefly discusses learning objective topic (e.g. pain for 15 min) followed by group discussion 12:50 – Wrap up (including determination of next week’s patient for discussion) and feedback 4. Shared preparation and delivery of a formal group presentation Topic of students’ choice B Clinical team also makes suggestions of topics Replaces required presentations where possible Presentation to entire team (open to entire organization and academic faculty) Roles in IPE Placement Program IPE Leader B Overall co-ordination and liaising with academic partners B Site leadership with managers in choosing and preparing clinical teams B Overall orientation, education and support to Facilitators B Overall evaluation and ongoing development of program IPE Co-Facilitators B Orient to roles pre-placement B Coordinate planning of student IPE group tutorials B Co-facilitate IPE student group learning and function throughout placement IPE Clinical Faculty B Understands IPE placement philosophy, goals and processes B Fulfill supervisory obligations for student placement per usual academic processes within profession B Orient student to team member roles and team processes B Provide content expertise for group tutorials as appropriate IPE Student Article Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional education: The student perspective. Journal of Interprofessional Care, 20 (3): 246-253 Section 2 14 Section 2: Leading and Coordinating IPE Placements Appendix C: Sample Agenda for IPE Facilitator Orientation Meetings Chair: IPE Leader Attendees: All IPE Facilitators for IPE Placement block (e.g. with 3 placements, there will be 6 IPE co-Facilitators) Duration: 2 hours approximately Introductions and Welcome Review of who is involved, location and program/unit Share experiences as IPE Facilitators and with small group facilitation IPE Placements History and background Goals and roles Structure including co-facilitation Evaluation Review of roles – all (refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”) Resource review – e.g. refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”, Section 4 “Developing IPE Facilitator Skills: Workshop Resources”, and Section 6 “IPE Websites and Key References”, etc. Planning: Meetings with teams Gathering presentation ideas Orienting staff to roles Gathering student contact info Planning for introductory tutorials (room bookings, content expert, refreshments, etc.) Walking through each tutorial – what does it look like? (Refer to Section 3 “Hosting IPE Placements: A Resource for IPE Facilitators”) Forms and evaluations Pre- and post-evaluations Orientation material for students Content expert handout Clinical faculty evaluation IPE Facilitator evaluation and feedback form Planning next steps With co-Facilitator Student info gathering Planning sessions and booking rooms First content expert Student presentation ideas Next Meetings: Plan mid IPE placement meeting date and time Plan post IPE placement meeting date and time 15 Section 2 Appendix D: IPE Leader Checklist Pre IPE Placement Planning – Confirming involvement Finalize clinical teams and supervisors Liaise with Professional Practice Leaders and Academic partners re: IPE student placement planning – provide with general info (placement description, student schedule) Finalize IPE Facilitators (2 per placement) Preparing IPE Facilitators Provide IPE Facilitators with initial resource materials – e.g. small group facilitation resources, IPE readings, IPE facilitator resources, evaluation processes Plan and lead pre IPE placement meeting with IPE Facilitators (e.g. goals and roles, co-facilitation, pre-placement to-do’s, detailed overview of each session and materials in resource) IPE Facilitator workshop – Plan, lead and invite Facilitators to attend Follow up with student coordinators/professional leaders in organization and then send student email addresses to IPE Facilitators Preparing IPE clinical team Meet with clinical team – provide overview and opportunities for discussion (with IPE Facilitators if possible) Finalize clinical faculty (student supervisors) – send general information (e.g. placement description, student schedule) Logistical Planning Book presentation time and place, equipment and room setup Confirm budget (if any) for refreshments for introductory tutorials First Week of Placement Meet each group of IPE placement students to provide brief overview of student IPE placement program Student pre-placement evaluation reminders Check in with IPE Facilitators at the end of week 1 – remind re: gathering feedback evaluation End of week 2 Mid IPE Facilitator meeting – check in, feedback, collective problem solving, and discussion Email invitations for IPE presentations End of Placement (Week 4): IPE Certificates for students Post IPE placement evaluation reminders Clinical faculty evaluation and thank you letters Thank you email to manager, IPE Facilitators, others IPE Facilitator post meeting – review entire student IPE placement program Post Placement: Analysis of evaluation data Plan for the next placement Section 2 16 Section 2: Leading and Coordinating IPE Placements Appendix E: IPE Placement Program Evaluation for Clinical Faculty Thank you for your assistance and support of the IPE placement program. Your supervision of a student has been integral to the success of our IPE programs. As you know, the IPE portion of your student’s placement has finished. The information gathered from this survey will help us to develop the IPE program as we move forward with planning for future IPE learning. We are very interested in your perspectives of how the IPE placement experience has affected the student(s). Part A: Please tell us about yourself. 1. Please indicate your program: __________________________________________________ 2. Approximately how many students have you supervised throughout your career? None – this was my first One or more Approximately: _________ 3. Were you involved in any of the IPE tutorial meetings (either as a content expert or introducing the program overall in the introductory session)? Yes No Part B: Interprofessional Learning Experiences 1. Objectives of the IPE portion of this placement (attending tutorials, participating in the presentation, etc.) included increasing the students’ understanding of the roles, contributions and expertise of other health professions, as well as gaining an understanding of the importance of interprofessional collaboration. From your perspective, were these objectives met? Yes No Don’t know Please provide a specific example: 17 Section 2 2. How do you think attending the tutorials and preparing for and delivering the IPE presentation affected the student and his/her learning or attitudes overall? Please be as specific as possible. Yes No Don’t know N/A If so, how would you describe this difference? 3. In comparing this IPE placement to other placements, have you noticed any differences in the students’ learning or your supervision experience? 4. Do you have any suggestions for how to increase students’ interprofessional learning and collaboration in general? 5. Do you have any suggestions regarding the IPE placement program overall? Section 2 18 Section 2: Leading and Coordinating IPE Placements Appendix F: IPE Placement Program Description Sample from Toronto Rehabilitation Institute Students from Medicine, Nursing, Occupational Therapy, Physical Therapy, Social Work, Pharmacy, Speech Language Pathology, Psychology, Therapeutic Recreation and other professions have the opportunity to participate in interprofessional education (IPE) clinical placement experiences. The IPE placements will run in January/February and May/June this year. Students with a keen interest in interprofessionalism will be selected to participate in these student interprofessional teams. Once selected, students will be placed as an interprofessional team within one clinical care unit at Toronto Rehab. They will participate in one or two facilitated introductory tutorials and then continue to meet as a group on a regular basis for patient-themed tutorials. At some point during the later stages or on completion of their clinical experience, they will be asked to offer a group presentation. IPE Placement Program Goals The goals for this interprofessional placement program include: opportunity for students from various health care disciplines to develop an increased understanding of the expertise that each discipline brings to the solution of health problems provision of opportunities for students to learn and develop clinical expertise together opportunity to develop an understanding of team dynamics, communication skills within the team, and conflict resolution within the context of a well-functioning team Introductory Tutorials One or two introductory tutorials will be held at the beginning of the IPE placement. These tutorials will be held in the late afternoon to facilitate attendance. Students will have the opportunity to learn about each other, explore common professional interests, knowledge, experiences, and individual learning styles and needs. Students will have the opportunity to develop an understanding of team roles and responsibilities, conflict resolution, and any specific information related to the clinical skills required in the particular clinical placement. Patient-Themed Tutorials During the IPE placement, students will meet in facilitated tutorials on a regular basis. Students will take leadership in exploring learning issues pertaining to their clinical experience, the health system, and the delivery of health care services within the team. As well, students will have the opportunity to discuss issues related to interprofessional roles and collaborative practice. Shadowing experiences will be encouraged to supplement their clinical experiences. Presentation Throughout the IPE placement, students participate in the preparation of a joint interprofessional student presentation, which they will deliver at the end of the IPE placement. 19 Section 2 Debriefing and Wrap-up Following completion of their clinical experience, students will meet for a final tutorial to provide a final evaluation, an opportunity for the synthesis of knowledge, and personal reflections. Student Learning Outcomes (adapted from McMaster University Health Sciences North Interprofessional Education Pilot Project.) increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services to patients/clients (e.g. similarities, differences and potential areas of role overlap and conflict) increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions. increased knowledge and understanding of the importance of interprofessional collaboration in the delivery of health care (e.g. team building, team functioning, communication, conflict resolution) enhanced skills in building interprofessional relationships and maximizing team function. Evaluation of Student Learning Outcomes The Interprofessional Education Perception Scale (Luecht, et al., 1990) will be administered prior to and upon completion of the clinical experience to determine what changes in attitudes, if any, occurred throughout the placement. If you have any further questions regarding this innovative and exciting learning opportunity, please contact the Interprofessional Education Leader. Section 2 20 Section 2: Leading and Coordinating IPE Placements Appendix G: IPE Placement Program Overview Welcome to the IPE placement program. We are delighted that you have opted to participate in this innovative learning experience! This learning experience requires your participation and leadership; it is a self-directed, collaborative learning experience. The Facilitators are there to assist the group and facilitate your learning rather than as content experts themselves. This handout is a summary of the key elements of the placement program and expectations. What does the IPE placement consist of? IPE Placement Component A team of students are placed in the same clinical area (e.g. a common unit) Introductory Tutorials Weekly Patient-Themed Tutorials Presentation Details Students from as many professions as possible; students reflect make up of team 2 introductory tutorials (2 hours each) Once per week 1.5 hours in length Includes patient-themed discussion and feedback Last week of the placement Prepared and presented as a group Refer to detailed handout regarding presentations When do specific learning activities occur in the IPE placement? Patient Discussion Introductory Tutorials Review patient for week 1 tutorial Presentation Review details of presentation expectations Week 1 Week 2 Week 3 Discuss week 1 patient in tutorial Discuss week 2 Discuss week patient in tutorial 3 patient in tutorial Prepare for Prepare for week 2 patient discussion Confirm presentation date and time week 3 patient discussion Final date and time of presentation - Discuss group confirmed presentation - Presentation topic topic confirmed Week 4 Discuss week 4 patient in tutorial Prepare for Final placement week 4 patient debriefing occurs discussion in last weekly tutorial Prepare for Presentation presentation occurs Finalize evaluation 21 Section 2 Appendix H: IPE Placement Presentation Overview IPE Placement Presentation Students participating in an IPE placement are expected to be active group members in the tutorials and participate in the preparation and delivery of a group presentation. This group presentation is an opportunity for students to integrate learning from the literature and clinical IPE placement experiences. What if I am already expected to prepare and present for my profession? The student IPE presentation often replaces the presentation requirement set by each profession (e.g. the student OT who would usually prepare and deliver a presentation to OT participates in the student IPE presentation instead). Please discuss further with the IPE Facilitator and your supervisor to clarify details. What does planning for the IPE presentation require? As a group, the following details will need to be addressed: Confirmation of presentation topic, date and time Room and equipment booking – coordinate with IPE Facilitators Participation – all group members should be involved in the preparation and delivery of the presentation. The planning for the IPE presentation will need to be coordinated by the group. This will mean some coordination and meeting outside of the tutorials. Invitations – ensure the team working with the students is aware of and able to attend if at all possible (e.g. develop poster, announcements in rounds, etc.). Members from academic faculties may also be invited. Feedback – the group should determine how they would like to be evaluated What are the content expectations for the IPE presentation? Must meet requirements for your profession (review with your supervisor) Evidence – integration of evidence from the literature is required IPE placement experiences – the presentation should include learning from the clinical experience Consult with the IPE Facilitators for additional guidance and suggestions What if I still have questions? Please contact your IPE Facilitator if you have any other questions Section 2 22 Contents Introduction��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Roles and Responsibilities of the IPE Placement Team Members� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 3 Preparing to be an IPE Facilitator��� ��� ��� ��� ��� ��� ��� ��� ��� � 5 Tutorial Descriptions� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 7 Appendices - Selected References��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Interprofessional Collaborative Competencies��� - IPE Placement Program Description� ��� ��� ��� ��� ��� ��� - IPE Placement Program Overview ��� ��� ��� ��� ��� ��� ��� - IPE Placement Presentation Overview ��� ��� ��� ��� ��� - Pre IPE Placement Evaluation��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Icebreakers� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Facilitator Feedback Evaluation ��� - Facilitating Interprofessional Dialogue��� ��� ��� ��� ��� ��� - Small Group Troubleshooting Tips��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Content Expert Handout��� ��� ��� ��� - Post IPE Placement Evaluation � ��� ��� ��� ��� ��� ��� ��� ��� ��� - Sample IPE Student Presentation Evaluation ��� ��� - IPE Placement Presentation Handout: Overview for Clinical Team Members��� ��� ��� ��� ��� ��� - IPE Placement Presentation Handout: Overview for Students� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - IPE Placement Presentation Handout: Group Process for Students��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� �20 � 21 � 22 � 24 � 25 � 26 � 27 � 29 � 30 �31 � 33 � 34 � 35 A Resource for IPE Facilitators Section 3 A B C D E F G H I J K L M N O P Hosting IPE Placements: �36 � 38 �40 Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 3: Hosting IPE Placements Introduction This resource has been created to facilitate the development of Interprofessional Education (IPE) placements and support IPE Leaders and Facilitators in hosting student IPE placement programs at your facility. In this resource you will find the description and goals of an IPE placement, an outline of the roles and responsibilities of the IPE Placement Team Members, as well as tutorial descriptions. This resource is intended to supplement additional materials created by Toronto Rehab within this toolkit already available (e.g. workshops, resources, education, Facilitating Interprofessional Collaboration with Students DVD, etc.). The resource includes tools to support communication (e.g. handouts for students, powerpoint presentations); tools to keep IPE Facilitators on track (e.g. tips, checklists); and materials to enhance understanding (e.g. select references). Please note that although this resource provides guidelines for IPE placements, it may need to be adapted to meet the needs of your facility. Description of IPE Placement IPE has been defined as, “occasions when two or more professions learn with, from and about one another to improve collaboration and the quality of care” (UK Centre of Interprofessional Education, 1997). IPE placements provide students from a variety of professions (e.g. Nursing, Occupational Therapy, Physical Therapy, Medicine, Psychology, Social Work, Therapeutic Recreation, Pharmacy, Speech Language Pathology, Chiropody, Chaplaincy, etc.), who are presently involved in their own professionspecific clinical placement, with the opportunity to participate in interprofessional placement experiences. The students are ideally placed on the same unit/clinical area at the same time to facilitate interprofessional learning in a clinical environment. Students with a keen interest in interprofessionalism should be selected by their academic faculties to participate in these student interprofessional teams. The timing of this placement will depend on the availability of the students. For example, students from some professions may only be on placement for 5 weeks, whereas others may be learning in one clinical environment for several months. The time period in which the students overlap is designated as the IPE placement (e.g. for 4 consecutive weeks). Additional information concerning the timing of the IPE placements can be found in Section 2 “Leading and Coordinating IPE Placements: A Resource for Education Leaders and Coordinators”. While on site, students will meet in facilitated tutorials throughout their IPE placement experience. Membership will vary according to the timing of placements among the various professions. Students will have the opportunity to discuss issues related to interprofessional roles and collaborative practice. Students will also take leadership in exploring learning issues pertaining to their clinical experience, the health system, and the delivery of health care services within the team. Prior to commencement of the IPE placement (or early in the placement), students will participate in two introductory tutorials. These tutorials will provide the students with: a shared, basic understanding of the patient population served by the interprofessional (IP) team; an orientation to fundamental group skills and the establishment of group norms for the tutorials that follow. Once students are involved in their IPE placement, they will continue to meet as a group on a regular basis (usually once per week). These regular patient-themed tutorials will afford students the opportunity Section 3 to learn about a specific topic area (chosen by the group) as led by the IPE Facilitators and a “content expert”. The focus of these discussions will be the application of learning and experiences to a particular client with whom the students are already working. Throughout the IPE placement, students participate in the preparation of a joint interprofessional student presentation, which they will deliver at the end of the IPE placement. Students therefore benefit from participating in: 1. an interprofessional placement that may meet their academic requirements/evaluation 2. one or two introductory interprofessional tutorials 3. regular interprofessional patient-themed tutorials during their IPE placement 4. a joint interprofessional student presentation IPE Placement Goals Each IPE placement will provide the opportunity for students from various health care disciplines: to develop an increased understanding of the expertise that each discipline brings to the solution of health problems to develop an understanding of team dynamics, communication skills within the team, and conflict resolution within the context of a well-functioning team to learn and develop clinical expertise together Expected student outcomes include the following: increased knowledge and understanding of the roles, contributions and expertise of various team members in the delivery of health care services to patients/clients, e.g. similarities, differences and potential areas of role overlap and conflict increased understanding and respect for the values, beliefs and attitudes