Towards an IP Certificate at Laurentian

1. Example of a step-wise approach to pre-licensure IPE for undergraduate students in multiple health disciplines Towards an IP Certificate at Laurentian Coordinator, Radiation Therapy Program & Collaborative Health Initiatives Dianne Cameron, PhD Faculty of Science & Engineering Northern Health Research Conference Sudbury, June 4-5, 2010

2. Conflict Disclosure Information Presenter: Dianne Cameron, Laurentian University Title of Presentation: Towards an IP Certificate at Laurentian I have no financial or personal relationships to disclose Nothing to Hide

3. Introduction • IECPCP:“interprofessional education for collaborative patient-centred care”(Health Canada. Interprofessional Education for Collaborative, Patient-Centred Practice. Discussion Paper & Research Report Request for Proposal. October 2003) • Interprofessional Education:“occasions when two or more professions learn from and about each other to improve collaboration and the quality of care”(Centre for Advancement of Interprofessional Education (CAIPE), 1977, revised) • 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, 2000)

4. Introduction … Interprofessional education (IPE) leads to interprofessional care (IPC) How do we get there? Many valid ideas: short courses, seminars, workshops, focus groups, … • A quick search on Health Canada finds 10,000 references on IPE/IPC • Collaborative practice initiatives for post-licensure IPE: – high priority, good evidence of positive patient outcomes • Pre-licensure IPE: less development, less evidence, lack of research • How to prepare large numbers of students in many educational programs/disciplines for fulfillment of interprofessional practice in their professions ???

5. IPE/IPC issues from IECPCP report • Necessity for a “spectrum of learning” • Call for competency-based IPE to guide teaching strategies • Little literature for educators on facilitating IPE: urgent need for faculty development • Evaluation methods for program and student assessments relevant to IPE are needed • Most successful collaborative practice initiatives were in service or mixed settings (92%), rarely in higher education settings (7%) • Opportunities for IPE in transcultural perspectives are lacking or inadequate in most professional programs and do not address how to provide culturally sensitive care

6. IPE/IPC issues from IECPCP report… • Professional schools should include clinical experiences where students from the different professions work collaboratively in teams providing care to culturally diverse populations. • Students in health care need to be aware of the contributions of all health care providers, particularly non-traditional health care providers, and how to work more collaboratively with them. • An interprofessional collaborative approach among professionals, health care providers (traditional/non-traditional) and the community is desirable and possibly the only feasible way in which health care can be delivered in Canada's northern native communities and remote settings • Successful implementation of interprofessional education will require both individual and collective learning

7. IPE/IPC issues from IECPCP report… IECPCP distinguishes between:Educational Interventions to Enhance Learner Outcomes; and Collaborative Practice to Enhance Patient Outcomes • These concepts cannot work in isolation • Interprofessional education conducted at the pre-licensure level of training must take place in settings that house successful collaborative practices by practicing health professionals who can act as role models and provide experiences for students to work collaboratively • Competency alone is not enough for practice change to materialize • Elements of collaboration need to be understood, promoted and sustained throughout the continuum of learning • Learners entering their training programs already have pre-existing stereotypes developed about other health professionals

8. Challenges for undergrad IPE Incorporation of IPE into undergraduate curricula has been slow, and faces numerous challenges: • Professional programs need to focus on discipline specific education • Little room in busy timetables for IP courses • “Silos” remain intact in many institutionsAdministrative support is lacking • Courses not shareable across disciplines • Faculty assigned to one department or one program, one instructor per course • Class times across programs conflict • No “credit” for extra-curricular IPE

9. Model for an IPE Certificate Which courses are already in common among professional health programs? Which courses could be shared and/or revised to meet at least some of the elements of IPE? Identify a “core” set of required courses and an “elective” set Make both sets tailorable to the needs of any participating program For any program, students MUST take a certainnumber of core IPE credits and MAY takeanother number of elective IPE credits to gainan additional IPE certificate Collaboration is key!

10. Examples: Common Courses and Health Disciplines at Laurentian Sample Disciplines: • Nursing • Medicine • Midwifery • Radiation Therapy • Social Work • Gerontology Sample Courses/Subjects: • Anatomy and Physiology • Clinical or introductory chemistry • Pathophysiology or pathobiology • Bioethics • Public Health & Epidemiology • Patient Care • Microbiology, cell biology, genetics • Statistics • Research Methods; research project or thesis

11. Examples: Common Electives Sample Disciplines: • Nursing • Medicine • Midwifery • Radiation Therapy • Social Work • Gerontology • Introduction to Psychology • Human Biological Variation, Adaptations & Health • Ethnomedicine: Cross-Cultural Healing • Food and Disease Prevention • Origins of Sickness and Medicine • Ethnobotany • Organic Chemistry/Biochemistry for Health Sciences • Natural Products Chemistry • Business Communication • La médecine populaire • Aging and Wellness • Ethnogerontology (Aging in a Multicultural Society) • North American Native People: Tradition & Culture • Introduction to Ergonomics • Ethical Issues for the Elderly • Social Inequality • Women and Aging • Women’s Health Issues

