Fort Wayne Area Interprofessional Consortium for Health Care Education: Interprofessional Education Seminar Series
|9294||1||December 17, 2012|
The Fort Wayne Area Interprofessional Consortium of Health Care Education developed a series of three team based educational activities to foster interprofessional education (IPE). The consortium includes faculty from University of Saint Francis (USF) Department of Physician Assistant Studies (PA), USF Department of Nursing (graduate nursing (MSN) and Family Nurse Practitioner (FNP)), Indiana University-Purdue University Fort Wayne (IPFW) graduate nursing (MSN, Adult Nurse Practitioner (ANP) and Women’s Health Nurse Practitioner (WHNP)) and undergraduate nursing, Indiana University School of Medicine- Fort Wayne (IUSM-FW), the Fort Wayne Medical Education Program (FWMEP Family Practice Residency Program) and the Manchester University College of Pharmacy Doctor of Pharmacy program (PharmD).
The general model for the IPE activities was a light dinner, a networking session, and a plenary session. Teams worked together in breakout sessions (preserving the membership of the teams for longitudinal experience). The whole group reconvened for sharing between groups, debriefing and announcement of the next session. Faculty provided the structure for the plenary sessions but involvement during team session was to keep teams on task, watch time, and answer questions that learners could not answer. Faculty facilitated the debreifings. Each seminar lasted 1.5 hours including the dinner.
The Readiness for Interprofessional Learning survey (RIPLS) was distributed to learners at the beginning of the series.
The resources provide the materials for each of the three sessions.
Session 1: Introduction to Interprofessional Education and Health Care Provider Activity, introduced IPE by the consortium faculty. Students divided into teams up to 10 members. After introductions and learning about their field of study, each team worked on an activity which investigated a themed health care professions list to learn about providers and allied health professionals as well as alternative/complementary personnel that their patients may encounter. Students used electronic devices for online access to investigate their list. Teams appointing a member to present the most surprising profession or information from their team exercise at the debriefing.
Session 2: BATHE (Background, Affect, Trouble, Handling, and Empathy) Model of Psychosocial Interviewing, included participants from the prior session and new attendees distributed into the teams. A clinical psychologist presented the model at the plenary session. Breakout sessions were conducted with cases used with permission (Ana Maldonado of Touro University California). Within the teams, each learner role-played one of the three roles: patient, provider, and observer/evaluator. Learners were provided with laminated cards that summarized BATHE. Learners within a triad provided feedback via formal evalation forms that covered patient rapport and success of employing the BATHE model. The group debriefing summarized the events and provided for questions with presenter.
Session 3: Root Cause Analysis (RCA): Lewis Blackman Case introduced RCA and a case video was shown. Breakout sessions analyzed the case and documented on the fishbone diagram. Each team determined the single most important change to implement to avoid this outcome. Each team then appointed a representative to share the change and reasoning behind the team decision.
Post RIPLS was administered to all at the end of the third session.
LaBarbera D, Kiersma M, Yoder M, Maldonado A, Poling D. Fort Wayne Area Interprofessional Consortium for Health Care Education: Interprofessional Education Seminar Series. MedEdPORTAL; 2012. Available from: www.mededportal.org/publication/9294
Upon completion of the series, the health care learner will be able to, as part of a team:
- Define interprofessional education.
- Describe the goals and associated elements of interprofessional education.
- Determine which activities qualify for the definition of interprofessional education.
- Explain why interprofessionalism is important for patient-centered care.
- Express the motivation, intention and necessity for incorporation of interprofessional education.
- Collaborate with other health professionals to explore health care and related professions.
- Discuss interprofessionally, how health professionals and patients may utilize and understand the role of various providers and services.
- Apply the elements of the BATHE (Background, Affect, Trouble, Handling, and Empathy) communication model to a mock patient interview
- Self-assess a mock interview and respectfully critique team members using an established rubric that includes: establishing rapport, displaying empathy, using verbal and non-verbal communication skills, encouraging patients to share concerns, and patient-centered interviewing including answering questions in an informative, respectful and nonjudgmental manner
- Apply the elements of the Root Cause Analysis model retrospectively to a real patient scenario
- Delineate the issues associated with a scenario using the fishbone diagram
- Develop potential solutions by identifying factors associated with a scenario
- Employ and improve personal communication skills to convey and accept professional knowledge as part of an interprofessional team
- Demonstrate principles and values of team dynamics to successfully function in various team roles.
- Interprofessional Education, Pharmacy Practice, Graduate Nursing (MeSH), Physician Assistant (MeSH), Family Practice Residents, Medical Students (MeSH), Health Related Professions, Communications Skills, Root Cause Analysis (MeSH), Lewis Blackman, BATHE model, Psychosocial Interviewing, Interprofessional Education Collaboration (IPEC)
- Family Medicine
- Interpersonal & Communication Skills
- Practice-based Learning & Improvement
- Systems-based Practice
- Critical Thinking
- Interpersonal & Communication Skills
- Lifelong Learning
- Basic Sciences
- Psychology/Behavioral Science
- Professional School
- Allied Health Student
- Medical Student
- Nursing Student
- Pharmacy Student
- Professional School Post-Graduate Training
- Attitudes & Beliefs
- Communication Skills
- Confidence (Self-efficacy)
Authors & Co-Authors
Dawn LaBarbera, PhD, PA-C, BA, MS
University of Saint Francis
Mary Kiersma, PhD, PharmD
University of Manchester College of Pharmacy
Ana Maldonado, BS, MPH, DHSc, PA-C
Joint MSPAS/MPH Program, Touro University
Mindy Yoder, DNP, FNP-BC, RN
University of Saint Francis School of Nursing
Deborah Poling, PhD, RN, FNP-BC, CNE
Indiana University, Purdue University Fort Wayne School of Nursing
Sponsorship or Funding Source
Funded in part by the Josiah Macy Jr. Foundation in fulfillment of the AAMC/IPEC interprofessional education initiative.
