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InterprofessionalEducation
Mora ClaramitaMedical Education Department and Family Medicine Department
Faculty of MedicineUGM
MAIN GOALS of Collaborative Team Work
• PATIENT-SAFETY
• HEALTH PROVIDER-SAFETY
IP Competencies in Health Care
• “Integrate the enactment of knowledge, skills,and values/attitudes that define workingtogether across the professions, with otherhealth care workers, and with patients, alongwith families and communities, as appropriateto improve health outcomes in specific carecontexts.”
• Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education
Collaborative
Paradigm Shift
Physician Centered practice to Patient Centered practice
Practitioner autonomy to Team collaboration
Focus on illness & cure to Focus on health promotion
Passive patient role to Involved patients & families
Acute, episodic care to Care for chronic conditions
Aschenbrener CA, Clearning a Path Ahead for IPEPresentation: Collaborating Across Borders II, Halifax, 2007
Institute of Medicine, Crossing the Quality Chasm (2001)
IPE – C - C
• Inter-professional Education
• Inter-professional Communication
• Inter-professional Collaborative Practice
WHO, 2010
What does InterprofessionalEducation (IPE) Mean?
• 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)
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What is interprofessionalcollaboration (IPC)?
“…an interprofessional process of communication and
decision-making that enables the separate and sharedknowledge and skills …to synergistically influence the… care provided”
Way , Jones & Busing (2000)
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7 Essential Elements for Collaboration Way ,
Jones & Busing (2000)
Ehpic course, June 2009
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What does IPE NOT look like?
It is not:
a collective of learners from different professions sitting in the same room listening to the same lecture
- or -
learners from one profession sharing knowledge with one or more other professions in a one way exchange
http://www.afmc.ca/aiphe-afiss/documents/AIPHE_Principles_and_Implementation_Gu
ide_EN.pdf
*
Inter-professional Education
More effective when:
1. Applying principles of student-centered learning (e.g. PBL – various learning methods)
2. Interactions during independent learning sessions occurs between students from different health professionals
3. Contextual learning
4. Using different level of students-assessment (knows, knows-how, and observation based assessment)
WHO, 2010, Sedyowinarso and Claramita, 2014
Learning Activities
Fieldwork placement
Case studies with
real/simulated
Structured practical experience
Small group discussion
*
Inter-professional Education
• The inter-professional learning domains:
1. Team work2. Communication3. Roles and responsibilities4. Professionalism5. Critical reflection skills6. Collaboration with patients 7. Ethical practice
WHO, 2010
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative *
Domain 1:
Values/Ethics for Interprofessional Practice
Domain 2:
Roles/Responsibilities
Domain 3: InterprofessionalCommunication
Domain 4:
Teams and Teamwork
Interprofessional Collaborative Practice Competency Domains
*
Examples of Inter-professional team work practice
1. “The first 1000 days of life” – University of Hassanuddin
2. “The Community and Family Health Care Program (CFHC)” – University of Gadjah Mada
3. “Cultural competence program to rural areas” –University of Indonesia
4. “Family Medicine – Home Visits” – University of Padjajaran
Inter-professional team work practice
• a “PROJECT-BASED” education
• Small group
• Mutual theme
• Clear objectives
• Field activities
• Supervised by faculty and stakeholders
• Commitment of the top management
• Contextual learningWHO, 2010
Three Key Questions for Collaborative Teams
1. What is the goal of our team?
2. How will our team communicate? How will our teamwork be coordinated?
3. How will our team repeatedly review what we are trying to achieve and how effective we are?
– Balance of task/content (the ‘what’) and process (the ‘how’)
Adapted from Aston West OD
& Schmidt, 2006
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1. What is the goal of our team?
• Shared goal and vision• All team members are clear about roles• Roles reviewed regularly to ensure satisfaction
and optimal use• Opportunities for team members to get to
know each other to find out what contributions team members can make
Government of Ontario, Family Health Team Guide to Collaborative Team Practice (2005)
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2. How will our team communicate and coordinate?