12. Example Interdisciplinary Courses • Interdisciplinary Pathophysiology • Clinical Research Methods in Interdisciplinary Practice • Interprofessional Practice and Cultural Competency • Interprofessional Practice and Patient Care Common Elements: • Team taught – instructors from various disciplines, faculties, institutions • Case based, patient centred • Combination of individual learner and team projects • Students from different disciplines • Health care role exploration and role play

13. Pathophysiology- Interdisciplinary Practice • Uses the vehicle of common subject material in pathophysiology, illustrated in patient case studies • Stresses a team approach to patient care to integrate learners from different professional disciplines • Case studies explore a variety of episodic and complex health challenges from an individual, family and community perspective, cultivating an understanding of interprofessional practice • Team taught by 7-8 faculty from radiation therapy, oncology, midwifery, neuroscience, human biology, radiology, nursing, forensic science… some from Laurentian, some from Hôpital régional de Sudbury Regional Hospital

14. Pathophysiology - Interdisciplinary Practice… Example Learner Activities (individual and team work): • Each student is assigned a preliminary case study patient and a health care role NOT matching his/her discipline • Stage I case study report includes researching the role, scope of practice, licensure, interaction with patient, case based questions on pathophysiology, patient background • Stage II case study – identifies classmates with different health care roles sharing same patient; team must pool information and submit joint case report • Stage III case study – includes pathophysiology lab with tests/exploration related to each case • Final Health Care Team report & oral presentation

15. Clinical Research Methods in Interdisciplinary Practice • Prepares learners for conducting a clinical research project in a team setting with health care professionals from various disciplines • Integrates learners from different disciplines in exploring methods for ethical human research, experimental design and analysis, interpretation of results, and scientific presentation • Case studies in interdisciplinary research projects • Team taught by ~6 faculty from Radiation Therapy, Hôpital régional de Sudbury Regional Hospital, Research Ethics Board, NOSM IPE, Library • Weekly seminars from guests from various professions: Social Work, Nursing, Oncology, etc.

16. Clinical Research Methods in Interdisciplinary Practice… Example Learner Activities (individual and team work): • Critical evaluation of presentations attended (seminars) • Chairing a seminar • Literature Review • Collaborative Editing • Mock Ethics application • Consent Form Design • Questionnaire/Survey Design • Team Research Proposal • Research Team Poster & Oral Presentation

17. Interprofessional Seminar Series (2009/10)

18. Measuring Effectiveness • Each course uses an entry/exit assessment tool to evaluate changes in knowledge and awareness of IPE/IPC by students who have completed the course • Participating course instructors are asked for input before, during, and after course completion • Students complete a course evaluation at the end of each course • Still needed: longer term tracking to evaluate effect of undergraduate IPE on patient outcomes in professional practice

19. References • Barr, H., Koppel, I., Reeves, S., Hammick, M., & Freeth, D. (2005). Effective interprofessional education - Argument, assumption and evidence. CAIPE London, United Kingdom: Blackwell Publishing. • Commission on the Future of Health Care in Canada. (2002). Building on values: The future of health care in Canada: Final report. Commissioner: Roy J. Romanow. Ottawa: Queen's Printer. • Health Canada (2004). Interprofessional education for collaborative patient-centred care (IECPCP) • Health Force Ontario (2007). Interprofessional Care: A Blueprint for Action in Ontario. www.healthforceontario.ca/IPCProject • Martin-Rodriguez, L., Beaulieu, M., D'Amour, M., & Ferrada-Videla, M. (2005). The determinants of successful collaboration: A review of theoretical and empirical studies. Journal of Interprofessional Care, 19(1 Suppl), 132-147. • McNair, R., Brown, R., Stone, N., & Sims, J. (2001). Rural interprofessional education: Promoting teamwork in primary health care education and practice. Australian Journal of Rural Health, 9(Suppl), S19-S26. • Oandasan, I., Baker, G.R., Barker, K., Bosco, C., D'Amour D., et al. (2006). Teamwork in healthcare: Promoting effective teamwork in healthcare in Canada. Policy synthesis and
recommendations. Ottawa: Canadian Health Services Research Foundation. • Parsell, G., & Bligh, J. (1999). Interprofessional learning. Postgraduate Medical Journal, 74, 89-95. • Parsell, G., Spalding, R., & Bligh, J. (1998). Shared goals, shared learning: Evaluation of a multiprofessional course for undergraduate students. Medical Education, 32, 304-311. • Purden, M. (2005). Cultural consideration in interprofessional education and practice. Journal of Interprofessional Care, 19(1 Suppl), 224-234. • Zwarenstein, M., Reeves, S., & Perrier, L. (2005). Effectiveness of pre-licensure interprofessional education and post-licensure interprofessional collaboration interventions. Journal of Interprofessional Care, 19(1 Suppl), 148-165.

20. Example of a step-wise approach to pre-licensure IPE for undergraduate students in multiple health disciplines Towards an IP Certificate at Laurentian Coordinator, Radiation Therapy Program & Collaborative Health Initiatives Dianne Cameron, PhD Faculty of Science & Engineering Northern Health Research Conference Sudbury, June 4-5, 2010