Effectiveness and Significance
The findings on the assessment of effectiveness and significance are outlined below:
i. 175 learner participants over the 3 seminars; 105 different learners.
ii. 10 regularly participating facilitators with other faculty joining sessions when available.
b. Session 1: 74 learners
c. Session 2: 52 learners; 18 new attendees
d. Session 3: 49 learners; 13 new attendees
2. Pre and Post RIPLS
a. 116 RIPLS surveys completed
b. 81 unique individuals completed either pre, post or both
c. 27 PA students completed both the pre and post survey
i. PAs “readiness” lowest pre-mean score 4.26. Did not change significantly with paired t-test.
1. Likely due to team approach to health care with physician
2. Likely due to team approach in USF’s problem-based learning curriculum
ii. Statistically significant decrease in two readiness items but may be Type II error and/or not practically significant.
d. Other learners scored above 4.0 (agree) indicating readiness to work together possibly due to volunteer attendance
3. Formal debriefing
Conducted by consortium after each activity and at the close of series. Included a report of findings from formal and informal debriefing with health care learners, facilitators and faculty.
a. Introduction to the Health Professions Exercise
i. PA students formally debriefed. Spoke of initial reluctance to have more added to their schedules but they clearly understood the rationale after the first session citing many examples of discussions and misunderstandings between learners of different professions.
ii. Introductory PowerPoint needed to be more concise
iii. Flow of session needs to improve, especially food service logistics
iv. Materials can be further organized for easy access by each team of students and their faculty facilitator
i. Need more student sharing at formal wrap up of event as there was no closing discussion from students
ii. Needed to combine groups due to attrition from one event to the next
iii. New attendees need to be better oriented to quickly assimilate
iv. Timing was tight, partially again due to food service logistics
v. Organization of materials and room logistics improved with the implementation of team folders
vi. Medical students enjoyed applying history taking skills
c. Root Cause Analysis
i. Most beneficial session
ii. Case is also conducive to communication role playing activity and can be used for two activities
iii. Medical students enjoyed discussion from different perspectives
iv. PAs stated this activity left a deep impression as to rationale for interprofessional education
d. Overall seminar series
i. Faculty found value in longitudinal experience in addition to individual sessions and felt introductory activities were important for the academic exposure and to begin to form teams
ii. Students were happy to meet other “interesting people” that they would not have met otherwise
iii. Positive “Energy” at each session
Special Implementation Guidelines or Requirements
This pilot seminar series required little beyond what is typically available in educational settings.
Physical space required a large room for the plenary session, a strategic location to serve food and break out rooms for the teams. Larger rooms successfully accommodated more than one team.
Technology needs included PowerPoint lecture capability, video access, and internet access. Individual programs posted related materials on their electronic learning management sites.
Teams were kept organized via folders with sign in sheets, agenda, worksheets, and other materials/handouts. Numbered table cards and door signs posted on breakout rooms helped facilitate the flow.
There were lessons learned from planning meetings to the curriculum elements themselves. As expected, scheduling was the most difficult piece. The only time available was during dinner. A light meal encouraged attendance but presented serving time issues and funding problems. Second, even though prior team-based sign in sheets were provided to look up team numbers and members, facilitators were not consistent from session to session, so reorientation/check-in wasted precious time.
Consortium members learned some faculty were more supportive of IPE than others, whether programs at the table or colleagues from their programs. Each profession had learners at each session but only one physician was present from the medical school and the family practice residency program remained unrepresented due to scheduling.
Consortium members learned more about each other’s professions including that Nurse Practitioners are no longer are called “mid-level providers.” Acronym deciphering was commonplace such as explaining what AAMC stands for.
There were several stories from learners as the sessions evolved. A PA student wrote the following regarding the first session:
I just wanted to say that tonight was very interesting and …the activity was a good team building experience….We had the opportunity to talk with one another about the differences in our education. This activity helped facilitate this conversation…. The NP… proceeded to tell us that she just couldn't see how we could be clinicians based upon only 27 months of schooling and our "lack of clinical experience" ….
…As healthcare providers, our common goal is to provide the best care possible for our patients. … it would be sad to see a patient refuse healthcare … because of a misconception from another medical professional. This destroys trust, teamwork, and is not in the best interest of the patient. This evening was a wonderful learning experience…”
Direct follow-up with a NP student by her program’s facilitator revealed the NP student was appreciative of the feedback concerning how her communication may be perceived by others in the health care team.
After the first session, students were surprised by the commonality of roles held in patient care. Students trained in the medical model and involved in The BATHE interview session were appreciative of the emphasis that the nursing model places on this type of communication skill.
The Root Cause Analysis was the favorite activity. This was not only due to the improved organization and efficiency of the sessions but that the case reinforced the message of IPE. Students were able to focus on why the case turned out poorly and successfully avoided assigning blame to professions or personnel.
In closing, as one NP student wrote:
“…last night’s IPE was wonderful, sad, and moving. I know evening events are hard for students but this was so valuable and everyone would have benefited. I know you can't make them mandatory but they have been so worthwhile….There were very few from our program and I think they would have learned from it. Keep recommending them to students… Thanks…”
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