• Strategies may include:– Team members meet regularly– Members involved in planning for activities in which they
will be involved– There is an effective decision-making method – Issues are confronted and problems resolved as they arise– There is a process for identifying/clarifying role overlap – Role of leader is understood by team members – Leader encourages active participation of all team
members
Government of Ontario, Family Health Team Guide to Collaborative Team Practice (2005)
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3. How will our team repeatedly review what we are trying to achieve and how effective we are?
• Accomplishments and achievements are celebrated
• There is an evaluation process for follow-up, to ensure goals are being met
• Team process is reviewedGovernment of Ontario, Family Health Team Guide to Collaborative
Team Practice (2005)
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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
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Oandasan & Reeves (2005)
Ehpic course, June 2009
Collaboration: What can you do?
• Knowledge of Roles
–Provide opportunities for clarifying your role (e.g. interview, education, shadow opportunities)
–Request opportunities to clarify team members’ roles
–Orientation for new team members? Or changes in roles over time?
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Collaboration: What can you do?
• Communicate and reflect– Enhance your own collaborative communication
e.g. giving and receiving feedback, conflict resolution, monitor for jargon, etc.
– Invite feedback re: specific collaborative competencies
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Collaboration: What can you do?
“We may look in the same direction, even at the ‘same lines,’ and not see what our colleague sees.”
McKee (2003)
Reflect on your own ways of knowing, e.g.
• What assumptions am I making?
• Where did I learn these values?
• What values orient me?
• How might someone whose role is different than mine look at this?
McKee (2003)
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Inter-professional Communication
Being the patients’ advocate
The “Greet-Invite-Discuss” for inter-professional communication
GREET
to minimize the socio-hierarchical gap
Content Strengtened interpersonal skills
to respect role, task and function of other health professionals
I respect other health professionals as partners
to build trust and equal relationship with other health professionals
I try to learn from other health professionals
build two-way exchange information between health professionals for the sake of Patient-safety
I welcome other health professionals’ contribution to help my task for the sake of Patient-safety
The “Greet-Invite-Discuss” for inter-professional communication
INVITE
to be open to others’ participation
Content Strengthened advocation skills
to initiate conversation with other health professionals (between individual or during a group meeting)
I initiate communication with other health professionals (e.g. for a life-saving case that needs immediate action or for chronic illnesses that needs long and extensive treatment)
to maintain ethics during communicating with other health professionals
I respect medical laws, norms, values and believes during communicate with other health professionals
to communicate the use of CAMmedicine
I try to communicate this issue carefully to other health professionals for the sake of Patient-safety
“The Greet-Invite-Discuss” for inter-professional communication
DISCUSS
to be open to dialogs and discussions
Content Strengthened dialogic skills
to share information and to provide proper complimentary information to other health professionals
try to discuss any appropriate information
to apply paradigm that are: willing to help, willing to strengthen information from and willing to adjust information from other health professionals – based on role, task and function of each health professionals
try to strengthen, adjust and synchronized any information
to approach mutual agreement with other health professionals
try to discuss and negotiate any unsynchronized information
to collaborate and cooperate with other health professionals
try to maintain good relationship
GREET
• RESPECT
• EQUITY
• TWO-WAY COMMUNICATION
INVITE
• INITIATIVE OF TWO-WAY COMMUNICATION FOR PATIENT’S CONCERN
• COULD BE INDIVIDUAL OR IN A GROUP DISCUSSION
• ETHICS• INITIATIVE TO DISCUSS THE CARE-PLAN
DISCUSS
• COMPLEMENTARY INFORMATION
• COMPLEMENTARY HELP
• NEGOTIATION
• COLLABORATION
When I am so much younger than todayI never needed any body’s helping anyway
Help me get my feet back on the ground….And I do appreciate you will be around,
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