that both differentiate the various health disciplines and appreciation of those that are common increased knowledge and understanding of the importance of interprofessional collaboration in the delivery of health care, e.g. team building, team functioning, communication, conflict resolution enhanced interprofessional collaborative competencies ( Appendix B “Interprofessional Collaborative Competencies”) and skills in building interprofessional relationships and maximizing team function Staff involvement in IPE placements as IPE Facilitators will provide them with opportunities to: Section 3 develop or build on small group facilitation competencies from an interprofessional perspective enhance interprofessional communication role model interprofessional collaboration with an IPE co-Facilitator further develop interprofessional knowledge and interprofessional collaborative competencies Section 3: Hosting IPE Placements Roles and Responsibilities of the IPE Placement Team Members Hosting a successful IPE placement involves collaborating with individuals from across your facility and the academic community. The following outlines some of the roles and responsibilities of members of the larger IPE Placement Team. IPE Leader coordinates planning of IPE placement including determination of which placement opportunities will be offered (with program service managers), liaising with appropriate academic faculties and providing relevant information regarding IPE placement to academic faculties orients clinical faculty to IPE placement philosophy, goals and processes with Facilitators, orients students to IPE placement learning opportunities and expectations orients and supports IPE placement Facilitators, clinical faculty and students in each of their respective roles lead the evaluation and development of IPE student placement program refer to the IPE Leader Guide for additional details ( Section 2 “Leading and Coordinating IPE Placements: A Resource for Education Leaders and Coordinators” IPE Co-Facilitators meet with IPE Leader prior to placement to orient to role once settings have been identified for IPE placement, Facilitators work together to coordinate the introductory tutorials (includes booking of room, arranging for refreshments, facilitating groups, orienting group to content, facilitating interprofessional learning, initiating opportunities for formative feedback throughout placement) during IPE placement, the Facilitators act as the main coordinator for the patient-themed tutorials (includes facilitating groups, finalizing learning objectives/topics for tutorials and identification of appropriate clinical faculty content experts, responding to questions from clinical faculty, liaising with IPE Leader as appropriate, orienting students to IPE presentation expectations, coordinating presentation planning with students) meet with IPE clinical faculty to orient team, respond to questions and share relevant information review expectations with content experts (prior to content expert presentation during placement tutorials) Section 3 Clinical Faculty (students’ profession-specific clinical supervisors) understand and support IPE placement philosophy, goals and processes fulfill supervisory obligations for student placement per usual academic processes within profession including profession specific student evaluation orient student to team member roles and team processes provide content expertise for group tutorials as appropriate support IPE learning processes Students identify interest in and willingness to participate in IPE placement participate in group tutorials and presentation share expertise regarding profession with group provide feedback regarding IPE placement program Academic Faculty provide initial information regarding IPE placement opportunities to students select students for IPE placement responsible for overseeing profession-specific student placement learning Program Service Manager identifies a team who is interested in hosting a student IPE placement enables interested staff to participate in IPE placement teaching and learning opportunities liaises with IPE Facilitator as appropriate provide feedback regarding IPE placement orient students to interprofessional learning opportunities with staff, identifies and builds on interprofessional collaboration learning opportunities Senior Sponsor Section 3 organizational champion for IPE model of clinical placement provides support for IPE Leader role, IPE Facilitators, clinical faculty and management with IPE Leader, disseminates evaluation results and provides direction for student IPE placement program Section 3: Hosting IPE Placements Preparing to be an IPE Facilitator IPE Facilitator Resources There are several resources available to assist the IPE Facilitator. Facilitators may benefit from referring to information regarding IPE itself, group facilitation, giving/receiving feedback and conflict resolution. Other helpful resources include: IPE Leader, Senior Sponsor and previous IPE Facilitators Clinical faculty development learning opportunities (e.g. workshops that address giving and receiving feedback, conflict resolution, small group facilitation, etc.) Orientation and education sessions regarding IPE placements (led by IPE Leader) Key references and resources that have been included in Appendix A “Selected References” http://www.ipe.utoronto.ca – Office of IPE at the University of Toronto has many helpful resources IPE Section 6 “Websites and Key References” FACILITATION TIP Sample Small Group Troubleshooting Tips, Appendix J “Small Group Troubleshooting Tips”, may be helpful to review (in addition to resources listed in the references). Planning with IPE Co-Facilitator In facilitating IPE student small groups, an interprofessional co-facilitation model is recommended (two Facilitators from different professions) to role model collaborative patient-centred practice. Having two Facilitators for an IPE placement has worked particularly well when the novice IPE Facilitator is paired with a more experienced IPE Facilitator to build mentorship opportunities. Both students and co-Facilitators benefit from this collaboration. There are many other reasons why IPE co-facilitation is used in an IPE student placement including: role model shared learning and interprofessional collaboration Facilitators can complement each other regarding roles and tasks provision of two different role models for student learning support and learning from each other joint problem solving Facilitators can act as each other’s back up for unexpected events IPE co-Facilitators can optimize joint facilitation of the group through consideration of the following: taking the time to get to know each other (e.g. facilitation style, experience, hopes, learning opportunities) developing plans for the tutorials well in advance deciding how to share leadership agreeing on a method of communication during the tutorial supporting each other’s contributions and efforts debriefing together (e.g. share impressions – commonalities and what is unique?) Section 3 providing feedback to each other negotiating differences additional resources are listed in the references ( Appendix A “Selected References) As co-Facilitators, you will also need to discuss how you would like to gather feedback from the students (e.g. verbal or in writing). A sample facilitator feedback form has been included in Appendix H “IPE Placement Facilitator Feedback Evaluation” and can be adapted to meet the unique needs of the group and Facilitators. FACILITATION TIP You may consider asking the students for facilitator feedback both at the end of and throughout the placement (e.g. after the first couple of tutorials) to inform your ongoing facilitator development. It is critical for the IPE Facilitators to plan collaboratively and debrief after each tutorial in order to provide and receive feedback, discuss observations, reflect on process issues, consider what is working well and how to build on this, address areas of concern, discuss instances in which Facilitators felt pleased/ uncomfortable/etc. These discussions also occur with the IPE Leader on an ad hoc basis and, at minimum, mid way through the IPE placement and after the IPE placement. Frequently Several weeks (e.g. 4 weeks) prior to the IPE placement, there are some Asked logistical details of the IPE placement meetings that also need to be addressed: Question Meet with clinical team prior to IPE placement (meeting led by IPE Q Should clinical Leader) to review IPE placement program and provide opportunity faculty (student for any pre-placement discussion ( Appendix N “IPE Placement supervisors) attend the Presentation Handout: Overview for Clinical Team Members”) IPE tutorials? With reference to anticipated student schedules (e.g. consider who is part time or full time), book meeting time and location with your A As a Facilitator co-Facilitator or IPE Leader, you may Contact students (often via email) to confirm timing and location of be asked if student first orientation tutorial supervisors (clinical Provide students with copies of the IPE placement information via faculty) can attend the email in advance of the placement IPE tutorials. As this may inhibit group members’ B IPE placement program description participation, it is ( Appendix C “IPE Placement Program Description”) recommended that B IPE placement program overview student supervisors ( Appendix D “IPE Placement Program Overview”) (clinical faculty) do not B IPE placement presentation overview attend the tutorials. ( Appendix E “IPE Placement Presentation Overview”) However, clinical faculty Forward confirmed schedule of initial meeting(s) to clinical faculty should be encouraged to (direct supervisors) and clinical team discuss the tutorials with Plan content expert for first introductory tutorial the students and may be Follow up with team regarding gathering presentation ideas for IPE invited by the group to students participate in a tutorial Planning for the first tutorial may also include arranging refreshments as a content expert. and nameplates to facilitate introductions and learning of names Section 3 Section 3: Hosting IPE Placements Tutorial Descriptions The IPE tutorials are described below. Suggestions for more detailed activities (and sample questions) have been included for your reference. However, these are suggestions – it is important for you to facilitate the learning in a way that suits your personal style as well. Please do feel free to be creative and flexible (and share your ideas with everyone!). IPE Placement Introductory Tutorials The purpose of the two introductory tutorials is to initiate the building of rapport and communication between group members. Consequently, once the students commence the placement, they will already be forming an interprofessional team mirroring the existing staff interprofessional team. The timing of the introductory tutorials will vary depending on scheduling. If possible, the introductory tutorials should be scheduled prior to the actual placement beginning. Each introductory tutorial is usually 2 hours in length (often scheduled at the end of the work day). Sometimes, it may be advantageous to condense the 2 introductory tutorials into one if this is more feasible for participants’ schedules and/or if the group is smaller (e.g. 3 or 4 students). Introductory Tutorial One Outline In tutorial one, the students will begin to work together as a group. This initial tutorial provides opportunities for the students to begin to learn about each other as individuals; start to understand each other’s professional roles; explore common professional interests, knowledge and experiences; share individual learning styles and needs and begin to learn about why each group member has chosen to participate in this unique learning experience. Sample Agenda: Introductory Tutorial One introductions of group members B students and co-Facilitators icebreakers ( Appendix G “Icebreakers”) – learning about each other as individuals and professionals B consider icebreakers that both encourage students to get to know each other on both a personal and professional level role of IPE co-Facilitators introduction to IPE ( Appendix O “IPE Placement Presentation Handout: Overview for Students”) introduction to patient population and program (by content expert from team) Group process discussion and plans Introductions of Group Members In the first tutorial, name tags or name plates may be introduced to facilitate introductions. Further, a contact list of current email addresses should be established to facilitate future communications. While group members are arriving, you may consider inviting students to complete the pre-placement evaluation. This evaluation may include a survey ( Appendix F “Pre IPE Placement Evaluation”) to collect qualitative data as well as a standardized tool (such as the Interdisciplinary Education Perception Scale, Luecht, 1990). Please refer to the Office of IPE website ( http://www.ipe.utoronto.ca) and the Section 3 references in this resource for additional suggestions regarding evaluation tools. At Toronto Rehab, we have used the Interdisciplinary Education Perception Scale (Luecht, 1990) successfully for several years. Icebreakers There are a range of icebreakers that can be used to facilitate interpersonal and interprofessional learning. There are several reasons to use icebreakers including: opportunity for introductions creates a relaxed, safe learning environment builds trust, respect & support enhances professional identity creates inclusion & honours diversity encourages leadership & self-direction fosters cooperation & teamwork builds a foundation for collaboration have fun From an IPE perspective, icebreakers help students to learn about each other as individuals and may also introduce them to the professional roles in a more interactive way. Importantly, the icebreakers are one way that IPE Facilitators will begin to create an environment where members can feel safe to raise and respond to questions respectfully, as the primary purpose of this group is to advance interprofessional learning and understanding. FACILITATION TIP If you are holding two introductory tutorials, consider focusing on learning about each other as individuals first and use icebreakers focused on learning about professions in tutorial two. A range of icebreaker resources are included in this package ( Appendix G “Icebreakers”). Role of IPE Co-Facilitators The role of the IPE co-Facilitator is outlined in the introduction of this resource. It is important for the students to understand that your role is to facilitate interprofessional understanding and collaboration, and content expertise will be introduced as the learning needs are identified by group members. At this point, it may be important to discuss one way of understanding groups in terms of content (tasks to do) and process (how the group functions), stressing that a group needs both in order to function effectively. This can also be addressed towards the end of this tutorial. It is also important to be transparent with respect to student evaluation. Clinical faculty may invite feedback from the IPE Facilitators regarding a student’s performance. In this initial tutorial, it is critical that the students are aware that, although you are not supervising them, the clinical faculty member who is supervising may ask for feedback from the Facilitators as they may with any other team member with whom the student works. Section 3 Section 3: Hosting IPE Placements FACILITATION TIP Students will likely want to know why you have opted to be an IPE Facilitator. Facilitators are encouraged to share reasons for participating and experiences with interprofessional working and IPE. Facilitators should also discuss what they are hoping to learn from working with the group. Role modeling lifelong learning and growth in interprofessional collaboration and education may be powerful for students to hear. This may also help to set the stage for a feeling of safety in the group as everyone is learning and may help students to provide feedback to the Facilitators. Introduction to IPE The IPE Leader or IPE Facilitator will provide an initial orientation to the concept of IPE widely and its history in the organization. It is important to ensure the students share a common understanding of interprofessional education and have the opportunity to discuss this. ( Appendix O “IPE Placement Presentation Handout: Overview for Students”) FACILITATION TIP This portion can run the risk of becoming very didactic and may reduce the energy in the group. It is therefore advisable to consider how to best convey the information in an interactive manner that builds on the group’s knowledge and experiences. Sample questions that can facilitate discussion may include: What is interprofessional education? How does IPE differ from multiprofessional education? What do you know about IPE coming into this placement? What are you hoping to gain from the IPE placement? How do you think it differs from other placements? The overview will also include an introduction to the expectations of the IPE placement that may differ from traditional placements. These expectations include: regular attendance at all tutorials (communicate via email if absence cannot be avoided in advance of tutorial) and contribution to group tutorials and presentation (date and time set in advance of placement by IPE Leader). These general IPE placement program expectations are important to discuss in this tutorial as the group will build on this in developing specific group norms in the second introductory tutorial. Handouts may be used to supplement student understanding of the material (some Facilitators include these in a folder for each student): IPE placement program description ( Appendix C “IPE Placement Program Description”) IPE placement program overview ( Appendix D “IPE Placement Program Overview”) IPE placement presentation overview ( Appendix E “IPE Placement Presentation Overview”) Section 3 FACILITATION TIP As students may have had experience with interprofessional learning, consider asking them to share their most meaningful interprofessional learning experiences with the group. FACILITATION TIP Students may also want to learn about how former students have found the IPE placements. Facilitators may wish to consider referring to an article written by students who participated in the IPE placement program previously (Lumague et al, 2006 – refer to Appendix A “Selected References”). Introduction to the Patient Population and Program A clinical faculty member from the staff interprofessional team will provide group members with an overview of the patient population and key issues of importance with respect to the specific patient population. The content expert (consider using content expert handout, Appendix K “IPE Placement Content Expert Handout”) should provide students with a description of the patient population (e.g. common patient goals, length of stay, where they are discharged), how it fits into the larger organization and an overview of who is on the team (including which professions). This initial content expert may also be the unit/service’s manager or director. Students may find it helpful to receive an information pamphlet about the service if feasible. Group Process Discussion and Plans It is important for IPE Facilitators to set the stage for interactive group work throughout placement including your role as Facilitators (not content experts) and expectation of group feedback at the end of each tutorial. For example, the group may decide to plan time at the end of each tutorial to discuss group process. Introductory Tutorial Two Outline In the second introductory tutorial, students will have the opportunity to develop a better understanding of team roles and responsibilities. They will discuss their experiences as group members (e.g. belonging to a sports team) and Facilitators and consider how these experiences can impact interprofessional team functioning. As the students will have a range of familiarity with group structure and processes, discussion of types of groups, group roles, processes, characteristics and dynamics may be addressed. Skills involved in giving/receiving feedback and conflict resolution in a group setting may also be addressed. At the end of this tutorial, the group will be encouraged to set specific group goals (e.g. tutorial learning objectives) that will frame their development and learning together during the IPE placement. Section 3 10 Section 3: Hosting IPE Placements Frequently Asked Question Q Should the content expert be expected to deliver a formal presentation? A Ideally, content experts should be able to speak to their subject without too much preparation (beyond gaining an understanding of the needs of the group members). Content experts should be encouraged to be interactive in their approach and provide key points. This may also be a good opportunity for the content expert/IPE Facilitators to identify IP learning opportunities outside of structured tutorials (e.g. shadow each other, family conference participation, interprofessional goal setting, etc.). Sample Agenda: Introductory Tutorial Two introductions of group members icebreakers ( Appendix G “Icebreakers”) learning about each other’s roles development of group norms understanding group process development of group learning objectives review of IPE student presentation ( Appendix E “IPE Placement Presentation Overview”) planning for first patient-themed discussion Introductions of Group Members In the second tutorial, nameplates can again be used to facilitate introductions (and may be used throughout all tutorials if desired). Icebreakers A range of icebreakers ( Appendix G “Icebreakers”) resources are included in this package. Importantly, the icebreakers are one way that IPE Facilitators will begin to create an environment where members can feel safe to raise and respond to questions respectfully, as the primary purpose of this group is to advance interprofessional learning and understanding. Please refer to tutorial one outline above for additional details regarding icebreakers. Learning about each other’s roles In tutorial one, you may not have had the opportunity to discuss the roles of the various professions in sufficient detail. IPE Facilitators indicate that this initial discussion is fundamental to the students’ understanding. FACILITATION TIP Questions that may prompt process discussion include: When do you think the group was working at its best? What contributed to this? How did our team work today? What worked well? How can we build on what is working well? Suggestions for changes? 