Kesinambungan belajar berbasis IPE pada tahap akademik dan penerapannya

pada tahap profesi

Diantha SoemantriKoordinator Kurikulum Terintegrasi

Rumpun Ilmu Kesehatan Universitas Indonesia

“ It is no longer enough for health

workers to be professional. In the

current global climate, health

workers also need to be

interprofessional “

(WHO, 2010, p.36)

Main concepts of IPE

IPE in academic stage (current

implementation)

IPE in profession

stage (future plan)

PRESENTATION OUTLINE

MAIN CONCEPTS OF IPE

The need for an interprofessional education

Educational and Health System according to WHO (2010)

Collaborative practice

Perbaikan patient care & safety

Perbaikan outcome pada pasien

penyakit kronik

Penurunan angka clinical error

Peningkatan kepuasan pasien

Compliance terhadap terapi yang lebih baik

WHO (2010). Framework for Action on Interprofessional Education and Collaborative Practice

Interprofessional education

Effective interprofessional education

Effective interprofessional

team

Effective interprofessional

care

Sargeant (2008): “Contact … is notenough to build an effective team. Teamwork is a sophisticated social activity requiring cognitive (knowledge), technical (skills), and affective (attitude) competencies and education for developing these”

Components of Interprofessional Education Program (WHO, 2010)

How to organize an interprofessional education

“International environmental scan”

Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91

Only 38% reported that IPE is MANDATORY Only 66% reported that the students know the

LEARNING OBJECTIVES of IPE program Only 37% reported that the learning objectives are

ASSESSED Only 31% reported that there is a TRAINING for

staff involved in IPE program 30% reported that IPE program is not EVALUATED

IPE IN ACADEMIC STAGE Current implementation

in Universitas Indonesia…

• A learning module in which students sit together listening to the same lecture or reading the same book is not adequate

Multiprofessional education

• Informally, students can interact with each other in this module, most probably superficially

in Universitas Indonesia…

• Therefore, multiprofessional education must be accompanied with interprofessional education

• Interprofessional education specifically aims to equip students with the ability to collaborate and work in a healthcare team effectively

in Universitas Indonesia…

Health sciences

Medicine

Nursing

PharmacyDentistry

Public health

• Resource sharing• Efficiency of

resource use• Closer relationship

and more effective communication between professions

• Added competency: the ability to collaborate and work in a team in providing health care services

Structure of Health Sciences Faculties curriculum

Study program (profession specific) modules

Faculty compulsory modules

University compulsory modules

Multiprofessional & interprofessional learning modules

Shared learning modulesCOMPETENCY MODULE CREDIT (in SKS)

Ethics and Law Ethics and law in health profession 2

Basic biomedical sciences Basic biomedical sciences 3 (theory) + 1 (practical)

Communication Effective communication in healthcare services

2

Disaster management Disaster Management 2

Research Research 3

Teamwork and collaboration of healthcare team

Teamwork and collaboration of healthcare team(preclinical and clinical)

2 (preclinical) + 1 (clinical)

MPE

IPE

Universitas Indonesia (2013)

Canada (2010) IPEC (2011)

Group dynamics Interprofessional communication

Interprofessional communication practices

Concept of collaboration and healthcare service system

Patient/client/family/community-centred care

Roles and responsibilities

Conflict management Role clarification Values and ethics

Interprofessional communication & leadership

Team functioning Interprofessional teamwork & team based practice

Roles of each profession Collaborative leadership

Obstacles & strategies for interprofessional collaboration

Interprofessional conflict resolution

Interprofessional competency domains in the “Teamwork & Collaboration of Healthcare” Module

Module: Teamwork and collaboration of healthcare team

Teaching methods

– Introductory lecture– Collaborative learning– Question based learning – Case based discussion– Plenary presentation

Assessment system

• Self reflection• Tutor & peer assessment • Written exam (in group)• Group project

Pre-module Post-module01020304050607080

37.68 38.27

30.47 30.48

5.75 5.88

Roles and re-sponsibilitiesProfessional identityTeamwork and col-laboration

Mean score comparison of RIPLS (Readiness for Interprofessional Learning Scale) in year 1 Health Sciences students

Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague

Input from students:“Continuity of program from academic to professional stage”

“Real world application of interprofessional collaboration principles” hospital? community?

