‘Pre-Professional’ Interprofessional Education in an Urban Academic University Setting

Diane R. Maydick, EdD, RN, ACNS-BC, CWOCN - Assistant Professor of Nursing Stephen R. Marrone, EdD, RN-BC, NEA-BC, CTN-A - Associate Professor of Nursing

Harriet Rothkopf Heilbrunn School of Nursing, Long Island University, Brooklyn, New York

Communication failure has been identified as the leading root cause of sentinel events and a primary contributing factor of adverse events and near misses in the clinical setting1,2.Although each health profession identifies patient-centeredness as a core value, each has its own values, beliefs, norms, and practices that vary sufficiently to potentially create role conflict and communication failure when delivering patient care.

To address the need for improved communication the paradigm in our health care delivery system is shifting from individual to team effectiveness and is now the dominant culture in health care delivery models. Now it is necessary to prepare a “collaborative practice-ready” workforce3.

Communication failure has been identified as the leading root cause of sentinel events and a primary contributing factor of adverse events and near misses in the clinical setting1,2.

Although each health profession identifies patient-centeredness as a core value, each has its own values, beliefs, norms, and practices that vary sufficiently to potentially create role conflict and communication failure when delivering patient care.

Background

Thus we are seeing trends in health professions education in academic and practice settings which support the benefits of interprofessional collaboration in both education and practice4.

This addresses the IOM5 mandate that health care workers must be more than professional; they must be interprofessional.

Ideally, socialization of professionals happens early in the pre-professional period of their education with IPE, which lead to creation of IPE events at our University.

Pre-Professional Interprofessional Education Student Events

Goal Improve health professions students’ understanding of their own as well as other health professions professional cultures, values and ethics, roles and responsibilities, and communication strategies that advances interprofessional collaborative practice across diverse clinical settings.

Evolution of IPE

Faculty and student events…

Lead to relationship building and

thinking “outside the box”…

Developed other IPE collaborative

projects including…

IPE implementation in the clinical

setting (2013-present)

IPE Student Interview Project

January 2015

Disseminating IPE experiences

Lessons Learned

• Training for faculty who serve as facilitators is essential.• Administrative support is imperative during the event planning

process.• Large venue needed to accommodate large student volume • Financial support necessary (chair rental, printing, room

reservation); although return on investment is elusive.• Outcome evaluation is crucial.

Next Steps

• Cross-campus programs• Online modules (2016-IPE grant-Josiah Macy Foundation)• Simulation• Additional student workshops • Additional facilitator workshops• Partner with healthcare facilities– IPE initiatives– follow-up with graduates

• Disseminate findings

Process• IPE events focusing on Interprofessional Collaborative Practice Competency

Domains were offered over a period of two academic years.

• Students from various health professions programs were invited to participate and were pre-registered.

• Groups of 10 students representing different health profession were assigned in advance and lead by a faculty facilitator.

• All teams worked on a case scenario aimed at fostering shared decision-making and consensus regarding a particular patient care issue and/or decision.

• Debriefing protocol: How the group came to consensus; how health professionals contributed to solve the problem; and how patients and families were included in the decision making process.

• Student’s pre- and post-event perceptions of their understanding of the culture, values and ethics for interprofessional practice, team roles and responsibilities, interprofessional communication, and teamwork were collected electronically and analyzed.

Core Competencies

Teamwork

Roles/Responsibilities

Values/Ethics

Communication

Work with individuals of other professions to maintain

a climate of mutual respect and shared values.

Utilize knowledge of the professions to assess and address the health care needs of the patients/

populations served.

Apply relationship-building values and the principles of team dynamics to perform, plan and deliver care that is safe, timely, efficient,

and equitable.

Communicate responsibly with patients, families, communities, and professionals to support health maintenance & treatment of disease.