11 Section 3 FACILITATION TIP Sample questions have been listed below to guide the role discussion (more detailed than the first introductory tutorial): Why did you choose to enter your profession? Describe the role of your profession B How does your profession become involved (e.g. referral?) B Assessment processes B Interventions B Discharge planning What other professions do you work closely with? How or in what way? Development of Group Norms It is critical for groups to develop norms or ground rules for how the group will work and how members will interact. Group norms can be renegotiated at any time during the group’s meetings. The group may decide to keep these available for reference in the event that anyone would like to discuss further/renegotiate them (e.g. post them in each session). FACILITATION TIP Some group members may feel quite comfortable and open in sharing group norms. Others may need more time for reflection prior to engaging in discussion. In order to accommodate both styles, consider asking students to reflect individually on some of the questions below and record their thoughts prior to sharing with the group at large. You may want to ask the students to generate group norms in a list or use the suggestions below to make this more interactive. In pairs or groups of 3, share with each other a positive group/team experience. What contributed to the group’s success? In the large group, brainstorm re: effective functioning. What do students want their group to look like by the end of the placement? What group norms do they want for this group? What formal group roles do we want in this group (if any)? E.g. a timekeeper, recorder, treat bringer, chair, etc. How will these be determined in each meeting? Sample group norms that have been used in previous interprofessional groups include: Section 3 12 Group members should be encouraged to ask questions and clarify jargon Group members will commit to checking email at least once daily to facilitate communication Section 3: Hosting IPE Placements The group will set aside 10 minutes minimum in each tutorial to discuss explicitly how the group is functioning (group process) At the beginning of each tutorial, members will briefly check-in with each other (e.g. How is everyone doing today? Discuss any other pertinent information from last tutorial, address housekeeping issues, etc.) Feedback should be both constructive and positive and geared to individuals and group FACILITATION TIP As the discussion of group norms is critical for interprofessional collaborative teamwork, it is extremely important that the development and adherence to group norms is role modeled effectively and that group norms are considered in discussions throughout the tutorials. Students may also be challenged to consider how this may impact their own working life beyond the IPE placement experiences. For example, how will they go about learning the group norms in their next placement/employment? How can they address the challenge of working on teams that don’t seem to have group norms? Understanding group process This may also be a good opportunity to briefly discuss group process. This may be addressed in several ways (suggestions listed below): Many students may have had the opportunity of working in small groups in the past. Ask them to discuss how they understand group process. Facilitators can provide an overview of how groups are understood (e.g. stages of group development, content/task vs. process) based on the sample handout ( Appendix P “IPE Placement Presentation Handout: Group Process for Students”). Tools that may assist in understanding the group’s process have been included in the references ( Appendix A “Selected References”) FACILITATION TIP The role of the Facilitator will change with the stage of group development. Co-Facilitators will want to reflect on the stage of group development throughout the tutorials and consider how best to enact their role as Facilitators. For example, in the forming stage, the Facilitator may take on more of a directive role. Development of group learning objectives To gear the patient-themed tutorials to the needs of the students, it is critical that the group develops shared interprofessional learning objectives. Through the development of common objectives, the shared learning needs of students who may be at different levels in their education and have diverse experiences can be identified. As a group, determine and prioritize the group learning objectives – what will be particularly helpful for the entire group to learn? These objectives will then inform subsequent selection of patients and content experts for the weekly discussion tutorials. 13 Section 3 FACILITATION TIP Students may be asked to reflect on sample learning objectives individually, record these and then share with the group to facilitate equal participation. Sample Interprofessional Learning Objectives: Understand the unique contributions of the professions Identify areas of common practice (e.g. shared scopes of practice) Describe the roles of team members effectively to patients/families Describe how the interprofessional team addresses pain management on the unit Review of IPE student presentation The IPE student presentation is a critical component of the IPE placement program. Students have consistently reported that this presentation strongly encourages interprofessional collaboration and is an exceptionally valuable learning experience. As many students have student presentation requirements as part of their profession specific student placement program, the IPE presentation can be considered as a replacement; this will need to be negotiated with the clinical and academic faculty. The IPE student presentation may also be of great value to the clinical team as the team initially provides the student group with a list of potential topics they would like addressed. The IPE student group therefore has the opportunity to ‘give back’ to the clinical team. From the discussion of the group’s learning objectives, the group may begin to identify a potential presentation topic. The Facilitators can also share the potential presentation ideas provided by the clinical team for the students’ consideration. Although this is only the second tutorial, it is important for the students to work towards identifying a potential presentation idea early in the placement. FACILITATION TIP Many IPE student groups have identified the advantages of preparing a presentation based on issues they have addressed to some extent in the tutorials (as opposed to working on a totally separate topic). Planning for the First Patient-Themed Tutorial In this tutorial, the group will need to identify criteria for the selection of a patient for the first weekly patient-themed discussion (to allow time for students to prepare). Selection of the patient can be conducted in different ways – it may be completed using a chronological approach (e.g. start with a newly admitted patient, followed by one midway through the admission, one being discharged, etc.) or based on prevalent challenges (e.g. communication problems, motor, cognitive, etc.) or other. It is up to the group, based on the learning needs as a whole, to decide. For example, the students may indicate that they want to learn more about how the interprofessional team addresses pain management. The patient selected for discussion may then be identified by the clinical team (prompted by the Facilitators) based on the students’ learning needs and on the students’ work with the patient (i.e. ideally the students are all working with the same patient). Section 3 14 Section 3: Hosting IPE Placements Frequently Asked Question Q Does there need to be a separate patient for discussion for each tutorial? A It depends on the needs of the group. For some placements, the IPE student group has opted to discuss a complex patient for the entire 4 weeks, whereas many groups opt to discuss one patient per tutorial. Frequently Asked Question Q Do the students need to actually meet the patient for discussion each week? A Students need to come prepared to discuss their professional role for each tutorial. In the event that the student is not already working with that patient, the student should be encouraged to discuss options with the clinical faculty (e.g. speak with the clinical faculty about his/her role with that particular patient, have the opportunity to read the chart and discuss with the clinical faculty, or talk about how clinicians in the profession might work with someone with a similar or identical diagnosis and range of issues, etc.). Issues regarding confidentiality in relation to the preparation for patient discussions are critical to address (consider what your organization’s practices are). Weekly Patient-Themed Tutorials In planning for the weekly patient-themed tutorial: Confirm learning objectives and corresponding content expert Confirm identification of patient for discussion each week Send confirmed schedule to clinical faculty (including content and locations) Review format of tutorial with expert ( Appendix K “IPE Placement Content Expert Handout”) Based on the students’ interprofessional learning objectives, the patients and content experts are selected (as far as possible in advance to provide sufficient notice). The group will also need to consider how to address issues that may not be readily filled by a single content expert. For example, in addressing the need to learn more about the roles of several professionals who are not represented in the group, students may decide to each interview/ shadow another profession to learn about their role generally and with respect to a common patient. This information is then shared with the group. Depending on the learning needs of the students, a content expert (interprofessional team member) may be invited to the patientthemed tutorial to provide input related to a common learning issue. Selection of the team member is driven by the common learning needs of the students related to the particular patient to be discussed that week. For example, students may be working with a patient on the unit for whom discharge planning is of concern. The Social Worker may then be invited towards the end of the tutorial to discuss discharge planning generally and as it relates particularly to the patient. We have learned that inviting the content expert towards the end of the session is one strategy to facilitate interactively. If the content expert is invited in at the beginning and stays throughout the session, the tutorial may become more didactic and focused on content (e.g. pain management) rather than interprofessional learning. Students incorporate information from the content expert into the discussion of the clients. The objectives of the placement tutorials are to learn more about a particular content area, to learn from each other the role of various professionals in addressing a particular area of concern for a particular client and to continue developing their interprofessional collaborative competencies. 15 Section 3 FACILITATION TIP Facilitators should consider how they plan to facilitate interprofessional dialogue in these tutorials. ( Appendix I “Facilitating Interprofessional Dialogue”) Preparing the Content Expert Section 3 16 Clear guidelines (e.g. maximum 15 minutes in length, interactive, create stops/pauses in presentation where students can engage and discuss amongst themselves etc.). Discuss strategies regarding format that will maximize student participation and student collaboration. Refer to content expert handout, Appendix K “IPE Placement Content Expert Handout”, for additional details (this is an option to consider). As clinicians’ teaching experience is often limited to their own professions and is one-to-one in nature, we recommend a brief discussion with content experts to explore teaching and group dynamics and consideration of how to structure their presentation so that the students engage with each other. It is important for the content experts to understand that the role of the Facilitators is to promote student engagement with one another and that the tutorial is not solely for the presenter to disseminate information. For example, the content experts often appreciate knowing in advance that they may be interrupted in order to help facilitate the discussion if students are not participating. Supplemental learning resources may be used if desired but not expected (e.g. handout, reference to resources available on unit, etc.). Content experts do not need to stay for the entire tutorial. Sometimes it facilitates group discussion further if the content expert leaves the tutorial after questions have been addressed. Frequently Asked Question Q Is a content expert required at each tutorial? A A content expert is not required at each tutorial. Alternatively, the group may decide that they want to reflect on a common team opportunity instead (e.g. everyone observes rounds and the group reflects on what happened, roles, etc.). The group may decide to review a patient and then reflect as a group about how the professional team functions. This may be an opportunity to address team collaboration (e.g. What is it? How does it occur? Who makes decisions? How are decisions made on this team? etc.) Other groups have also used a tutorial to clarify the theoretical foundations of each profession and then explore commonalities and differences amongst professions. Section 3: Hosting IPE Placements Sample agenda for weekly patient-themed tutorial: 11:30 Group starts with ‘housekeeping’ and member check-in (e.g. energy level rating, best thing about this week, last tutorial, interesting interprofessional learning opportunities experienced, etc.) 11:45 Patient for that week discussed from perspective of each student 12:15 Content expert arrives and presents until 12:30 12:30 to 12:45 Further discussion 12:45 to 1:00 Wrap up (including determination of next week’s patient for discussion) and group feedback FACILITATION TIP As the placement progresses, Facilitators will want to ensure process issues are addressed on an ongoing basis. Tools such as the Facilitator feedback form, ( Appendix H “IPE Placement Facilitator Feedback Evaluation”), may be used to gather information. The Critical Incident Questionnaire (Brookfield, 1998) outlined below can also be used to understand practice through the lens of the learner: Critical Incident Questionnaire (Brookfield, 1998) At what moment were you… B most engaged? B most distanced? What action anyone took was… B most affirming or helpful? B most puzzling? B most confusing? What surprised you the most? These questions are provided in a handout and students are asked to complete anonymously (with the explicit understanding that the composite results may be discussed in the next tutorial). The Facilitators can then use the information to inform facilitation in the future and reflect the information back to the group for further discussion. Brookfield, S. (1998). Critically reflective practice. Journal of Continuing Education in the Health Professions, 18:197-205. 17 Section 3 IPE Presentation Towards the end of the placement, the students will be expected to present a topic of relevance to their IPE learning experiences. This presentation should include the contributions of all of the students and requires the students to integrate research evidence into their own IPE experiences. The presentation should be approximately 40 minutes in length (plus 10 minutes for discussion). The students are expected to set time outside of their tutorials to prepare for their presentation. Specifically, the students will need to: decide on topic work together to prepare develop evaluation plan (sample IPE Student Presentation Evaluation feedback form, Appendix M “Sample IPE Student Presentation Evaluation”, can be adapted) deliver presentation as a group Students may benefit from learning about prior IPE student groups presentations; please contact the IPE Leader if you would like copies. Students must review their contributions to the IPE placement presentation with their respective clinical faculty for feedback. Students should also be encouraged to practice their presentation at least once for the IPE Facilitators (to enable Facilitators to provide feedback prior to the actual presentation). Final Tutorial In the final patient-themed tutorial, the post IPE placement evaluation, Appendix L “Post IPE Placement Evaluation”, (e.g. qualitative survey and scale) is administered to the students. Students should also be invited to provide feedback regarding their experiences. This tutorial will also provide an opportunity for the synthesis of knowledge and personal reflections. Sample questions may include: What did they learn about themselves? What surprised them about the placement? What surprised them about working with the other disciplines? How do they think they can continue this learning in their own practice/studies? What do they take with them from this experience? How do you plan to develop your interprofessional skills in the future? The group may find that there is insufficient time in this last tutorial to re-administer the scale and survey. These may also be submitted after the last tutorial to the Facilitator (or IPE Leader). IPE Facilitators may also invite specific feedback from the group members regarding their own abilities as IPE Facilitators. Students who are continuing their placements should be encouraged to build on their interprofessional learning and feel free to continue to meet informally with other students on placement. Section 3 18 Section 3: Hosting IPE Placements We hope that you have found this resource helpful and that you and your IP student teams will benefit from this teaching and learning opportunity as much as we have. Lynne, Mandy, Tracy, Aleks Toronto Rehab/University of Toronto 19 Section 3 Appendix A: Selected References Barr, H. (1998). Competent to collaborate: Towards a competency-based model for interprofessional education. Journal of Interprofessional Care, 12:181-187. Barr, H., Koppel, I., Reeves, S., Hammick, M. & Freeth, D. (2005). Effective interprofessional education: Argument, assumption and evidence. Blackwell Publishing: Oxford. Crow, J. & Smith, L. (2003). Using co-teaching as a means of facilitating interprofessional collaboration in health and social care. Journal of Interprofessional Care, 17(1): 45-55. D’Amour, D. & Oandasan, I. (2005, May). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care, 19 (Supplement 1):8-20. Davoli, G. (2004). Stacking the deck for success in interprofessional collaboration. Health Promotion Practice, 5(3): 266-270. Freeth, D. Hammick, M. Reeves, S., Koppel, I. & Barr, H. (2005). Effective interprofessional education. development, delivery and evaluation. Blackwell Publishing: Oxford. Heinemann, G.D., Schmitt, M.H., Farrell, M.P. & Brallier, S.A. (1999). Development of an attitudes toward health care teams scale. Evaluation & the Health Professions, 22: 123-142. Luecht R.M., Madsen M.K., Taugher M.P. & Petterson B.J. (1990). Assessing professional perceptions: design and validation of an Interdisciplinary Education Perception Scale. Journal of Allied Health 19(2):181-91 Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional education: The student perspective. Journal of Interprofessional Care, 20 (3): 246-253. Orchard, C.A., Curran, V. & Kabene, S. (2005). Creating a culture for interdisciplinary collaborative professional practice. Med Educ Online, 10:11. Available from http://www.med-ed-online.org Parsell, G. & Bligh, J. (1998). Interprofessional Learning. Post graduate Medical Journal, 74: 89-95. Tiberius, R.G. (1995). Small Group Teaching: A Trouble-Shooting Guide. OISE Press/The Ontario Institute for Studies in Education. Toronto: Canada. Westberg, J. & Jason, H. (1996). Coleading small groups. In Fostering Learning in Small Groups. Springer Publishing Co. Inc. p. 110-155. Tools that may assist in understanding group process include: Working on Teams Survey: What Stage is our Team in? http://web.mit.edu/hr/oed/learn/teams/tool_stage.html e.g. Team Effectiveness Surveys http://web.mit.edu/hr/oed/learn/teams/tool_effectiveness.html http://www.ballfoundation.org/ei/tools/teams/survey-print.html Section 3 20 Section 3: Hosting IPE Placements Appendix B: Interprofessional Collaborative Competencies There are different ways of understanding interprofessional collaborative competencies. D’Amour and Oandasan (2005) describe the IP competencies as: Barr (1998) describes interprofessional collaborative competencies as follows: Knowledge Roles • Describe one’s roles and responsibilities clearly to other professions. Skills/Behaviours Communication Reflection • Recognize and observe the constraints of one’s role, responsibilities and competence, yet perceive needs in a wider framework. Attitudes Mutual respect Open to trust Willing to collaborate • Recognize and respect the roles, responsibilities and competence of other professions in relation to one’s own. • Work with other professions to effect change and resolve conflict in the provision of care and treatment. • Work with others to assess, plan, provide and review care for individual patients. • Tolerate differences, misunderstandings and shortcomings in other professions. • Facilitate interprofessional case conferences, team meetings, etc. • Enter into interdependent relations with other professions. Way, Jones & Busing (2000) describe seven essential elements for collaboration: Mutual trust and respect Autonomy Responsibility Communication Coordination Assertiveness Cooperation The authors also acknowledge issues of power, hierarchy and conflict that impact these elements. 21 Section 3 Appendix C: IPE Placement Program Description Sample from Toronto Rehabilitation Institute Students from Medicine, Nursing, Occupational Therapy, Physical Therapy, Social Work, Pharmacy, Speech Language Pathology, Psychology, Therapeutic Recreation and other professions have the opportunity to participate in interprofessional education (IPE) clinical placement experiences. The IPE placements will run in January/February and May/June this year. Students with a keen interest in interprofessionalism will be selected to participate in these student interprofessional teams. Once selected, students will be placed as an interprofessional team within one clinical care unit at Toronto Rehab. They will participate in one or two facilitated introductory tutorials and then continue to meet as a group on a regular basis for patient-themed tutorials. At some point during the later stages or on completion of their clinical experience, they will be asked to offer a group presentation. IPE Placement Program Goals The goals for this interprofessional placement program include: opportunity for students from various health care disciplines to develop an increased understanding of the expertise that each discipline brings to the solution of health problems provision of opportunities for students to learn and develop clinical expertise together opportunity to develop an understanding of team dynamics, communication skills within the team, and conflict resolution within the context of a well-functioning team Introductory Tutorials One or two introductory tutorials will be held at the beginning of the IPE placement. These tutorials will be held in the late afternoon to facilitate attendance. Students will have the opportunity to learn about each other, explore common professional interests, knowledge, experiences, and individual learning styles and needs. Students will have the opportunity to develop an understanding of team roles and responsibilities, conflict resolution, and any specific information related to the clinical skills required in the particular clinical placement. Patient-Themed Tutorials During the IPE placement, students will meet in facilitated tutorials on a regular basis. Students will take leadership in exploring learning issues pertaining to their clinical experience, the health system, and the delivery of health care services within the team. As well, students will have the opportunity to discuss issues related to interprofessional roles and collaborative practice. Shadowing experiences will be encouraged to supplement their clinical experiences. Presentation Throughout the IPE placement, students participate in the preparation of a joint interprofessional student presentation, which they will deliver at the end of the IPE placement. Section 3 22 Section 3: Hosting IPE Placements Debriefing and Wrap-up Following completion of their clinical experience, students will meet for a final tutorial to provide a final evaluation, an opportunity for the synthesis of knowledge, and personal reflections. Student Learning Outcomes (adapted from McMaster University Health Sciences North Interprofessional Education Pilot Project.) increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services to patients/clients (e.g. similarities, differences and potential areas of role overlap and conflict) increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions. increased knowledge and understanding of the importance of interprofessional collaboration in the delivery of health care (e.g. team building, team functioning, communication, conflict resolution) enhanced skills in building interprofessional relationships and maximizing team function. Evaluation of Student Learning Outcomes The Interprofessional Education Perception Scale (Luecht, 1990) will be administered prior to and upon completion of the clinical experience to determine what changes in attitudes, if any, occurred throughout the placement. If you have any further questions regarding this innovative and exciting learning opportunity, please contact the Interprofessional Education Leader. 23 Section 3 Appendix D: IPE Placement Program Overview Welcome to the IPE placement program. We are delighted that you have opted to participate in this innovative learning experience! This learning experience requires your participation and leadership; it is a self-directed, collaborative learning experience. The Facilitators are there to assist the group and facilitate your learning rather than as content experts themselves. This handout is a summary of the key elements of the placement program and expectations. What does the IPE placement consist of? IPE Placement Component A team of students are placed in the same clinical area (e.g. a common unit) Introductory Tutorials Weekly Patient-Themed Tutorials Presentation Details Students from as many professions as possible; students reflect make up of team 2 introductory tutorials (2 hours each) Once per week 1.5 hours in length Includes patient-themed discussion and feedback Last week of the placement Prepared and presented as a group Refer to detailed handout regarding presentations When do specific learning activities occur in the IPE placement? Patient Discussion Introductory Tutorials Review patient for week 1 tutorial Presentation Review details of presentation expectations Section 3 24 Week 1 Week 2 Week 3 Discuss week 1 patient in tutorial Discuss week 2 Discuss week patient in tutorial 3 patient in tutorial Prepare for Prepare for week 2 patient discussion Confirm presentation date and time week 3 patient discussion - Discuss group presentation topic Final date and time of presentation confirmed - Presentation topic confirmed Week 4 Discuss week 4 patient in tutorial Final placement Prepare for debriefing occurs week 4 patient in last weekly discussion tutorial Prepare for Presentation presentation occurs Finalize evaluation Section 3: Hosting IPE Placements Appendix E: IPE Placement Presentation Overview IPE Placement Presentation Students participating in an IPE placement are expected to be active group members in the tutorials and participate in the preparation and delivery of a group presentation. This group presentation is an opportunity for students to integrate learning from the literature and clinical IPE placement experiences. What if I am already expected to prepare and present for my profession? The student IPE presentation often replaces the presentation requirement set by each profession (e.g. the student OT who would usually prepare and deliver a presentation to OT participates in the student IPE presentation instead). Please discuss further with the IPE Facilitator and your supervisor to clarify details. What does planning for the IPE presentation require? As a group, the following details will need to be addressed: Confirmation of presentation topic, date and time Room and equipment booking – coordinate with IPE Facilitators Participation – all group members should be involved in the preparation and delivery of the presentation. The planning for the IPE presentation will need to be coordinated by the group. This will mean some coordination and meeting outside of the tutorials. Invitations – ensure the team working with the students is aware of and able to attend if at all possible (e.g. develop poster, announcements in rounds, etc.). Members from academic faculties may also be invited. Feedback – the group should determine how they would like to be evaluated What are the content expectations for the IPE presentation? Must meet requirements for your profession (review with your supervisor) Evidence – integration of evidence from the literature is required IPE placement experiences – the presentation should include learning from the clinical experience Consult with the IPE Facilitators for additional guidance and suggestions What if I still have questions? Please contact your IPE Facilitator if you have any other questions 25 Section 3 Appendix F: Pre IPE Placement Evaluation Placement Site: Program (e.g. musculoskeletal, spinal cord): Location (e.g. unit, day hospital): Current professional program: Year of study in current professional program: 1 2 3 4 Other: ____________ Please write the degree that you will receive at the end of your program: ______________________________________________________________________________ If you have completed any previous clinical placements, please indicate how many weeks and in what practice area: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Please list any previous interprofessional education sessions or events that you have attended: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Why are you involved in this IPE placement? _______________________________________________________________________________ ______________________________________________________________________________ __________________________________________________________________________________________________ _________________________________________________________________________________________________ What do you hope to learn from the IPE placement? _______________________________________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________________________ ___________________________________________________________________________________________ Thank you! If you have any questions, please contact the Interprofessional Education Leader. Section 3 26 Section 3: Hosting IPE Placements Appendix G: Icebreakers Misconceptions Get into pairs. Share with your partner the biggest misconception the public has about your profession. How would you educate the public about this misconception? Come back to the large group and process your findings – what did you learn? How did you feel about speaking about the misconceptions or hearing the misconceptions? How might this occur when working with patients or caregivers? Speed Disciplining Set up chairs in 2 circles, one inside the other. Have students sit in the circles facing a partner. Facilitator will be the timekeeper. The students have two minutes to find out all they can about the other student’s discipline (education, training, areas of employment, what they do in day-to-day practice etc.). Timekeeper calls time at two minute mark and everyone quickly goes to a new seat with a new partner and repeat the process. Come back to the large group after and share one or two things that they learned or surprised them about another discipline. Here’s My Card Hand out cue cards and pens – have the students think of 3 or 4 qualities of their discipline or activities of their profession but don’t write the name of the discipline on the card. Have them write the 3 or 4 qualities plus a catchy advertising phrase on their business cards. Have the students exchange cards, and then share what’s written on the card one at a time in the large group. Large group guesses which profession it is. True or False? Ask the students to say 3 things about themselves – 2 which are true and one that is not. Everyone has to guess the false one. Then the students think of 3 things about their profession; 2 things that are false and one thing that is true – guess the true thing. Similar/Dissimilar Get into groups of 3. One person is the recorder. Write down all the things about your professions that are similar. Write down all the things that are different in your professions. Come back and share in the large group. Magic Hat Students write down 2 questions each about 2 different professions – put the questions in a hat. Pass the hat around and each student pulls a question out of the hat to answer. They have to convince the groups that they are that particular profession – afterward try to guess who the actual nurse, PT, etc. are – clarify any of the questions/answers at that time. School Ties Get into pairs – share with your partner what profession you are in and where you are studying. Share what has been the most challenging part of your education to date. Share what has been the most exciting and rewarding part to date. In the large group share what you think your “growing edge” for the IPE placement is. Consider writing these on a flip chart to learn where students have similar IPE goals. 27 Section 3 Time Capsule You are building a time capsule and are asked to put 3 things in the capsule that best reflect your profession and what you do in patient care. Introduce yourself to the group, and share with the group what things you would choose, and why. Jargon Acronyms and Jargon – ask everyone to write down 3 acronyms/jargon words that are common to their profession but that may not be as familiar to other professions. Invite the group to search through the list looking for commonalities or differences in how words are used (e.g. transfer from acute care, transfer from bed to wheelchair, etc.). Or you may choose to have the students work in 2s or 3s and swap papers and ask others to guess what they are. The writer can then explain, clarify and ask who else uses these words/acronyms (e.g. PT, OT, Nursing very likely have shared understanding of transfer). Profession Description Choose a profession. Ask everyone to write down on a paper (anonymously) what he or she believes describes the role, educational preparation, etc. The student whose profession was chosen then reviews these and comments on their accuracy, what surprised them. First Moments In pairs – share the moment when you decided to become your particular health care professional. Describe it – where you were, when it was etc. What were the factors or inspiration for your choice? Come back to the large group - What are 3 qualities of your profession? How are you like those qualities? Ball of Yarn Stand in a circle facing each other. One person starts, holding a ball of yarn. Share patient care activities with the group. Hold onto your end of the yarn and pass the ball of yarn to someone opposite you. That person grabs onto the line of yarn and shares their activities. If you notice that someone shares an activity that is similar to what you may do or how you might work with a patient, ask for the ball of yarn to be passed back to you. Continue to hold onto points on the line and build a yarn “patient care” net connecting all of you. You may wish to be creative on how you wrap the yarn around each other! These next exercises are fun, a little more creative, and may be more risky for the students Superhero “Superman…faster than a speeding bullet…able to leap tall buildings in a single bound… challenged by kryptonite.” Create a superhero name for your discipline/profession and a phrase that indicates your profession’s superhero ability or quality plus the biggest challenges in your profession. Introduce yourself to the group as your superhero persona. Fairy Tale (this is actually taken from a Comedy Improvisation game) All Fairy Tales have a protagonist (patient) and a challenge to overcome (injury/disease) and heroes or heroines (health care providers). Sit in a circle – starting with the opening line “Once upon a time…. in the far off land of…….” Start your story and then stop when you want the person beside you to take over. Be sure to include aspects of your profession in the funny little fairy tale. You may choose to say a whole phrase or just one word – the challenge is to leave the story hanging and for the next person to rush in with the next part of the story. Icebreakers prepared by Barb Coulston, Pharmacist, Toronto Rehab Section 3 28 Section 3: Hosting IPE Placements Appendix H: IPE Placement Facilitator Feedback Evaluation Date: Name of Facilitator(s): Please comment on the following general Facilitator characteristics. Please rank on a 7 point scale, where 1=poor and 7 = Excellent. Promotion of thinking and problem solving 1 2 3 4 5 6 Comments: 7 Ability to encourage interaction 1 2 3 4 5 6 Comments: 7 Provision of an environment in which you felt safe and comfortable participating 1 2 3 4 5 6 7 Comments: Facilitation of the group’s learning (e.g. address learning objectives) 1 2 3 4 5 6 7 Comments: Ability to highlight clinically relevant issues 1 2 3 4 5 6 7 Comments: Ability to role model and facilitate interprofessional collaboration 1 2 3 4 5 6 Comments: 7 What other feedback would you like to provide to the Facilitator(s)? Consider both positive and constructive feedback (areas to improve). Comments: 29 Section 3 Appendix I: Facilitating Interprofessional Dialogue 1. Introduction Introductions – invite group members to introduce self; nameplate use Recorder? Time keeper? (if roles decided upon earlier in group tutorials) 2. Role discussion Students should briefly review client chosen for discussion (relate to learning issue identified) What has your role been with the patient? How does that differ from another profession’s role? Did anything surprise you on learning about each other’s roles? Where do the roles overlap? What is unique about this role? How can you work together more closely to address the patient’s concerns more effectively? Knowing what you now know, will this change how you work with the patient? With other professions? What have you identified as areas for additional learning? Describe? How will you address these? 3. Content expert input 4. Check understanding What questions do you have for the content expert? How does this relate to your experiences? 5. Wrap up Final questions or comments? Suggestions for future tutorials? Including selection of next patient for discussion 6. Group Feedback Section 3 30 How did you find the group today? What worked well? Suggestions for improving group function? Section 3: Hosting IPE Placements Appendix J: Small Group Troubleshooting Tips Some strategies to address challenges you may encounter in your groups are listed below: Poor time planning – set goals and time agendas, invite group to select a time keeper, remind group of schedule, delegate tasks, summarize key points to assist the group to move forward, ask the group how they would lie to address time problems Digression from goals – use flip chart with group goals listed, redirect, use agreed upon learning objectives that were developed by group to guide discussions Students are not active enough – use probing questions (open ended), give positive feedback, address individually - ask directly to comment (e.g. what would the role of the pharmacist be in this situation?), take turns responding in order, give everyone a minute or 2 to think about a particular question (some may want this time for quiet reflection prior to being able to speak ‘off the top of their heads’), don’t always try to fill the silence Students may be reluctant to share their lack of knowledge about a key area. Prior to moving on to interpretation, ensure that the group has clarified all of the relevant information up front (focus on the facts, clarify terms, ask others to clarify jargons and acronyms, etc.), ask, ‘what surprised you?’ Students who dominate – redirect (e.g. “before we move on, I would like to get some reactions from others…”), everyone takes a turn around the group Conflict – identify conflicts openly – “there seems to be a conflict here, how should we as a group move on and address this?”, work to identify source (e.g. lack of information, environmental stress, etc.), use of conflict resolution resources Lack of feedback – you may want to invite your group to give positive and constructive feedback (e.g. what did you like best about that? What do you think could be improved for next time? How?) Students interacting with Facilitator or speaker primarily rather than each other – ask direct questions (e.g. How would this work for speech language pathology?), when the person responds to you, look at other group members to encourage them to do the same, ask questions of the group for the students if necessary e.g. ‘ what questions do you have about speech language pathology?’, comment directly e.g. ‘this is a time for you to learn about each other – you needn’t respond directly to me’; ‘we want you to become more comfortable working as a team, try commenting or asking questions of each other directly’, ask them to reflect on something in pairs or triads and then share with group. For more information, please refer to IPE facilitator resources (including Tiberius, R.G. (1995). Small group teaching: A trouble-shooting guide. OISE Press: Toronto). With files from L. Sinclair and M. Lowe 31 Section 3 Sample Small Group Facilitation Tips 1. Use of open-ended questions to promote discussion 2. Thank group members for their participation 3. Be aware of own and others’ non-verbal communication (e.g. eye contact) 4. Listening is key 5. Encourage enthusiasm and be enthusiastic – e.g. speak with interest 6. Allow time for silence 7. Invite open participation– members are more likely to respond if assured that the purpose of the group is to learn – there is no “wrong” answer 8. Encourage interaction – “That’s similar to what Kate said, what do you think Pete?” 9. Attend to visual (e.g. Body language, eye contact) and verbal cues of group members 10. Use humour - have fun Section 3 32 Section 3: Hosting IPE Placements Appendix K: IPE Placement Content Expert Handout Thank you for agreeing to be a content expert as part of the IPE placement program. We look forward to the tutorial and wanted to share with you some background information in order to work with you to prepare for the tutorial. Please discuss the tutorial with the IPE Facilitators in advance regarding the specific learning needs of the group and other strategies individualized to address the needs of this particular group. Students in this group are from a range of professional backgrounds and are at varying stages in their academic preparation (students may be in their first or last placements). The group has also been meeting for a very short time overall. The IPE placement is only 4 weeks long, and meets for 2 introductory tutorials and once weekly patient-themed tutorial discussions (6 times in total, depending on length of placement). In this tutorial, students will be discussing a patient and sharing their perspectives as collaborative team members, discussing what each profession can bring to the professional team in working with the patient and family as well as opportunities for collaboration. The role of the IPE Facilitators is to facilitate the interprofessional learning of the students. They will ask probing questions, clarify jargon and address misconceptions and opportunities for collaboration. The IPE Facilitators are not acting in the capacity of content expert. The group has selected a patient for discussion in advance of your tutorial with them. From this discussion, they have determined a common learning need for which they require your expertise. Your contribution to this group may be best thought of as contributing to the group discussion overall. It is hoped that the students will interrupt you to ask questions and feel free to discuss issues you raise (an interactive tutorial as opposed to a didactic lecture). You may consider stops/pauses where students can engage and discuss amongst themselves. You may want to be prepared with questions you can ask the students. After the tutorial, please do provide feedback to the IPE Facilitators. We look forward to your feedback. Thank you again. 