Interprofessionalism: Breaking Down the Barriers

1
InterprofessionalismBreaking Down the Barriers

• Alex Harris
• BNSc Student
• QUIPPED Student Stipend

2
IPE Definition

• Occasions when two or more professions learn
  from and about each other to improve
  collaboration and the quality of care Journal of
  Interprofessional Care (JIPC), p. 166)

3
Why IPE?

• Effective interprofessional collaboration is
  believed to lead to more comprehensive services,
  greater efficiencies in delivery of care,
  increased patient satisfaction and ultimately
  better patient care and health outcomes (JIPC,
  p. 77).

4
The Basics of IPE

• 1) Methods of Learning
• i. Teaching learning strategies
• ii. Models of IPE
• iii. Specific topics that lend itself to IPE

5
The Basics Methods of Learning

• i. Teaching/Learning Strategies
• Small group learning case-based learning,
  problem-based learning
• Group Balance equal mix of professionals is
  essential
• Group Size should consist of approximately 5-10
  members
• Group Stability best if theres little
  turnover
• Exposure Best done during early years of
  education
• Immersion Best done in the year in which the
  student is graduating from their professional
  program

6
The Basics Methods of Learning

• ii. Different Models of IPE
• Shared instruction in core content only (Common
  Learning Program in the UK)
• Shared content with specific interprofessional
  focus (Pain week at U of T)
• Elective program (UBC)
• Intermittent discussions throughout the
  undergraduate education (Dalhousie, McMaster)
• Separate courses at a particular point in the
  undergraduate progamme (at UofA students learn
  about each others professions)
• Individual clinical placements

7
The Basics Methods of Learning

• iii. Specific Topics that Lend Themselves to IPE
• Community health/prevention
• Medical ethics
• Communications
• Critical appraisal
• Epidemiology

8
Barriers to Implementing IPE

• The difficulty lies, not in the new ideas, but
  in escaping the old ones, which ramify, for those
  brought up as most of us have been, into every
  corner of our minds.
• (John Maynard Keynes) p 93

9
Interprofessional Literature Identified Problems

• Those involved in IPE are busy and publication
  takes time and effort
• Difficult to measure changes in behaviour of
  clinicians
• Much evidence is based on self-assessment -
  happiness data is usually regarded as having
  very limited value (p. 148)
• The effects of pre-licensure IPE on
  patient/client care are unknown. (p. 148)

10
Faculty

• Professional beliefs play a critical role in
  student training
• Academics educated in close disciplinary bounds
  frequently display attitudes that are not
  commensurate with an interprofessional view
• Majority of health and human service faculty are
  members of professional associations
  professional associations seek autonomy and
  respect for their members
• Faculty members who engage in interprofessional
  activities do so at their own peril -
  promotion/tenure/merit adjustments are predicated
  on service to a single department

11
Accrediting Bodies Management

• Four barriers problems with schedule/calendar,
  rigid curriculum, turf battles, lack of perceived
  value
• Administration
• Institutional structuring
• Governing bodies
• We need champions at all levels.

12
Other Barriers

• Funding when budgets are constrained,
  disciplines tend to regroup around
  disciplinarity funding for anything outside
  disciplinary bounds is usually reduced or cut

13
Moving Forward NaHSSA

• Formed in January 2005 at UBC
• Currently consists of 19 Canadian universities
• QHSSA formed in November 2005
• Working towards increased interprofessional
  interaction and collaboration

14
Moving Forward

• Clinical settings where collaborative practice is
  modeled for learners by current professionals.
• Identify health professionals who are working
  collaboratively and learn from them to
  operationalize ways of teaching and practicing
  collaboration.
• Target not only academic faculty, but practicing
  clinicians and teachers in the community
• Appreciate that many health care workers are
  educated in a college environment, rather than in
  a university

15

• If health care providers are expected to work
  together and share expertise in a team
  environment, it makes sense that their education
  and training should prepare them for this type of
  working arrangement.
• (Romanow Report, 2002)