The purpose of this presentation is to describe the design, implementation, and ongoing evaluation of IPE initiatives at an academic health sciences center, Long Island University.Long Island University, in Brooklyn, is part of an ethnically diverse, multi-campus, teaching intensive community (urban, suburban, global) with over 18 degree granting programs in the health professions.Programs include undergraduate and graduate baccalaureate, masters, doctoral, post-doctoral, and continuing education in nursing, pharmacy and health professions (athletic training and exercise, diagnostic medical sonography, occupational therapy, physical therapy, physician assistant, public health, social work, surgical technology).

Purpose and Setting

Outcome

Students reported that attending one or more IPE events led to:

• Understanding of the culture, values, and ethics of their own profession as well as other health professions,

• Understanding of the unique as well as shared roles and responsibilities among the different health professionals within their work team, and

• Greater appreciation related to shared decision-making, improved communication, and teamwork among the health professions within their work teams.

Implications

IPE is becoming a more common component of school curricula in the United States and is increasingly viewed as a means to reduce medical errors, and improve health care systems. Long Island University will continue to expand IPE initiatives to provide faculty and students with opportunities to improve their understanding of interprofessional education and practice and aloes support the process of integrating IPE competencies into the professional curricula currently offered.

References

1. Joint Commission. (2010). Patient safety. Retrieved from http://www.jointcommission.org/topics/patient_safety.aspx

2. U.S. Department of Veterans Affairs. (2011). VA National Center for Patient Safety. Retrieved from http://www.patientsafety.va.gov/professionals/publications/handbook.asp

3. World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice.Geneva: WHO.

4. Josiah Macy Jr. Foundation. (2013). Conference recommendations on Transforming patient care: Aligning interprofessional education with clinical practice redesign. Atlanta, GA: Josiah Macy Jr. Foundation.

5. Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.

6. Health and Human Services. (2015). The affordable care act. Retrieved from http://www.hhs.gov/healthcare/rights/index.html

7. Interprofessional Education Collaborative (2013). Core competencies for interprofessional collaborative practice. Retrieved from https://ipecollaborative.org/uploads/IPEC-Core-Competencies.pdf

8. Gropack, S., Goldman, K.D., Nathan, J., Maydick, D., Kirschenbaum, H., Flower, S., Salzer, E., Nogid, A., Dimitropoulou, K., & Krase, K. (2013). Investigation of interprofessional education. Poster presented at Discovery Day 2013, Brooklyn, New York, March, 2013.

9. Gropack, S., Kirschenbaum, H., Nogid, A., & Maydick, D. (2013) Faculty workshops to introduce interprofessional education (IPE) among 12 disciplines. Podium presentation at the Association of Schools of Allied Health Professions Annual Conference, Orlando, Florida October 24-25, 2013.

10. Jaffee-Gropack, S., Beric, B., Maydick, D., Nogid, A. (2014). A faculty development workshop: Aligning interprofessional education with practice. Podium presentation at the Association of Schools of Allied Health Professions Annual Conference, Las Vegas, NV, October 22-24, 2014.

11. Dimitropoulou, K., Goldman, K., Gropack, S., Krase, K., Maydick, D, Nogid, A. (2013) Student IPE event opens doors! Podium presentation at the Associations of Schools of Allied Health Professions Annual Conference Orlando, Florida, October 24-25, 2013.

12. Marrone, S. R., Maydick, D., Jaffee-Gropack, S., Beric, B, & Gordon-Handler, L (2015) The interprofessional health care team: Understanding the culture of interprofessional collaborative practice. Podium presentation at the 41st

Annual Conference of the Transcultural Nursing Society, Interprofessional Approaches to Health Care: Transcultural Nurses Leading the Way, October 28-31, 2015, Portland, OR, October 28-31, 2015.

Interprofessional Education (IPE)• IPE occurs “when students from two or more professions

learn about, from, and with each other to enable effective collaboration and improve health outcomes.” 3

• The aim of interprofessional learning is to prepare health professions students for deliberatively working together within a patient-centered, community/population-oriented healthcare system.

• IPE events were designed based on the four interprofessionalcollaborative practice domains.

• The framework developed by IPEC to support patient-centered team-based care, promote delivery reform and foster interprofessional experiences was used as a guiding framework. 3

Structure IPEC Core Competencies: Four Domains