33 Section 3 Appendix L: Post IPE Placement Evaluation Please complete the following questions: Placement Site: Program (e.g. musculoskeletal, spinal cord): Location (e.g. unit, day hospital): Current professional program: What were the 3 most important things that you learned in this IPE placement? What do you wish had been different or would have helped you to learn more about IPE? Do you think this will have changed your school experience and/or career choices? If so, please describe further. We are trying to learn more about how IPE affects patient care directly. If possible, please describe a situation during which your learning from this IPE educational experience had a direct impact on patient care. Thank you for your feedback! If you have any questions, please contact the Interprofessional Education Leader. Section 3 34 Section 3: Hosting IPE Placements Appendix M: Sample IPE Student Presentation Evaluation Strongly Disagree Did you learn what you were expecting to learn from this session? Strongly Agree 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 Were the Presenters: Enthusiastic? Knowledgeable? Clear and well-organized? Were the principles of interprofessionalism clearly demonstrated? What did you like about the presentation overall? What suggestions do you have for improvements? Any other comments? Thank you for providing feedback. 35 Section 3 Appendix N: IPE Placement Presentation Handout: Overview for Clinical Team Members IPE (Interprofessional Education) Placement IPE Placement Program History and Plans Student Learning Outcomes January, February or May, June One or Two introductory tutorial sessions B Pre-placement assessments B What is IPE? B Orientation to organization and unit B Group functioning and norms B Group learning objectives Weekly group tutorials (1.5 hours) with IPE Facilitators and content expert Role of IPE Facilitators 36 Students placed in common unit/area 1 or 2 introductory tutorials Weekly, patient-themed tutorials Joint student presentation IPE Placement Details Understanding of the roles, contributions and expertise of various health professionals Understanding and respect for the values, beliefs and attitudes that differentiate the various health professions Understanding of the importance of inter-professional collaboration in the delivery of health care Enhanced skills in building inter-professional relationships and maximizing team function Elements of IPE Placement Program Section 3 IPE Leader (name): IPE Co-Facilitators (names): Facilitation of interprofessional learning - process Coordinate tutorials Respond to questions and share relevant information with IPE clinical faculty and students Review role of content experts (prior to content expert involvement during tutorials) Logistics e.g. when, where, planning of presentation, etc. Section 3: Hosting IPE Placements IPE Clinical Faculty Supervise student (per usual standards) Orient student to team member roles and team processes Provide opportunities for learning for students from different professions (e.g. shadowing, initiating contact with other students/team members, etc.) May participate in group tutorials as a clinical Facilitator by providing content expertise regarding a particular learning issue of interest Provide feedback re: IPE placement experiences Sample IPE Weekly Patient Themed Tutorial Who will be involved in supervising IPE students? 11:30 – group starts with any ‘housekeeping’ and member check-in 11:45 – patient for that week discussed from perspective of each student 12:15 – content expert arrives and presents until 12:30 12:30 to 12:45 – further discussion 12:45 to 1:00 – wrap up (including determination of next week’s patient for discussion) and group feedback IPE Facilitators: Names Profession: Supervisor Name Profession: Supervisor Name Profession: Supervisor Name Profession: Supervisor Name Profession: Supervisor Name Next Steps Planning of introductory session(s)? B Content Expert? B When? Confirmation of students Days/times preferences for tutorials? IPE student presentation/project ideas? 37 Section 3 Appendix O: IPE Placement Presentation Handout: Overview for Students Interprofessional Education Student Placement: Learning With, From and About Each Other Introductory Sessions – Sample Outline for Session 1 Icebreaker – getting to know each other as people Introduction to professional roles in group What is Interprofessional Collaboration (IPC)? What is Interprofessional Education (IPE)? Overview of placement B Schedule B Presentation B IPE beyond the tutorial sessions Overview of unit (guest) Contact information – email address/other exchange What does IPE Mean? Interprofessional Education Definitions “Members (or students) of two or more professions associated with health or social care, engaged in learning with, from and about each other” (CAIPE, 2002) Student Education “interprofessional learning is education specifically designed to help students to function as part of the health care team when they graduate” (Cook, 2004) Interprofessional 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 & Busing, 2000 Interprofessional Practice Health Care Assessment Uniprofessional-centric model Patient Individual Professionals Section 3 38 Section 3: Hosting IPE Placements Multiprofessional Practice Health Care Assessment Integrated Care Plan Shared care plan Individual Professionals Patient Goals of Student IPE Placement Program Increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services Increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions Increased knowledge and understanding of the importance of inter-professional collaboration in the delivery of health care Enhanced skills in building inter-professional relationships and maximizing team function 4 Key Elements of IPE Placement Program 1��� 2��� 3��� 4��� Interprofessional students placed together in a shared practice area at same time One or two introductory tutorials Four weekly, patient-themed group discussion tutorials Shared preparation and delivery of a formal group presentation 39 Section 3 Appendix P: IPE Placement Presentation Handout: Group Process for Students Interprofessional Education: Learning From, With and About Each Other Session 2 Why use small group learning in IPE? To promote: B Involvement in learning B Motivation and satisfaction with learning B Critical thinking and application of ideas B Enhance communication and collaboration A Balancing Act…. Task Stages of Group Development 40 Identify actions or issues that are interfering with group functioning Create opportunities for improvement and change Find ways for the group to share responsibility Fostering Group Function: How? Section 3 Forming - tentative, hesitant Storming - realize work ahead, almost panic Norming - as they work together, initial resistance fades, start helping each other Performing - more comfortable with each other, effective Adjourning/Mourning Fostering Group Function: We All Have a Role Process Observe and clarify group process Listen and question Summarize and help to focus the group Identify sources of interprofessional conflict Give and receive feedback Section 3: Hosting IPE Placements Feedback Timing of feedback B Formative (ongoing) vs. summative (at the end) General B How was the group today? Describe behaviour not character traits Giving Feedback using CORBS Clear Observed (and Owned) Regular Balanced – positive and constructive Specific – use examples Receiving Feedback Potential Causes of Conflict Differences Feeling obligated Feeling controlled Feeling unappreciated Pride, fear, feelings of low self-esteem may also contribute to conflict Addressing Conflict Thank person for providing feedback Ask for clarification as needed Listen and summarize to ensure comprehension Discuss strategies to address and consider establishing a plan Breathe Listen, listen, listen…listen some more Focus on the issue Use positive communication B e.g. CORBS when providing feedback Maintain integrity and relationship Interprofessional Group Learning Objectives 41 Section 3 Contents Introduction��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Workshop Overview ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Planning for the Workshop ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 2 Orientation/Introduction� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 4 Icebreakers� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 5 Small Group Learning and IPE��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 6 Facilitating Small Interprofessional Student Groups – DVD� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 7 Developing IPE Facilitator Skills: Workshop Resources Small IP Group Facilitation: Strategies for Challenges� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 8 Evaluation and Wrap Up� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 8 Debriefing for Workshop Leaders and Organizers��� � 9 Section 4 Appendices A B C D E F G H I J - Small IPE Group Facilitation Workshop: Satisfaction & Feedback��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Small IPE Group Facilitation Workshop: Pre-Test ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Small IPE Group Facilitation Workshop: Pre-Workshop Reflections� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Sample Orientation/Introduction Presentation��� - Icebreakers� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Icebreaker Presentation��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� - Small Group Facilitation Resources��� ��� ��� ��� ��� ��� ��� - Facilitating Small Interprofessional Groups� ��� ��� ��� - DVD Scenario Analysis Exercise�� ��� ��� ��� ��� ��� ��� ��� ��� - Small IPE Group Facilitation Workshop: Post-Test��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 10 � 11 � 12 � 13 � 17 �19 � 20 � 24 � 27 �28 Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 4: Developing IPE Facilitator Skills Introduction This resource has been developed to assist Interprofessional Education (IPE) Leaders/Coordinators in leading a half day workshop that will enable key stakeholders to learn more about the student IPE placement program. The workshop is designed primarily to assist IPE co-Facilitators (individuals who lead the IPE student placement groups) develop small interprofessional (IP) group skills. It is also offered to those planning to participate in an IPE placement as clinical faculty (staff supervising students) or as members of the team in which the students will be working, as well as managers and other leaders interested in learning more about IPE facilitation. Workshop Overview This workshop is designed for a group of approximately 30 participants from a range of professions and roles. This allows for both large and small group interactions and activities. Sample agenda for a morning workshop: 8:30 - 8:50 Orientation/Introduction 8:50 - 9:30 Interprofessional Education (IPE) Overview: theory/ models/ environmental scan 9:30 - 10:00 Icebreakers 10:00 - 10:30 Small Group Learning and IPE 10:30 - 10:45 Break 10:45-11:30 Interactive session on facilitating small IP student groups using an educational DVD 11:30 - 12:15 Identifying strategies to address challenges of small IP group facilitation 12:15 - 12:30 Evaluation & Wrap Up Materials required to lead the workshop have been included throughout this document. We have included key teaching points based on our experience of leading this workshop since 2006. Section 4 Planning for the Workshop Participants should be asked to RSVP in advance of the workshop so the content and process can be tailored to the participants’ needs. You might consider conducting a brief needs assessment prior to the workshop to further inform the design of the workshop. In planning for the workshop, there are several factors to consider as outlined below: Workshop Leaders and Support Workshop leaders should have experience with both interprofessional education and workshop leadership. It is ideal if at least 2 (possibly 3) leaders run the workshop. Administrative support is key to the success of the workshop. For example, having another person register participants while the leaders prepare for the workshop is very helpful. Set Up It is recommended that small tables seating approximately 6 people are set up in the room. One flip chart and markers should be available for each table. Table Assignment In order to maximize interprofessional (IP) learning and to optimize the range of professions represented at each table, it is highly beneficial if participants are assigned to tables in advance. Interaction can be further facilitated through nameplates. Resource Table It may be helpful to have key articles and books available for participants to refer to throughout the workshop. We typically include the following on our resource table: Barr, H., Koppel, I., Reeves, S., Hammick, M. & Freeth, D. (2005). Effective Interprofessional Education – Argument, Assumption & Evidence. Blackwell Publishing Ltd.: Oxford. Freeth, D., Hammick, M., Reeves, S., Koppel, I. & Barr, H. (2005). Effective Interprofessional Education – Development, Delivery & Evaluation. Blackwell Publishing Ltd.: Oxford. D’Amour, D. & Oandasan, I. (2005, May). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care, 19 (Supplement 1), 8-20. Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional education: The student perspective. Journal of Interprofessional Care, 20 (3): 246-253. Oandasan et al. (2005) Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada, Canadian Health Services Research Foundation (CHSRF). Available from http://www.chsrf.ca/research_themes/workplace_e.php Orchard, C.A., Curran, V. & Kabene, S. (2005). Creating a culture for interdisciplinary collaborative professional practice. Medical Education Online, 10:11. Available from http://www.med-ed-online.org Section 4 Section 4: Developing IPE Facilitator Skills Evaluation Planning for the workshop should also include careful consideration of evaluation data. We have used both an educational evaluation form (satisfaction with workshop and feedback) and a knowledge pre- and post-test self-assessment (refer to Appendix A “Small IPE Group Facilitation Workshop: Satisfaction & Feedback” and Appendix J “Small IPE Group Facilitation Workshop: Post-Test”). DVD Considerations The “Facilitating Interprofessional Collaboration with Students” DVD and companion teaching manual are used in this workshop. As the DVD contains 6 scenarios, it is important that the workshop leaders are familiar with the scenarios and select them based on the needs of the participants (we recommend no more than 2 scenarios be used per workshop). The DVD teaching manual is an invaluable resource of teaching strategies and key teaching moments. This DVD, and others (including “Student Experiences in IPE”), are available from the Office of IPE at the University of Toronto ( http://www.ipe.utoronto.ca). Audiovisual Requirements A videodata projector will be required for the powerpoint presentation. For the DVD, it is critical that the computer has both video and audio capabilities. Depending on the room setup, a handheld microphone may need to be held next to the computer speaker. Material Preparation In preparing printed materials, we have found it helpful to use coloured paper for easy identification; for example, the DVD handouts can then be referred to as “the pink sheets”. Section 4 Orientation/Introduction The purpose of the orientation (~ 20 minutes in length) is to provide participants with terminology, history and context regarding IPE. An overview of the student IPE placement program can also be discussed so participants start to develop an understanding of the student IPE placement process and the roles associated with the program. Finally, the agenda for the workshop is reviewed. Participant Arrival After participants register (sign in, receive workshop material and table assignment, and complete a nameplate), they can complete the pre-workshop reflections form that will be used towards the end of the workshop, as well as the anonymous pre-workshop test. (Refer to Appendix C “Small IPE Group Facilitation Workshop: Pre-Workshop Reflections and Appendix B “Small IPE Group Facilitation Workshop: Pre-Test”). The pre-test should be collected prior to the start of the workshop. Detailed Outline (refer to Appendix D: “Sample Orientation/Introduction Presentation”) Participants complete pre-workshop material Pre-Test and Pre-Workshop Reflections Workshop (refer to Appendix B “Small IPE Group Facilitation Workshop: Pre-Test” and Appendix C “Small IPE Group Facilitation Workshop: Pre-Workshop Reflections”) Agenda for workshop: B Definitions of IPE and IPC Section 4 B Rationale for IPE B Workshop objectives B Student IPE placement program overview FACILITATION TIPS • In reviewing the agenda, participants may also be invited to share their hopes for the workshop and these can be recorded (e.g. on a flip chart). The workshop leaders can then refer to these throughout the workshop as appropriate. • In reviewing the definitions, participants may be invited to reflect on IPE, multiprofessional practice and interprofessional practice and share their responses with the large group. Section 4: Developing IPE Facilitator Skills Icebreakers As members of the interprofessional small groups within the workshop will be working together and may not be familiar with each other as individuals or in their professional roles, it is important to assist them in their work by providing the opportunity for icebreakers (refer to Appendix E “Icebreakers”). This is valuable learning, as they will also experience how the students might feel when engaging in this activity. Detailed Outline Brief presentation (refer to Appendix F “Icebreaker Presentation”) Assigning of icebreakers Icebreaker participation Debrief about icebreakers FACILITATION TIPS In providing an overview, it is helpful to ask participants why they could use/ have used icebreakers It is helpful to select icebreakers in advance to provide the entire group with a range of icebreakers. If there are 6 tables, we often assign the same icebreaker to 2 tables resulting in 3 different icebreakers for discussion Ensure sufficient time is provided for the icebreakers – at least 20 minutes for actual icebreaker participation. In the large group debrief, invite each table to discuss the icebreaker they used and their reactions – what did they like about it? Could they see this working with students? Section 4 Small Group Learning and IPE In this section, participants are very briefly introduced to small group theory, the role of the IPE Facilitator, feedback and special considerations when working with interprofessional small groups. Participants should also be alerted to the resources (refer to Appendix G “Small Group Facilitation Resources”) in the handout including troubleshooting, feedback and references. Detailed Outline (refer to Appendix H “Facilitating Small Interprofessional Groups”) Discussion – why use small groups? Understanding small groups: B Task and process B Stages of group development B Roles played Facilitator role Feedback Special considerations with small interprofessional groups FACILITATION TIPS As this session is fairly didactic and is right before the break, there may be a risk of a drop in the group’s energy; engage interaction by asking questions of the participants. Workshop leaders may consider moving this session before the icebreakers and ending with icebreakers just before the break. Section 4 Section 4: Developing IPE Facilitator Skills Facilitating Small Interprofessional Student Groups – DVD This session uses the educational DVD developed by Toronto Rehab and the Office of IPE, entitled, “Facilitating Interprofessional Collaboration with Students”. Workshop participants will have the opportunity to view interprofessional small group facilitation and discuss strategies specific to the scenarios. What makes this session particularly effective is the opportunity to engage in experiential learning; participants see, feel and react emotionally to the interprofessional scenarios. The DVD insert (21 pages) contains valuable descriptions and teaching tips. One DVD Scenario Analysis Exercise handout will need to be provided to each participant for each scenario used (i.e. 2 per participant if viewing 2 scenarios). Refer to Appendix I “DVD Scenario Analysis Exercise”. Detailed Outline Introduction to DVD Orientation to DVD handouts (refer to Appendix I “DVD Scenario Analysis Exercise”) Play a video scenario Participants individually reflect and record responses Participants discuss in their small groups Large group discussion Play another video scenario Participants individually reflect and record responses Participants discuss in their small groups Large group discussion FACILITATION TIPS In the interest of time, you may consider inviting participants to reflect individually on viewing the second scenario and then move to a “pause and play” model in which the scenario is played again and participants indicate to the large group when and how they would intervene as a Facilitator (i.e. exactly what words they would use). Section 4 Small IP Group Facilitation: Strategies for Challenges In this section, participants have the opportunity to form groups based on the challenges they outlined in their pre-workshop reflections (refer to Appendix C “Small IPE Group Facilitation Workshop: Pre-Workshop Reflections”). The formation of these groups requires careful facilitation by the workshop leaders. This is an active way to engage participants in generating possible strategies to address common challenges. This session is valuable as it provides a forum for interprofessional sharing and networking among participants. Detailed Outline Introduction to activity Large group discussion B What small IP group facilitation challenge did each person identify? Share with large group Create small groups (according to common challenges). Develop strategies to address the challenges and record insights and suggestions on a flip chart Share strategies with large group FACILITATION TIPS F orming groups can be challenging in the moment. It may be advantageous for less experienced leaders to determine common small IP group facilitation challenges ahead of time and assign to tables. As the groups are developing their strategies, it is important for the workshop leaders to ‘float’ and encourage an interprofessional focus as much as possible. Participants often report very meaningful learning from this portion of the workshop. Consequently, it may be helpful to collect the flip chart papers, collate the information and send to the participants after the workshop. Evaluation and Wrap Up In this section, a summary of the workshop and final comments/questions are addressed and post-workshop data is gathered (refer to Appendix A “Small IPE Group Facilitation Workshop: Satisfaction & Feedback” and Appendix J “Small IPE Group Facilitation Workshop: Post-Test”). Section 4 Section 4: Developing IPE Facilitator Skills Debriefing for Workshop Leaders and Organizers After the workshop, it is advisable to evaluate the workshop and consider what changes may be necessary for future iterations. We hope that you have found this resource helpful and that you and your interprofessional teams will benefit from this teaching and learning opportunity. We wish you the best with your teaching! Lynne, Mandy, Tracy, Aleks Toronto Rehab/University of Toronto Section 4 Appendix A: Small IPE Group Facilitation Workshop: Satisfaction & Feedback 1. What did you find most useful about today’s session? 2. What is the one thing you will do differently with your students/learners? 3. How do you feel we can improve today’s workshop? 4. What other topics would you like to see addressed in future workshops? 5. Speaker Evaluation: Please rate by circling the appropriate number (1=poor, 5=excellent) Speaker Clarity Relevance Audiovisual 12345 12345 12345 12345 12345 12345 12345 12345 Comments 12345 6. What learning format would you prefer in future sessions (e.g. Small group work, lectures, case discussions, a mix of different activities, etc.)? 7. Please rate your overall satisfaction with this workshop Very Dissatisfied 1 2 3 4 5 6 Very Satisfied 7 8 9 10 8. Any other comments? Thank you for your feedback. It will help us to develop future sessions. Section 4 10 Section 4: Developing IPE Facilitator Skills Appendix B: Small IPE Group Facilitation Workshop: Pre-Test 1. Please rate your understanding of the rationale for interprofessional education for students. (1 = poor, 5 = excellent) 1 2 3 4 5 2. Please rate your ability to describe the rationale for small group work with interprofessional learners. (1 = poor, 5 = excellent) 1 2 3 4 5 3. Please rate your ability to identify defining attributes of successful small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 4. Please rate your knowledge of the use of icebreakers in small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 5. Please rate your ability to use icebreakers as a Facilitator of small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 6. Please rate your ability to use strategies to address challenges encountered in interprofessional small group learning. (1 = poor, 5 = excellent) 1 2 3 4 5 7. Please rate your overall confidence as a Facilitator of interprofessional small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 11 Section 4 Appendix C: Small IPE Group Facilitation Workshop: Pre-Workshop Reflections (For your own reference – this will not be collected) Please take a few moments prior to the workshop to reflect on the following (you will be asked to briefly share later in the workshop): What specific difficulty have you encountered (or are most concerned about) in facilitating small interprofessional groups? (specific to interprofessional aspects of small groups) Section 4 12 Section 4: Developing IPE Facilitator Skills Appendix D: Sample Orientation/ Introduction Presentation Small IPE Group Facilitation Workshop Agenda 8:30 - 8:50 Orientation 8:50 - 9:30 (IPE) Overview/ theory/ models/ environmental scan 9:30 - 10:00 Icebreakers 10:00 - 10:30 Small Group Learning and IPE 10:30 - 10:45 Break 10:45-11:30 Facilitating small IP student groups - Interactive session with educational DVD 11:30 - 12:15 Identify strategies to address challenges with small IP group facilitation 12:15 - 12:30 Evaluation & Wrap up What does Interprofessional Education (IPE) Mean? Interprofessional Education Definitions B “Members (or students) of two or more professions associated with health or social care, engaged in learning with, from and about each other” (Geissler, 2002) B Student Education “interprofessional learning is education specifically designed to help students to function as part of the health care team when they graduate” (Cook, 2004) Multiprofessional Education Health Care Assessment Integrated Care Plan Shared care plan Individual Professionals Patient 13 Section 4 Interprofessional Education Health Care Assessment Uniprofessional-centric model Patient Individual Professionals Why Interprofessional Education (IPE)/ Collaboration (IPC)? 2005 - Health Canada IPE for Collaborative Patient Centred Practice B IPE is interdependent with collaborative practice B IPE must start in university B IPC must be modeled in hospitals & clinics Strengthen the Canadian healthcare system B Recruitment & retention B Improve patient outcomes B Enhance organizational & system efficiencies Why is interprofessional collaboration important? Sample Interprofessional Care Outcomes: 14 (Zwarenstein et al, 2005) (D’Amour & Oandasan, 2005) (Cohen & Bailey, 1997) U of T and TAHSN Mandate By 2009, the Office of IPE will establish curriculum for all Health Science Students B IPE learning activities B IPE clinical placements B Team assessment (e.g. TOSCE) Graduates must be competent collaborators What is Toronto Rehab’s Role? Section 4 Improved patient outcomes Improved cost efficiency Improved health professional satisfaction Share expertise Contribute to clinical placement program development Assist other sites to develop IPE placements Develop enduring materials accessible through the Office of IPE, U of T Section 4: Developing IPE Facilitator Skills Interprofessional Education Process & Outcomes Health Professional Collaborator Competencies Knowledge Roles of other health professionals Skills Communicating with others Reflecting upon my role and others Attitudes Mutual respect Willingness to collaborate Openness to trust (Oandasan & Reeves 2004) Workshop Objectives Goals of IPE Placement Interprofessional students placed together in a shared practice area at the same time Two introductory tutorials Four weekly, patient-themed group discussion tutorials Shared preparation and delivery of a formal group presentation Role of the IPE co-Facilitator Increased knowledge and understanding of the roles, contributions and expertise of various health professionals in the delivery of health care services Increased understanding and respect for the values, beliefs and attitudes that differentiate the various health professions Increased knowledge and understanding of the importance of inter-professional collaboration in the delivery of health care Enhanced skills in building inter-professional relationships and maximizing team function Four Key Elements of Student IPE Placement Program Identify rationale for IPE student placements Describe and use a range of icebreakers for small interprofessional groups Describe rationale for using small groups in interprofessional education Use effective strategies to address challenges while facilitating small groups of interprofessional learners Orient to role (with support of IPE Leader) pre-placement Coordinate planning of student IPE group tutorials Co-facilitate IPE student group learning and function throughout placement 1) Students in a shared practice area at the same time Purposeful and coordinated planning of placement Searches for times of overlap in the curricula B e.g. January/February and May/June 15 Section 4 Sample IPE Placement Schedule November December January February Social Work Pharmacy Psychology Physiotherapy RN OT Medicine RPN 2) Two introductory tutorials 3) Four weekly, patient-themed group discussion tutorials 16 Topic of students’ choice B Team also makes suggestions of topics Replaces required presentations where possible Presentation to entire team (open to all of organization and academic partners) Role of Clinical Faculty Section 4 Weekly group tutorials (1.5 hours) with IPE Facilitators and content expert Address student learning objectives in context of actual clinical cases Content expert 4) Shared preparation and delivery of a formal group presentation Icebreakers Pre-placement assessments B e.g. Interdisciplinary Education Perception Scale (Leucht et al., 1990) and IPE Placement Survey What is IPE? Orientation to organization and clinical area (e.g. unit) Group functioning and norms B What are the rules of conduct in this group? Group learning objectives B What do we as a group hope to learn together from this placement? Understands IPE placement philosophy, goals and processes Fulfill supervisory obligations for student placement per usual academic processes within profession Orient student to team member roles and team processes Provide content expertise for group tutorials as appropriate Section 4: Developing IPE Facilitator Skills Appendix E: Icebreakers Misconceptions Get into pairs. Share with your partner the biggest misconception the public has about your profession. How would you educate the public about this misconception? Come back to the large group and process your findings – what did you learn? How did you feel about speaking about the misconceptions or hearing the misconceptions? How might this occur when working with patients or caregivers? Speed Disciplining Set up chairs in 2 circles, one inside the other. Have students sit in the circles facing a partner. Facilitator will be the timekeeper. The students have two minutes to find out all they can about the other student’s discipline (education, training, areas of employment, what they do in day-to-day practice etc.). Timekeeper calls time at two minute mark and everyone quickly goes to a new seat with a new partner and repeat the process. Come back to the large group after and share one or two things that they learned or surprised them about another discipline. Here’s My Card Hand out cue cards and pens – have the students think of 3 or 4 qualities of their discipline or activities of their profession but don’t write the name of the discipline on the card. Have them write the 3 or 4 qualities plus a catchy advertising phrase on their business cards. Have the students exchange cards, and then share what’s written on the card one at a time in the large group. Large group guesses which profession it is. True or False? Ask the students to say three things about themselves – 2 which are true and one that is not. Everyone has to guess the false one. Then the students think of 3 things about their profession; 2 things that are false and one thing that is true – guess the true thing. Similar/Dissimilar Get into groups of 3. One person is the recorder. Write down all the things about your professions that are similar. Write down all the things that are different in your professions. Come back and share in the large group. Magic Hat Students write down 2 questions each about 2 different professions – put the questions in a hat. Pass the hat around and each student pulls a question out of the hat to answer. They have to convince the groups that they are that particular profession – afterward try to guess who the actual nurse, PT, etc. are – clarify any of the questions/answers at that time. School Ties Get into pairs – share with your partner what profession you are in and where you are studying. Share what has been the most challenging part of your education to date. Share what has been the most exciting and rewarding part to date. In the large group share what you think your “growing edge” for the IPE placement is. Consider writing these on a flip chart to learn where students have similar IPE goals. 17 Section 4 Time Capsule You are building a time capsule and are asked to put 3 things in the capsule that best reflect your profession and what you do in patient care. Introduce yourself to the group, and share with the group what things you would choose, and why. Jargon Acronyms and Jargon – ask everyone to write down 3 acronyms/jargon words that are common to their profession but that may not be as familiar to other professions. Invite the group to search through the list looking for commonalities or differences in how words are used (e.g. transfer from acute care, transfer from bed to wheelchair, etc.). Or you may choose to have the students work in 2s or 3s and swap papers and ask others to guess what they are. The writer can then explain, clarify and ask who else uses these words/acronyms (e.g. PT, OT, Nursing very likely have shared understanding of transfer). Profession Description Choose a profession. Ask everyone to write down on a paper (anonymously) what he or she believes describes the role, educational preparation, etc. The student whose profession was chosen then reviews these and comments on their accuracy, what surprised them. First Moments In pairs – share the moment when you decided to become your particular health care professional. Describe it – where you were, when it was etc. What were the factors or inspiration for your choice? Come back to the large group - What are 3 qualities of your profession? How are you like those qualities? Ball of Yarn Stand in a circle facing each other. One person starts, holding a ball of yarn. Share patient care activities with the group. Hold onto your end of the yarn and pass the ball of yarn to someone opposite you. That person grabs onto the line of yarn and shares their activities. If you notice that someone shares an activity that is similar to what you may do or how you might work with a patient, ask for the ball of yarn to be passed back to you. Continue to hold onto points on the line and build a yarn “patient care” net connecting all of you. You may wish to be creative on how you wrap the yarn around each other! These next exercises are fun, a little more creative, and may be more risky for the students Superhero “Superman…faster than a speeding bullet…able to leap tall buildings in a single bound…challenged by kryptonite.” Create a superhero name for your discipline/profession and a phrase that indicates your profession’s superhero ability or quality plus the biggest challenges in your profession. Introduce yourself to the group as your superhero persona. Fairy Tale (this is actually taken from a Comedy Improvisation game) All Fairy Tales have a protagonist (patient) and a challenge to overcome (injury/disease) and heroes or heroines (health care providers). Sit in a circle – starting with the opening line “Once upon a time…. in the far off land of…….” Start your story and then stop when you want the person beside you to take over. Be sure to include aspects of your profession in the funny little fairy tale. You may choose to say a whole phrase or just one word – the challenge is to leave the story hanging and for the next person to rush in with the next part of the story. Icebreakers prepared by Barb Coulston, Pharmacist, Toronto Rehab Section 4 18 Section 4: Developing IPE Facilitator Skills Appendix F: Icebreaker Presentation Right from the Start How do you engage a group? How do you facilitate a group to B Learn about themselves B Interact with each other …. ICEBREAKERS! Goals of Icebreakers Opportunity for introductions Creates a relaxed, safe learning environment Builds trust, respect & support Enhances professional identity Creates inclusion & honours diversity Encourages leadership & self-direction Fosters cooperation & teamwork Builds a foundation for collaboration Most of all to have fun! 19 Section 4 Appendix G: Small Group Facilitation Resources Troubleshooting with Small Groups Some strategies to address challenges you may encounter in your groups are listed below: Poor time planning – set goals and time agendas, invite group to select a time keeper, remind group of schedule, delegate tasks, summarize key points to assist the group to move forward, ask group how they would like to address time problems. Digression from goals – use flip chart with group goals listed, redirect, use agreed upon learning objectives that were developed by group to guide discussions Students are not active enough – use probing questions (open ended), give positive feedback, address individually - ask directly to comment (e.g. what would the role of the pharmacist be in this situation?), take turns responding in order, give everyone a minute or 2 to think about a particular question (some may want this time for quiet reflection prior to being able to speak ‘off the top of their heads’), don’t always try to fill the silence Sometimes students may not be active enough as they may be reluctant to share their lack of knowledge about a key area. Prior to moving on to interpretation, ensure that the group has clarified all of the relevant information up front (focus on the facts, clarify terms, ask others to clarify jargons and acronyms, etc.), ask, ‘what surprised you?’ Students who dominate – redirect (e.g. “before we move on, I would like to get some reactions from others…”), take a turn around the group Conflict – identify conflicts openly – “there seems to be a conflict here, how should we as a group move on and address this?”, work to identify source (e.g. lack of information, environmental stress, etc.), use of resources from conflict resolution workshop Lack of feedback – you may want to invite your group to give positive and constructive feedback (e.g. what did you like best about that? What do you think could be improved for next time? How?) Students interacting with Facilitator or speaker primarily rather than each other – ask direct questions (e.g. How would this work for physio?), when the person responds to you, look at other group members to encourage them to do the same, ask questions of the group for the students if necessary e.g. ‘ what questions do you have about physio?’, comment directly e.g. ‘this is a time for you to learn about each other – you needn’t respond directly to me’; ‘we want you to become more comfortable working as a team, try commenting or asking questions of each other directly’, ask them to reflect on something in pairs or triads and then share with group. For more information, please refer to IPE facilitator resources (including Tiberius, R.G. (1995). Small group teaching: A trouble-shooting guide. OISE Press: Toronto). With files from L. Sinclair and M. Lowe. Section 4 20 Section 4: Developing IPE Facilitator Skills Feedback Do’s and Don’ts Adapted from: Lehner, G.P. (1975): Aids to Giving and Receiving Feedback. CA: University Associates Publishers: with files from L Sinclair. Some of the most important information we can receive from others (or give to others) consists of feedback related to our behaviour. Feedback can provide learning opportunities for each of us. By using the reactions of others we understand the consequences of our behaviour. Such personal data helps to make us more aware of what we do and how we do it, thus increasing our ability to modify and change our behaviour and to become more effective in our interactions with others. To help us develop and use the techniques of feedback for personal growth, it is necessary to understand certain principles important to the process. The following is a brief outline of some factors which may assist us in making better use of feedback, both as the giver and the receiver of feedback. This list is only a starting point. . Focus feedback on behaviour rather than the person It is important that we refer to what a person does rather than comment on what we imagine he or she is. When we talk in terms of “personality traits” it implies inherited, constant qualities that are difficult if not impossible to change. Focusing on behaviour implies that it is something related to a specific situation that might be changed. It is less threatening to a person to hear comments about his behaviour than his “traits”. This focus on behaviour implies that we use adverbs (which relate to qualities) when referring to a person. Thus we might say a person “talked considerably in this meeting”, rather than this person “is overly talkative”. . Focus feedback on observations rather than inferences Observations refer to what we can see or hear in the behaviour of another while inferences refer to interpretations and conclusions which we make from what we see or hear. In a sense, inferences or conclusions about a person contaminate our observations, thus clouding the feedback for another person. When inferences or conclusions are shared (and it may be valuable to have this data), it is important that they be so identified. . Focus feedback on description rather than judgment The effort to describe represents a process for reporting what occurred, while judgment refers to an evaluation in terms of good or bad, right or wrong, nice or not nice. Judgments arise out of a personal frame of reference or values, whereas description represents neutral (as far as possible) reporting. . Focus feedback on descriptions of behaviour in terms of “more or less” rather than in terms of “either-or” The “more or less” terminology implies a continuum on which any behaviour may fall, stressing quantity, which is objective and meaningful rather than quality, which is subjective and judgmental. Thus, the participation of a person may fall on a continuum from low participation to high participation, rather than good or bad participation. Not to think in terms of “more or less” and the use of continua is to trap ourselves into thinking in categories, which may then represent serious distortions of reality. 