IPE IN PROFESSION STAGEFuture Plan

1 ROLE MODEL

• Interprofessional team in hospitals/clinics

• Examples of interprofessional collaborative practice in hospitals/clinics

• Healthcare practitioners understand the roles of each profession, and aware of the importance of interprofessional, collaborative healthcare services

• Minimizing negative stereotyping and hierarchy of profession

2 INSTITUTIONAL SUPPORT

• Adjustment of the curriculum

• Time allocated for interprofessional education

• Allocation of human and physical resources, including a number of main/affiliated hospitals, satellite/family clinic, community health centers, etc.

• Training for teaching staff

3 ORGANIZATION

• Module management

• Organization of a high number and diverse students and teachers

• Individual preparedness: students, teachers

• Student-centered active learning

Some examples of IPE in profession stage (pre-qualification stage)

• Guest et al (2002)

– Interprofessional placement – Pediatric ward in a large teaching hospital– 90 senior nursing students, 90 junior medical

students ‘buddied’– Discuss and reflect students’ ward-based

interprofessional learning experiences

Some examples of IPE in profession stage (pre-qualification stage)

• Van der Horst et al (1995)

– Interprofessional community placement – Medicine, nursing, occupational therapy,

physiotherapy, social work – Activities: observation of community

interprofessional health teams, interviews with local community experts, interviews with the users of community health services

Some examples of IPE in profession stage (pre-qualification stage)

• Ker et al (2003)

– Simulated ward environment in a clinical skills centre

– Medical and nursing students interprofessional teams

– Responsibility for the ward for a shift prepare a joint report discuss and receive feedback from tutors

the way forward…

• Designing an instructional design for IPE program in professional (pre-qualification) stage by an interprofessional teaching team– Explicit learning objectives– Relevant activities– Valid assessment methods– Feasible timing

• Formation of interprofessional team of students– Medicine, nursing, dentistry, pharmacy and public health– 1 group 10 students max?

the way forward…

• Choices of placements:– Community placement• Students are given a patient/family who needs an

interprofessional healthcare approach, that they have to monitor and intervene during a particular period

– Clinical ward placement• Students team-up to observe and experience an

interprofessional approach in treating patients in the ward– Simulated ward environment • Similar to the clinical ward placement, but in a simulated

environment simulated patients. More opportunities for hands-on experience

the way forward…

• In each placement: – Tutors’ guidance and supervision– Discussion and reflection upon the experiences– Tutor assessment and feedback– Peer assessment and feedback

• Evaluation (program)– Level 1: students, teachers satisfaction– Level 2: students’ learning achievement

to sum up….• IPE is a must, preferably both at academic and profession stage

(continuum of the early and advanced stage of education)

• Classroom-based teaching main activities at the academic stage

• Community/hospital ward placement main activities at the profession stage

• Specifically at the profession stage: IMPORTANT not only the instructional design of the IPE program, but also the ROLE MODELING from healthcare practitioners

References• Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework.

February 2010. • Guest C, Smith L, Bradshaw M & Hardcastle W (2002). Facilitating interprofessional learning for medical

and nursing students in clinical practice. Learning in Health and Social Care 1: 132-138• Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core competencies for

interprofessional collaborative practice: report of an expert panel. Washington, DC. Interprofessional Education Collaborative.

• Ker J, Mole L & Bradley P (2003). Early introduction of interprofessional learning: a simulated ward environment. Medical Teacher 37: 248-255

• Modul Kolaborasi dan Kerjasama Tim Kesehatan. Rumpun Ilmu Kesehatan, Universitas Indonesia, 2012• Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative

Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91

• Sargeant J, Loney E & Murphy G (2008). Effective interprofessional teams: “contact is not enough” to build a team. Journal of Continuing Education in Health Professions 28(4):228-234

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

• Van der Horst M, Turpie I, Nelson W et al (1995). St Joseph’s Community Health Centre model of community-based interdisciplinary health care team. Health and Social Care in the Community 3: 33-42

• Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague