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Interprofessional learning and teaching in evidence-based practice

Interprofessional learning and teaching in evidence-based practice. Arlene Smaldone, PhD, RN. Interprofessional Education. Interdependence of health professions ’ education and practice needs. Learning within professional silos. Interprofessional teamwork, an IOM Core Competency.

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Interprofessional learning and teaching in evidence-based practice

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  1. Interprofessional learning and teaching in evidence-based practice Arlene Smaldone, PhD, RN

  2. Interprofessional Education

  3. Interdependence of health professions’ education and practice needs

  4. Learning within professional silos

  5. Interprofessional teamwork, an IOM Core Competency

  6. Teaching and learning evidence-based practice skills • 2007 IOM convened Roundtable on Evidence Based Medicine • To help transform the way evidence on clinical effectiveness is generated and used to improve health and health care • Goal – by 2020, 90% of clinical decisions will be supported by accurate, timely and up to date clinical information reflecting best available evidence Institute of Medicine (US). Evidence-Based Medicine and the Changing Nature of Healthcare: 2007 IOM Annual Meeting Summary. Washington (DC): National Academies Press; 2008. Appendix C

  7. Evidence-based practice is ideal for interprofessional education approach • Content and skills consistent across disciplines • Good practice for professional environment

  8. EBP Education has been well studied • Synthesis of 16 systematic reviews that examined effects of teaching evidence based health care (Young et al. 2014, PLOS ONE) • 10 SRs: Undergraduate and postgraduate • 6 SRs: Postgraduate and continuing professional development • Only 6 studies examined interprofessional EBP education

  9. Interprofessional EBP studies • 6 studies (1998 and 2014) • Canada, UK, Hong Kong • Variety of study designs • All reported attendees from ≥2 disciplines • None reported EBP faculty by discipline • Program intensity • Most one day or less

  10. Interprofessional EBP content • Formulating PICO questions (2) • Searching the literature (3) • Critical appraisal skills (3) • Appraisal of systematic reviews (1) • Apply evidence to decision-making (1) • Identify strategies to implement evidence in local context (1)

  11. Training programs in EBP • Focus on a narrow spectrum of knowledge and skills • Curriculum related to development, implementation and evaluation of evidence based clinical practices and policies and their implementation in clinical settings is often omitted • Most EBP education delivered in discipline specific silos • Few utilize interprofessional education approaches • Of these, most examined only immediate outcomes • Only one study examined longer term outcomes at 6 months • Knowledge and EBP core skill retention • No change in decision-making behaviors

  12. Teaching Evidence Assimilation for Collaborative Health Care • Unusual regarding • Broad scope • Level 1: acquisition of EBP skills with focus on care of individual patients • Level 2: how EBP skills are applied to development of national policies and learn how to adapt for use in local settings • Level 3: knowledge translation to maximize value of research in system wide improvement initiatives • Interprofessional learning environment • Simulate the practice setting

  13. TEACH: Interprofessional evolution over time • Data extracted from 2009-2016 workshop registrations, small group enrollments, assigned tutors and plenary sessions by disciplines • 2015 – added questions regarding interprofessional experience to workshop evaluation survey • Analyzed data • Descriptive statistics • Qualitative content analysis

  14. TEACH participants 2009-2016 * *2009 Nurses and librarians included in “other”

  15. Greater diversity in TEACH attendees over time

  16. TEACH enrollment track by year (2009-2016)

  17. TEACH small group facilitators (2009-2016)

  18. TEACH Plenary Sessions (2009-2016)

  19. 2015 what conference attendees said….. • While the majority of 2015 participants had received prior education in EBP, less than half had received this education with interdisciplinary educators (35%) or with attendees from other professions (45%) • Majority reported improved knowledge (94%), competence (90%) and performance (90%) as a result of TEACH participation • What attendees reported liking best • “the interdisciplinary interaction and ideas shared” • “problem focused, patient-centered and multidisciplinary…”

  20. Conclusions • Interprofessional EBP education not common • Having participants and faculty from several disciplines doesn’t make education interprofessional • Environment conducive to sharing of perspectives and mutual trust • Acquisition of skills doesn’t guarantee implementation of evidence into practice

  21. What you should expect

  22. Implementation of projects sparked during TEACH

  23. What will your long term outcomes be?

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