21 Section 4 . Focus feedback on behaviour related to a specific situation, preferably to the “here and now”, rather than to behaviour in the abstract, placing it in the “there and then” What you and I do is always tied in some way to time and place, and we increase our understanding of behaviour by keeping it tied to time and place. Feedback is generally more meaningful if given as soon as appropriate after the observation or reactions occur, thus keeping it concrete and relatively free of distortions that come with the lapse of time. . Focus feedback on sharing ideas and information rather than on giving advice By sharing ideas and information we leave the person free to decide for himself, in the light of his own goals in a particular situation at a particular time, how to use the ideas and the information. When we give advice we tell him what to do with the information, and in that sense we take away his freedom to determine for himself what is for him the most appropriate course of action. . Focus feedback on the value it may have to the recipient, not on the value or “release” that it provides the person giving the feedback The feedback given should serve the needs of the recipient rather than the needs of the giver. Help and feedback need to be given and heard as an offer, not an imposition. . Focus feedback on the amount of information that the person receiving it can use, rather than on the amount that you have which you might like to give To overload a person with feedback is to reduce the possibility that he may use what he receives effectively. When we give more than can be used we may be satisfying some need for ourselves rather than helping the other person. . Give feedback at appropriate times It is important to be sensitive as to when it is appropriate to provide feedback. Excellent feedback presented at an inappropriate time may do more harm than good. 0. Focus feedback on what is said rather than why it is said To make assumptions about the motives of the person giving feedback may prevent us from hearing or cause us to distort what is said. In short, if I question “why” a person gives me feedback, I may not hear what he says. . Allow sufficient time for feedback Make sure that enough time is allowed for feedback at the end of the session. Sometimes group members need a few minutes to warm up to giving feedback, therefore allow time to get started. . Stimulate feedback with self assessment Tutors may encourage increased feedback by requesting feedback on their own performance or by self evaluating or encouraging other group members to self evaluate. . Check feedback for accuracy Feedback should be checked for accuracy. One way of doing this is to have the receiver try to rephrase the feedback he has received to see it if corresponds to what the sender had in mind. It would also be helpful to have the giver and the receiver check with others in the group as to the accuracy of the feedback. Is the feedback shared by others? Section 4 22 Section 4: Developing IPE Facilitator Skills Small Group and Interprofessional Education References Barr, H., Koppel, I., Reeves, S., Hammick, M. & Freeth, D. (2005). Effective Interprofessional Education: Argument, Assumption and Evidence. Oxford: Blackwell Davoli, G. W. & Fine, L. (2004). Stacking the deck for success in interprofessional collaboration. Health Promotion Practice, 5(3), 266-270. D’Eon, M. (2004). A blueprint for interprofessional learning. Medical Teacher, 26(7), 604-609. Dolmans, D. H., Wolfhagen, H. A., Gerver, W. J., De Grave, W. & Scherpbier, A. J. (2004). Providing physicians with feedback on how they supervise students during patient contacts. Medical Teacher, 26(5), 409-414. Eller, J. (2004). Effective group facilitation in education : How to energize meetings and manage difficult groups. Corwin Press: Thousand Oaks, California Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional education: The student perspective. Journal of Interprofessional Care, 20 (3): 246-253. Page, S. & Meerabeau, L. (2004). Hierarchies of evidence and hierarchies of education: reflections on a multiprofessional education initiative. Learning in Health and Social Care, 3(3), 118-128. Postmes T, Spears R, Cihangir S. (2001) Quality of decision making and group norms. Journal of Personality and Social Psychology 80:918-930. Reeves, S. & Freeth, D. (2002). The London training ward: an innovative interprofessional learning initiative. Journal of Interprofessional Care, 16(1), 41-52. Steinert, Y. (1996). Twelve tips for effective small-group teaching in the health professions. Medical Teacher, 18(3): 203-7. Tiberius, R.G. (1995). Small group teaching: A trouble-shooting guide. OISE Press: Toronto. Web Resources University of Toronto http://ipe.utoronto.ca/students/about.htm Interprofessional Education for Collaborative Patient-Centred Practice http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/strateg/interprof/index_e.html UK Centre for the Advancement of Interprofessional Education http://www.caipe.org.uk 23 Section 4 Appendix H: Facilitating Small Interprofessional Groups Why use small group learning? Why use small group learning? To promote: B Involvement in learning B Motivation and satisfaction with learning B Application of ideas B Deep learning (understand and make sense of material vs. memorizing and reproducing) B Teamwork B Collaboration and cooperation B Etc…. Small Group Considerations To promote: B Understanding B Critical thinking B Problem solving abilities B Foster self-directed learning B Enhance communication skills B Favourable attitudes towards learning Number of members Location of group Characteristics: B Interaction occurs among members B Task to be achieved B Opportunity to reflect on learning Groups are more than the sum of their parts (group dynamics cannot be understood by adding qualities of individual group members) A Balancing Act……. Task Stages of Group Development Section 4 24 Process Forming - tentative, hesitant Storming - realize work ahead, almost panic Norming - as they work together, initial resistance fades, start helping each other Performing - more comfortable with each other, effective Adjourning/Mourning Section 4: Developing IPE Facilitator Skills Roles People Play May Interfere with Group Function Roles People Play May Contribute to Group Function Encourager Compromiser Summarizer Harmonizer Gatekeeper – Facilitator of quieter members Tension reliever (e.g. use of humour) Addressing Unproductive Roles Recognition – seeker Aggressor (e.g. hostile towards others) Group Clown Star (e.g. more important for the star to shine than for the group to succeed) Blocker (e.g. reject ideas without consideration) Ask yourself what is happening, what can you do differently, how responsibility can be shared amongst group Group problem solving in workshop Refer to handout as a resource “To talk well and eloquently is a very great art, but that an equally great one is to know the right moment to stop.” “…the facilitator role is to guide and support students through the process and enhance their understanding of what they have learned” - University of Alberta, 2005 Role of Facilitator Ensure introductions (consider icebreaker) Establish ground rules with group (norms) Role model – be open, genuine, reflective, trustworthy Set clear expectations Establish learning climate (including acceptance of limitations – “it is ok not to know”, respect, comfort, stimulating, promote participation) Build confidence Observe and clarify group process Listen Question (e.g. jargon) Focus the group (sort issues, determine main issue) Identify conflicts - Manage differences in opinion (summarize disagreement and explore meaning behind them to allow group to agree on task and process used e.g. “there seems to be a conflict here, how should we as a group address this?”), identify sources of conflict (e.g. lack of information, time pressures, etc.) Summarize Give and receive feedback 25 Section 4 Feedback Evaluating as a Group 26 Role modeling is key B Stereotypical beliefs about professions (e.g. gender, status, caring, power, etc.) Jargon and clarification Link between effective team collaboration and patient care (e.g. balancing task and process) Establish group norm for group participation and clarify Facilitator role early – minimize didactic approach Students may have range of educational experiences (e.g. first placement to last) Work with students to recognize and capitalize on opportunities for collaboration Inclusiveness Celebrate diversity – understand no one profession has all the answers for a patient References and Resources Section 4 What? (reflection) So what? (integration) Now what? (continuation) Some Special Considerations: IPE and Small Groups Did you understand the objectives? Were objectives met? Was the setting supportive? What did you like about the session? What did you dislike? What would you change? How could it be improved next time? Funnel Model of Debriefing Timing of feedback – formative vs. summative General – how was the group today? Specific – self assess first, then invite feedback from others B Balanced feedback – positive and constructive (refer to handouts for detailed suggestions) http://www.ipe.utoronto.ca/Educators/groups.htm - Teaching and Facilitating Small Groups Crow, J. & Smith, L. (2003). Using co-teaching as a means of facilitating interprofessional collaboration in health and social care. Journal of Interprofessional Care, 17(1):45-55. Davoli, G. (2004). Stacking the deck for success in interprofessional collaboration. Health Promotion Practice 5(3): 266-270. Orchard, C.A., Curran, V. & Kabene, S. (2005). Creating a culture for interdisciplinary collaborative professional practice. Medical Education Online, 10:11. Available from http://www.med-ed-online.org Tiberius, R.G. (1995). Small group teaching: A trouble-shooting guide. OISE Press/The Ontario Institute for Studies in Education. Toronto: Canada. Westberg, J. & Jason, H. (1996). Coleading small groups. In Fostering Learning in Small Groups. Springer Publishing Co. Inc. p. 110-155. Section 4: Developing IPE Facilitator Skills Appendix I: DVD Scenario Analysis Exercise In thinking about Facilitation, being a Facilitator and the intricacies of IPE Facilitation, view the DVD scenarios and answer the following questions. 1. What is happening in the scenario? What’s the “issue” at hand? 2. Who is involved? 3. What are the uniprofessional issues that may be present in the scenario? 4. What are the interprofessional issues that may be present in the scenario? 5. As a Facilitator, what could you have done differently? Practicing in the Moment As a Facilitator, what would you do in the moment? What exactly would you say? When? 27 Section 4 Appendix J: Small IPE Group Facilitation Workshop: Post-Test 1. Please rate your understanding of the rationale for interprofessional education for students. (1 = poor, 5 = excellent) 1 2 3 4 5 2. Please rate your ability to describe the rationale for small group work with interprofessional learners. (1 = poor, 5 = excellent) 1 2 3 4 5 3. Please rate your ability to identify defining attributes of successful small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 4. Please rate your knowledge of the use of icebreakers in small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 5. Please rate your ability to use icebreakers as a Facilitator of small groups. (1 = poor, 5 = excellent) 1 2 3 4 5 6. Please rate your ability to use strategies to address challenges encountered in interprofessional small group learning. (1 = poor, 5 = excellent) 1 2 3 4 5 7. Please rate your overall confidence as a Facilitator of interprofessional small groups. (1 = poor, 5 = excellent) 1 Section 4 28 2 3 4 5 Contents Interprofessional Learning Objectives and Activities��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Own role��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Team members’ roles� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 2 Teamwork ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 3 Factors contributing to collaboration ��� ��� ��� ��� ��� � 3 Assessment and treatment � ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 4 Collaboration with patients and families��� ��� ��� ��� � 4 Facilitation of group discussions ��� ��� ��� ��� ��� ��� ��� ��� � 4 Effective Communication� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 5 Supporting Other IP Learning Opportunities: A Menu of Options for All Types of Placements Reflection on interprofessional collaborative competencies.��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 5 Section 5 Appendix A - Interprofessional Collaborative Competencies��� ��� 6 Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 5: Supporting IP Learning Interprofessional Learning Objectives and Activities As interprofessional (IP) learning is not restricted to interprofessional education (IPE) placements, students should be encouraged to address IP learning priorities in all types of clinical placements. Early in the clinical placement, students and clinical faculty should discuss the student’s interprofessional learning needs and the range of interprofessional opportunities available in the clinical environment. This resource may facilitate a dialogue between the student and clinical faculty as it includes a menu of options for both sample IP learning objectives and IP learning activities from which to select and generate other options. Refer to Appendix A “Interprofessional Collaborative Competencies” for a brief overview of interprofessional and collaborative competencies. OBJECTIVE Own role POSSIBLE LEARNING ACTIVITIES I can describe my role and responsibilities clearly to other professions and patients (including limits of my profession). Review orientation materials provided to patients regarding the role of your profession. Describe your role to clinical faculty (supervisor) in relation to particular patients or patient populations. Invite feedback. Accurately describe professional role and responsibilities to patient/family – invite feedback and clarification. Accurately describe professional role and responsibilities to team member and other professional students – invite feedback and clarification. Reflect on your role with the following changes: B How might your role change at different points in the patient’s involvement with you? B Imagine the context were different for a particular patient or patient population (e.g. what if you were in the community rather than acute care), how might your role change? Reflect on and discuss myths and common misconceptions re: own professional role with your clinical faculty (supervisor). Consider how these may be addressed with patients/families and the team? Create a patient education brochure outlining the role of your profession. Section 5 OBJECTIVE Team members’ roles I can accurately describe the roles and responsibilities of team members. POSSIBLE LEARNING ACTIVITIES Review patient orientation material re: team roles. Observe family conference and rounds discussions. Discuss role perceptions with clinical faculty (supervisor). Shadow a team member to learn more about his/her role. Complete interviews with other professionals and patients/families to further your understanding of roles and reflect on your answers. Ask another team member how they describe your professional role to patients then ask them to provide feedback to you on your description of their roles. Interview patients/families regarding their work with a range of professionals. Meet with student/staff from another profession and discuss where your roles overlap and differ. B B Section 5 Discuss and reflect on which professions are not involved on this team. Are there others that you need to learn more about but don’t work with regularly? (e.g. team makes referrals to the audiologist, but audiology is not a part of the core team) How can you learn more about these professions? Ask other team members what the most common myth(s)/misbelief(s) are regarding their professions. Discuss strategies to address with them. Develop a brochure for patients outlining the role of each professional on the team. Gather feedback from each team member and patients/family. Develop a chart with a description of each team member’s role and invite feedback from team members/supervisor. Section 5: Supporting IP Learning OBJECTIVE Teamwork POSSIBLE LEARNING ACTIVITIES Shadow a patient to identify how the team works to address his/her needs collaboratively. Create a case study in which the roles of the different professionals on the team are illustrated (to assist future students in learning about the team for example). Draft a flow chart of a patient’s involvement with the interprofessional team and consider the following: I can describe how the team works (including how various professional roles interrelate). B B B B Develop a document that outlines shared areas of practice between each profession on the team and your profession. Work with team members from other professions on joint projects, tasks or patient care issues. OBJECTIVE Factors contributing to collaboration POSSIBLE LEARNING ACTIVITIES Work with interprofessional team members from other professions on joint projects/tasks or patient care issues. Observe a team interaction and reflect on what factors contributed to the successful collaboration and challenges. To consider the factors that contribute to effective team working or hinder its development, use resources available at http://www.ipe.utoronto.ca/students/teamwork.htm. B I recognize, describe and can begin to address factors that contribute to or hinder successful team collaboration. Who is involved when? What is their primary role at different times? What triggers involvement of different team members? What prompts discharge from the services provided by different professions? B onsider roles on team – task, maintenance or individual (refer to C http://www.ipe.utoronto.ca/students/resources/ryan1.html for details) Consider team in terms of stage of group development (refer to http://www.ipe.utoronto.ca/students/resources/ryan2.html for details) Describe team collaboration using the Team Performance Checklist (page 12) in Family Health Teams: Advancing Primary Health Care - Guide to Collaborative Team Practice. http://www.health.gov.on.ca/transformation/fht/guides/fht_collab_team.pdf Reflect on the team interactions you have observed, how would y ou characterize them? Task or process focused or both? Why? What suggestions may you have for the improved functioning of this team? Discuss with clinical faculty. Section 5 OBJECTIVE POSSIBLE LEARNING ACTIVITIES Assessment and treatment Shadow student from another profession working with one of the patients with whom you work (if student is not available, shadow team member). I work with others to collaboratively assess, plan and provide treatment for individual patients and shared patient issues. Attend and participate in patient discussions (care planning rounds/ patient rounds/ patient-family conferences/ etc.). Co-assess or co-treat patients with other team members as appropriate. Set interprofessional SMART (specific, measurable, achievable, relevant to patient/family, timely) patient goals with at least one other team member. Ask for feedback from clinical faculty (supervisor and team members) specifically regarding your interprofessional collaboration competencies. (Refer to Appendix A “Interprofessional Collaborative Competencies”). OBJECTIVE Collaboration with patients and families POSSIBLE LEARNING ACTIVITIES Gather feedback from patient (and family) regarding interprofessional teamwork. Invite feedback from patients and families regarding how you collaborate with them. For example, in working with patients and families do you: I collaborate with patients and families. B B B B OBJECTIVE Facilitation of group discussions I facilitate interprofessional meetings or discussions. Section 5 introduce yourself clearly? outline your role and check for understanding? invite the patient/family to describe their perceptions of the issues/ situation? work with the patient/family to plan for assessment and intervention? POSSIBLE LEARNING ACTIVITIES Review group facilitation strategies (e.g. those listed at http://www.ipe.utoronto.ca/Educators/groups.htm) After facilitating case conferences and/or team discussions, ask for feedback from team members (including patient if applicable). Identify team roles/activities that require strong collaborative abilities (e.g. conduct patient/family goal setting interview, participate in an admission meeting, etc.). Shadow team members in these roles and consider enacting parts of these roles as another learning opportunity. Describe the role of a ‘Facilitator’ (e.g. goal coordinator, case manager, etc.) on the team to a patient/family or other professionals/students. Section 5: Supporting IP Learning OBJECTIVE POSSIBLE LEARNING ACTIVITIES Effective communications Communication Workbook – self-paced workbook developed to promote effectiveness in interprofessional communication, produced and developed by the Universities of Ulster, Bournemouth and Northumbria http://www.practicebasedlearning.org/resources/materials/docs/CommsSkillsV2.pdf I communicate effectively with patients and interprofessional team members. Simulated web-based Interprofessional Edcuation – practice interview skills using a simulated patient online ( http://www.kcl.ac.uk/ipe/swipe.html) Invite feedback from clinical faculty (supervisor and team members) and patients/family re: your communication with them. Develop plan to continue to develop communication skills. Reflect on and record professional jargon used. Monitor self for its use in conversation and ensure communication is free of jargon as appropriate. Invite feedback from others re: your use of jargon. OBJECTIVE POSSIBLE LEARNING ACTIVITIES Reflection Maintain a reflective journal. I regularly engage in reflection to develop my interprofessional collaborative competencies. Student Reflective Records – developed by the University of Melbourne http://www.ruralhealth.unimelb.edu.au/ripe/Reflective Records.doc Learning and Assessing Through Reflection: A practical guide – this is a self-paced workbook developed to promote effectiveness in reflection, developed by the universities of Ulster, Bournemouth and Northumbria http://www.practicebasedlearning.org/resources/materials/docs/RoyalBromptonV3.pdf We hope that you have found this resource helpful and that you will benefit from these learning opportunities as much as we have. Lynne, Mandy, Tracy, Aleks Toronto Rehab/University of Toronto Section 5 Appendix A: Interprofessional Collaborative Competencies D’Amour and Oandasan (2005) describe the IP competencies as: Knowledge Roles • Describe one’s roles and responsibilities clearly to other professions. Skills/Behaviours Communication Reflection • Recognize and observe the constraints of one’s role, responsibilities and competence, yet perceive needs in a wider framework. Attitudes Mutual respect Open to trust Willing to collaborate • Recognize and respect the roles, responsibilities and competence of other professions in relation to one’s own. • Work with other professions to effect change and resolve conflict in the provision of care and treatment. • Work with others to assess, plan, provide and review care for individual patients. • Tolerate differences, misunderstandings and shortcomings in other professions. • Facilitate interprofessional case conferences, team meetings, etc. • Enter into interdependent relations with other professions. Way, Jones & Busing (2000) describe seven essential elements for collaboration: Mutual trust and respect Autonomy Responsibility Communication Coordination Assertiveness Cooperation The authors also acknowledge issues of power, hierarchy and conflict that impact these elements. Section 5 Barr (1998) describes interprofessional collaborative competencies as follows: Contents Interprofessional Education (IPE) Website Resources � ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 1 Key References��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� ��� � 6 IPE Websites and Key References Section 6 Copyright © Office of Interprofessional Education, University of Toronto, 2007 Section 6: IPE ������������������������������� Websites and Key References Interprofessional Education (IPE) Website Resources General IPE Information Review Office of Interprofessional Education University of Toronto http://www.ipe.utoronto.ca/ Educators/foundations.htm Information on IPE policies, initiatives, theory, research, and planning/ evaluating programs for pre- or post-licensure learners. B Links to material on facilitating small groups B Professional development opportunities B Student Section-IPHSA (Interprofessional Healthcare Students Association) includes curriculum-based & social events; information about the professions (roles, training, employment, professional organizations, standards of practice); links to information on healthcare in Canada; resources on team collaboration UK Centre for Advancement of Interprofessional Education (CAIPE) http://www.caipe.org.uk Resource for both universities and the workplace (health and social care), which promotes and develops IPE as a way of improving collaboration between clinicians and organizations. B Annual Interprofessional Learning Workshops to improve skills in facilitating interprofessional learning (educators, clinicians, managers) across the continuum of care B Research evidence on content, methods and effectiveness of IPE learning & collaboration B Working to create national framework B Links to other sites College of Health Disciplines Division of Interprofessional Education University of British Columbia (UBC) http://www.health-disciplines. ubc.ca/chd_site_files/programs/ education.htm Develops Interprofessional teaching programs, including format and materials. B Curriculum and Activities committees B Listing of approved IPE UBC courses B Links to IPE resources Interprofessional Network of B.C. (In-BC) http://www.in-bc.ca/about/ aboutus.php Brings together health and education partners to transform healthcare through IPE and collaborative patient-centred practice. B Projects link with key health care priorities and involve students and varied health professionals B Curriculum, including online learning modules for students B Evaluation resources and links University of East Anglia (Norwich, UK) (CIPP) http://www1.uea.ac.uk/cm/ home/schools/foh/cipp Detailed description of Centre’s Interprofessional Learning (IPL) program activities for pre- and post-registration students, including objectives, evaluation, and student feedback. European Interprofessional Education Network (EIPEN) http://www.eipen.org/ Six European countries share and develop interprofessional vocational training curricula, methods and materials. Disseminating the network model developed by the Higher Education Academy across the UK since 2000 Section 6 IPE Placement Information Section 6 Review Rural Health Interdisciplinary Program (RHIP) University of New Mexico Health Sciences Centre, Albuquerque http://hsc.unm.edu/som/programs/ruralhealth/ Description of Rural Health Interdisciplinary Program in which participants use case development and problem-based learning (PBL). Downloadable Materials: B Student Manual (Project Overview, Schedule, Administrative Processes, Financial Assistance, Guidelines: student responsibilities, developing interdisciplinary cases, tutorial facilitation) B Health and Legislative Reports B Community Project Guide B Evaluation Forms Rural Interprofessional Education Project (RIPE) University of Melbourne, Australia http://www.ruralhealth.unimelb. edu.au/ripe/ Rural interprofessional placement with focus on community-based project. B Valuable links to forms, placement sites and information B Downloadable information includes placement, forms, tutorials (student & tutor), selection criteria for Facilitator & students B Good FAQ section for students The Common Learning Project (Interprofessional Education for Modernized Health and Social Care, 2002) http://commonlearning.ncl. ac.uk/clp/index_html Program involving students from 3 universities in partnership with 2 Workforce Development Confederations that strive to develop “seamless” patient care through promotion of IPE. B Learning strategies (self-directed & enquiry-based) B Many downloads, including information for mentors, mentor training, and students B Good external links page Combined Interprofessional Learning Unit (CILU) http://www.cuilu.group.shef. ac.uk/index.htm Two year project for pilot Interprofessional Learning completed May 2005. B Guidelines and audit tools to determine IPE appropriate placements B Interprofessional Patient Assessment Pilot Tool (Patient feedback on team function) Rural Interdisciplinary Health Promotion (RIHP) http://www.allconet.org/ahec/ newrihp/index.html American project to bring together faculty, students and healthcare practitioners in rural, interdisciplinary clinical experiences to prepare students for practice in rural or underserved settings. B Four well-designed modules (including overview, curriculum, student activities, resources, faculty bios and bibliography): Rural Interdisciplinary Team, Stress Management (ID Health Promotion), Obesity Prevention (ID Health Promotion), and All Hazards Emergency Preparedness B Evaluation forms for students and faculty B Motivational Interviewing/ Stages of Change powerpoint presentation Facilitator Training & Tools Review Making Practice Based Learning Work http://www.practicebasedlearning.org/ Effectively organized practice-based student supervision teaching resources: facilitation, mentoring, coaching, etc. Section 6: IPE ������������������������������� Websites and Key References IPE Curricula (Seminar Based) Bronx VAMC (Veteran Administration Medical Centre) Geriatric Research Education and Clinical Centre (GRECC) a) http://www.mssm.edu/grecc/ GITT.shtml b) http://www.mssm.edu/grecc/ curriculum.shtml Review a) Geriatrics Interdisciplinary Teamwork Resource Manual & Reference Tool for interdisciplinary teams, medical educators and trainees. Includes information on: B Teamwork: history, need and benefit in geriatrics B Team: members and roles, team processes and communication, and care planning B Cases, team building exercises, references, web based resources b) Geriatrics, Palliative Care & IP Teamwork: An Interdisciplinary Curriculum B 22 module training curriculum: each module (~1.5 hrs.) builds on the previous B Variety of learning strategies: mini-lectures, trigger tapes, journaling, case analysis, role playing B Modules and sessions for journal club & case analyses Web-Based Interprofessional Learning Examples Review King’s College London (University of London) http://www.kcl.ac.uk/schools/ medicine/learning/clinicalskills/ipe. html Simulated Web-Based IPE: http://www.kcl.ac.uk/ipe/swipe. html IPE Program: First year communication and ethics, followed by clinically based sessions in subsequent years (no materials, however a contact name is provided) Simulated Web-Based Interprofessional Education to practice class-learned communication skills using a virtual family with feedback provided University of Leeds http://www.virtualfamily.leeds. ac.uk/ Virtual Family Website with an interprofessional perspective to learn about colleagues roles and responsibilities in health and social care of families Students On-Line in Nursing Integrated Curriculum (SONIC) University of Lancashire, UK http://www.uclan.ac.uk/facs/ health/nursing/sonic/index.htm Web-based resource of independent learning cases and facilitated PBL with links to educational information Centre for Interprofessional e-Learning (CIPeL) http://www.cipel.ac.uk/ Links to e-learning businesses Section 6 Other IPE Learning Opportunities Section 6 Review Interprofessional Initiative (IPI) University of Alberta’s Health Sciences Council http://www.uofaweb.ualberta. ca/ipi/ Offers interdisciplinary learning experiences, e.g. undergraduate courses and clinical team placements to health sciences students B Student and preceptor manual for team placement program (contact IPI directly) Centre for Health Sciences Interprofessional Education: Working Together for Better Health. University of Washington, Seattle, USA http://interprofessional.washington.edu Promotes curriculum and clinical innovations in IPE across the health science and information schools B Course descriptions (e.g. Developing Interprofessional Competencies) B Community site practicum at Salvation Army Rehab Centre B Developing an Objective Structured Clinical Examination (OSCE) The Office of Interprofessional Education. University of Creighton Medical Centre, Omaha, Nebraska, USA http://www.creighton.edu/ipe Strives to create an atmosphere of commitment to interprofessional practice, education, and research among the health science schools. B Clinical Conferences/Grand Rounds case based discussions with a panel of health care professionals B IPE Course including patient safety evaluation and field experiences B Seminars to learn from and about professional roles and responsibilities B Development of a library of cases for groups or individual web-based tutorials University of Minnesota: Interprofessional Education and Resource Centre http://www.ahc.umn.edu/ahc_ content/education/ierc/ Provides information and technology for OSCE and Group OSCEs, including simulation. CLARION, an IP student committee (faculty-advised) develops interprofessional experiences (leadership, teamwork, communication, conflict-resolution, etc.) and sponsors an international Case Competition for interprofessional student teams (http://www.chip. umn.edu/CHIP/committees/clarion/casecomp.html) The Health Sciences & Practice Subject Centre (part of The Higher Education Academy) http://www.health.heacademy. ac.uk/ipe UK-wide initiative to enhance student learning in several areas, including IPE. B Works with departments and individuals to support student learning (academic & practice) B Downloadable presentations from “Assessing Interprofessional Learning Workshop” B TRIPLE Project Report on IPE initiative at 3 UK centres Aberdeen Interprofessional Health & Social Care Education http://www.ipe.org.uk/ IPE information across the University of Aberdeen & Robert Gordon University. B Interprofessional e-learning project: On-line course (videos, webbased chat, internet discussion forums between pharmacy & medicine) B Numerous links IPE Home Page for City University School of Allied Health and Barts and The London, Queen Mary School of Medicine and Dentistry (London, England) http://www.ipecityqm.org.uk/facilitators.htm Provides a range of useful downloads for Facilitators. B Middle Year Common Learning Student Study Book (3 tasks) B Notes for Introductory and Debriefing Tutorials B Tips Section 6: IPE ������������������������������� Websites and Key References Canadian & UK IPE & IPC Resources Review Canadian Interprofessional Health Collaborative (CIHC) http://www.cihc.ca/projects/ cycle1.php# Developing the evidence base related to IECPCP (Interprofessional Collaboration for Patient Centred Care) towards improved programs to educate health care professionals, health services and health of Canadians. Canadian Collaborative Mental Health Initiative (CCMHI) http://www.ccmhi.ca/en/products/toolkits/educators.htm IPE Toolkit (PDF format) for Collaborative Mental Health Care Educators, including sections on theory, implementation and decision guide (helps identify organizational needs & readiness). Health Canada http://www.hc-sc.gc.ca/hcssss/hhr-rhs/strateg/interprof/index_e.html Supporting learning projects to build the evidence base for Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) B Links to publications, resources and partner organizations Health Force Ontario Interprofessional Care Project http://www.healthforceontario. ca/WhatIsHFO/IPCProject.aspx Background information on the Ontario MOHTLC (Ministry of Health and Long-Term Care) and MTCU (Ministry of Training, Colleges and Universities) interprofessional (IP) care project. B Description of the Blueprint for Action for implementation of IP care in Ontario’s health and educational settings B Project Reports: Advancing Interprofessional Education and Practice Summit Proceedings Report June, 2006 ( http://www.healthforceontario. ca/upload/en/whatishfo/summitproceedingsreportfinal.pdf ) Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada. Canadian Health Services Research Foundation June 2006 ( http://www.chsrf.ca/research_themes/ pdf/teamwork-synthesis-report_e.pdf ) Interprofessional Education for Collaborative, Patient-Centred Practice. Health Canada Canadian Health Services Research Foundation (CHSRF/ FCRSS) http://www.chsrf.ca/research_ themes/workplace_e.php Research funding base for priority themed research. B Teamwork video featuring Toronto Rehab Stroke Team & U of T Office of IPE’s Ivy Oandasan Creating an Interprofessional Workforce (CIPW) http://www.cipw.org.uk/index. php?p=articles&id=446 Creating an Interprofessional Workforce: An Education and Training Framework for the Practice of Interprofessional Learning and Development in Health and Social Care B A 3-year project funded by the UK Department of Health, completed 2007 B Three supplements (Health and Social Care Policy and the Interprofessional Agenda; Interprofessional Education in the UK: Some Historical Perspectives; and Walk the Talk) are available to download through links via the CIPW website. Section 6 Key References Interprofessional Education Readiness Barker, K. K., Bosco, C. & Oandasan, I. F. (2005). Factors in implementing interprofessional education and collaborative practice initiatives: Findings from key informant interviews. Journal of Interprofessional Care, 1(19 Suppl May), 166-76. Barr, H., Koppel, I., Reeves, S., Hammick, M. & Freeth, D. (2005) Effective Interprofessional Education: Argument, Assumption & Evidence. Blackwell Publishing Ltd.: Oxford. D’Amour, D. & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care, 19(Suppl 1), 8-20. Ginsburg, L. & Tregunno, D. (2005). New approaches to interprofessional education and collaborative practice: Lessons from the organizational change literature. Journal of Interprofessional Care, 1(19 Suppl May), 177-87. Mitchell, P. H., Belza, B., Schaad, D. C., Robins, L. S., Gianola, F. J., Odegard, P. S., Kartin, D. & Ballwig, R.A. (2006). Working across the boundaries of health professions disciplines in education, research, and service: The University of Washington experience. Academic Medicine, 81(10 Oct), 891-6. Oandasan, I. & Reeves, S. (2005). Key elements for interprofessional education. part 1: The learner, the educator and the learning context. Journal of Interprofessional Care, 1(19 Suppl May), 21-38. Oandasan, I. & Reeves, S. (2005). Key elements of interprofessional education. part 2: Factors, processes and outcomes. Journal of Interprofessional Care, 1(19 Suppl May), 39-48. Interprofessional Learning Opportunities Anderson, E., Manek, N. & Davidson, A. (2006). Evaluation of a model for maximizing interprofessional education in an acute hospital. Journal of Interprofessional Care, 20(2 Mar), 182-94. Eddy, M. E. & Schermer, J. (1999). Shadowing: A strategy to strengthen the negotiating style of baccalaureate nursing students. Journal of Nursing Education, 38(8), 364. Kilminster, S., Hale, C., Lascelles, M., Morris, P., Roberts, T., Stark, P., Sowter, J. & Thistlethwaite, J. (2004). Learning for real life: Patient-focused interprofessional workshops offer added value. Medical Education, 38(7 Jul), 717-26. Russell, L., Nyhof-Young, J., Abosh, B. & Robinson, S. (2006). An exploratory analysis of an interprofessional learning environment in two hospital clinical teaching units. Journal of Interprofessional Care, 20(1), 29-39. Schultze-Mosgau, S., Thorwarth, W. M., Grabenbauer, G. G., Amann, K., Zielinski, T., Lochner, J. & Zenk, J. (2004). The concept of a clinical round as a virtual, interactive web-based, e-learning model for interdisciplinary teaching. International Journal of Computerized Dentistry, 7(3 Jul), 253-62. Section 6 Section 6: IPE ������������������������������� Websites and Key References Interprofessional Education Placement Charles, G., Bainbridge, L., Copeman-Stewart, K., Art, S. T. & Kassam, R. (2006). The Interprofessional Rural Program of British Columbia (IRPbc). Journal of Interprofessional Care, 20(1 Jan), 40-50. Freeth, D., Hammick, M., Reeves, S., Koppel, I. & Barr, H. (2005) Effective interprofessional education - Development, delivery, evaluation. Blackwell Publishing Ltd: Oxford. Geller, Z. D., Rhyne, R. L., Hansbarger, L. C., Borrego, M. E., VanLeit, B. J. & Scaletti, J. V. (2002). Interdisciplinary health professional education in rural New Mexico: A 10 year experience. Learning in Health and Social Care, 1(1), 33-46. Gilkey, M. B. & Earp, J. A. (2006). Effective interdisciplinary training: Lessons from the University of North Carolina’s Student Health Action Coalition. Academic Medicine, 81(8 Aug), 749-58. Lumague, M., Morgan, A., Mak, D., Hanna, M., Kwong, J., Cameron, C., Zener, D. & Sinclair, L. (2006). Interprofessional Education: The student perspective. Journal of Interprofessional Care, 20(3 Jun), 246-53. Reeves, S. & Freeth, D. (2002). The London training ward: An innovative interprofessional learning initiative. Journal of Interprofessional Care, 16(1), 41-52. Stew, G. (2005). Learning together in practice: A survey of interprofessional education in clinical settings in south-east England. Journal of Interprofessional Care, 19(3 Jun), 223-35. Workshop Kwan, D., Barker, K. K., Austin, Z., Chatalalsingh, C., Grdisa, V., Langlois, S., Meuser,J., Moaveni, A., Power, R., Rennie, S., Richardson, D., Sinclair, L., Wagner, S.J. & Oandasan, I. (2006). Effectiveness of a faculty development program on interprofessional education: A randomized controlled trial. Journal of Interprofessional Care, 20(3 Jun), 314-6. Mellor, F., Foley, T., Connolly, M., Mercer, V. & Spanswick, M. (2004). Role of a clinical facilitator in introducing an integrated care pathway for the care of the dying. International Journal of Palliative Nursing, 10(10 Oct), 497-501. Steinert, Y. (2005). Learning together to teach together: Interprofessional education and faculty development. Journal of Interprofessional Care, 1(19 Suppl May), 60-75. Section 6