Modelling Interprofessional Collaboration in Pain Management:

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Modelling Interprofessional Collaboration in Pain
Management

• An Online Roundtable Discussion Activity

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Context Teaching Learning

• Masters in Pain Management
• Articulated program
• 4 core units (1st year)
• 4 elective units (2nd year)
• Online delivery (WebCT)
• Course materials licensed to other Universities
  (EU, UCSF)
• Target audience
• Doctors, anaethestists, dentists, nurses,
  physiotherapists, occupational therapists,
  psychologists etc.
• Often new to online learning
• Busy practitioners multiple commitments/time
  poor

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RTD Activity Curriculum Position
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Design Considerations
Adapted from van Ments (1989)
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Role Play Design Decisions

• Development of Scenario
• Real life/complex case
• Number and type of roles
• Keep it simple small numbers initially
• Tutor assigned specific role
• Incorporate consultant groups role reversal
• Group Allocation
• Teacher led based on student backgrounds/strengt
  hs
• Learning Supports
• Readings/role play supports
• Facilitator supports

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RTD Activity IPL Aims

• Model the clinical decision making process
• Develop skills in interprofessional collaboration
  
• Appreciate importance of interdisciplinary teams
• Gain insights into perspectives of different
  stakeholders
• Develop an integrated treatment management plan

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Role play structure

• Online group activity using available WebCT tools
  
• Assignment
• Group Participation in RTD Activity (context -
  adult)
• Individual written assessment (context
  children, plus reflection on RTD)

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http//learn-on-line.auth.usyd.edu.au/webct/public
/home.pl
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Initial Reflections Role Perspectives

• Taking a different role from the actual one we
  have been doing for some time is not an easy job
  but a good experiencethrough this experiencewe
  can appreciate the effort and the valuable
  knowledge of other team members. We also learn a
  lot about the adopted role
• The experience of the MDT is a challenging but an
  eye opener for me personally because I dont have
  that exposure in daily practice
• Being a psychologist instead of an anaesthetist
  in a pain team was an interesting experience, as
  our psychologist and psychiatrist refuse to allow
  any medical staff to observe what they do and
  often dont tell us how and why they are making
  the decisions they do
• Helped me think out of the square

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Initial Reflections New Insights

• This exercise highlighted to me the importance of
  good communication, planning, and teamwork within
  the MDT setting to ensure the best outcome for
  each patient.
• I realised during this exercise what an enormous
  difference there was between consulting and
  collaborating.
• The experience of the role play activity added
  a richness to the picture that could never have
  managed alone
• I believe there is no wrong or right treatment
  plan. CRPS is a complex condition with a largely
  unknown pathophysiology. Evidenced-based
  treatment options are wide ranging, and depend on
  each individual case, the biosychosocial pain
  presentation, age of the patient etcIf you ask 5
  experts from the same field, you would probably
  get 5 different answers

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Initial Reflections Clinical Reasoning

• It was enlightening to see an individual plan of
  care develop, that would have the best chance of
  returning a person to a functional and happier
  life. It was apparent to me that a single
  discipline would not be effective in most cases
• I would have liked to have read some of the other
  groups discussions for my own learning. Perhaps
  not while we were in role but afterwards

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Initial Reflections Challenges

• I found it difficult to play a role that I was
  not familiar with and to discuss a pain condition
  that I had never dealt with before
• The virtual reality of the MDT is difficult given
  how we were interacting online and not in real
  time I would suggest that if this activity was
  to be repeated that the lecturers might consider
  opening up a chat room type of situation whereby
  a set time for discussion could be arranged in
  order to give it more of a real feeling to the
  objective of experiencing what it is like to be
  part of the MDT meeting
• I think that organising one time for everyone to
  meet online may be a good way of approaching the
  online discussions or meeting. Even if this was
  for the three representatives in the MDT, with
  the option for the group members to watch the
  MDT discussion process unfold.

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Longer term reflections (18 months)

• I am more, I suppose, confident that there are
  things that I know are right to do and not right
  to do.
• I suppose thats one of the things as a result
  of RTD I am becoming better able to frame my
  argument because I am more aware of perhaps
  where other professionals are coming from.
• I understand more about the other
  professionswhat my psychologist mates are doing
  and what the doctors are doing. I am probably
  more aware ofwhat they know about what I do, and
  can more accurately guess that and therefore
  feeding back to them what I think is going to
  help them.

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Longer term reflections (18 months)

• The RTD helped me to realise how we edify
  others, and so if the psychologists are more
  aware of what I am going to do and if they trust
  me that Im following what the literature
  suggests is reasonable, then they can be
  confident that I am going to give them you know
  the right adviceSo I think that probably it
  works both ways. I learn more about them and
  theyre more confident that I know what I am
  talking about.

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Acknowledgements

• Macquarie University
• Garry Brierley, Mick Hillman and Leigh-Anne
  Funnell
• Pain Management Research Institute
• Damien Finness, Allan Molly, Michael Nicholas,
  Lois Tonkin, Trudy Maunsell
• Sydney University
• Helen Wozniak, Justin Tauber, Bec Plumbe, Mary
  Jane Mahony