Interprofessional Education: Second Life, SPICE, and the Quest for Meaningful IPE Clinton Pong, MD Amy L. Lee, MD Tufts University School of Medicine

Disclosures The presenters have nothing to disclose

Objectives Share methods about finding and collaborating with interprofessional education programs Brainstorm educational settings for IPE in your institution Discuss assessment and outcomes measures for IPE evaluation

RR1: Communicate one’s roles & responsibilities clearly RR2: Recognize one’s limitations RR3: Engage diverse healthcare professionals who complement one’s own professional expertise RR1: Communicate one’s roles & responsibilities clearly RR2: Recognize one’s limitations RR3: Engage diverse healthcare professionals who complement one’s own professional expertise CC2: Organize and communicate information with patients, families, and healthcare team members

Overview – our experience with IPE pilots at Tufts Med Problem Proposals Pilots Plan

The Problem Doctor-centric  Team-based care ACGME mandate for IPE Developing relationships and collaborating can be daunting to schedule and execute –especially for face-to-face IPE programs Interprofessional student teams aren’t a part of training now, but they need to be! I think it should have a degree of preparing us for graduation and getting out there in the real world and facing the realities of what it’s like to practice.

Tufts Med wants IPE Internal Curriculum Innovations Grants specifically solicit IPE pilot proposals Second Life Pilot is developed for pre- clinical IPE learners SPICE Pilot is developed for clinical IPE learners

VIP: Virtual-World Interprofessional Palliative Care Training Amy L. Lee, MD (Tufts Family Medicine) Suzanne Mitchell, MD, MS (Tufts Family Medicine) Rebecca Koeniger-Donohue, PhD, APRN (Nursing Simmons College)

VIP Proposal Virtual-World Interprofessional Palliative Care Training (VIP) Pre-clinical students meet together in “Second Life” Interprofessional student collaboration –Tufts medical students –Simmons nursing, social work, nutrition students Interprofessional students learn about an unfamiliar topic together

The VIP Pilot Interested students recruited for pilot –First year medical students –Nurse Practitioner –Social work –Nutrition Students all have “Second Life” orientation Med and Nursing faculty run interactive session on Advanced Care Planning in “Second Life” –Students practice interviewing a patient together Discussion, Debrief, and Survey

VIP Survey Results Weaknesses: -Face-to face “real” interaction was missing -Hard to develop a truly interactive relationship with other students -Technical aspects interfered with full participation Weaknesses: -Face-to face “real” interaction was missing -Hard to develop a truly interactive relationship with other students -Technical aspects interfered with full participation Strengths: -Good accessibility, students able to participate from school or home -”The sense of no judgment that the virtual world provided made it easier to have a difficult conversation” -Interesting new virtual world experience Strengths: -Good accessibility, students able to participate from school or home -”The sense of no judgment that the virtual world provided made it easier to have a difficult conversation” -Interesting new virtual world experience Overall Survey Results: -Perspective on Interprofessional teamwork was enhanced -Confidence in discussing Advanced Care Planning increased -Participants found the “Second Life” environment interesting and enjoyable for learning, but with some technical difficulties Overall Survey Results: -Perspective on Interprofessional teamwork was enhanced -Confidence in discussing Advanced Care Planning increased -Participants found the “Second Life” environment interesting and enjoyable for learning, but with some technical difficulties

The VIP Plan Create a virtual world interactive experience that teams of interprofessional students can do together without faculty Develop quantitative and qualitative assessment tools to evaluate Advanced Care Planning and IPE learning objectives

SPICE: Standardized Patient Interprofessional Collaboration Exercise Clinton Pong, MD (Tufts Family Medicine) Kelly Holland, MD (Tufts Family Medicine) Ellen Patterson, MD, MA (Tufts Dentistry) David Schnee (Pharmacy Simmons College)

SPICE Proposal “Referral and follow-up” system Interprofessional student collaboration in clinic –Med, nutrition, pharmacy, social work, & dentistry –Work together to develop a comprehensive care plan for standardized patients with complex needs A taste of IPE becomes an opportunity for peer-to-peer teaching

The SPICE Pilot Family Medicine elective –Fourth year medical students –Clinical pharmacy –Nutrition –Dentistry –Social work Medical student interview with SP “Referred” the patient for consultation –Appt w/ nutrition, social work, pharmacy & dentistry student counterparts Follow up appointment and debrief

SPICE Focus Group I like the idea of having it more integrated and more touch points of communication than what you might experience in real life right now because, honestly, the amount of integration between specialties or between fields is really poor right now, and, in my ideal mind, I want to work in a community health center that has [comprehensive multidisciplinary care] -Med Student I like the idea of having it more integrated and more touch points of communication than what you might experience in real life right now because, honestly, the amount of integration between specialties or between fields is really poor right now, and, in my ideal mind, I want to work in a community health center that has [comprehensive multidisciplinary care] -Med Student It’d be helpful as a student if we were to watch the medical student do their intake, and they were able to watch us do our intake because… there’s so much to do for the dental charting that we miss a big piece of the social interaction and how to make the patient trust us on a first-name basis and seem less of a service provider and more of a coordinator of their care, which is what a PCP would be. -Dentistry Student It’d be helpful as a student if we were to watch the medical student do their intake, and they were able to watch us do our intake because… there’s so much to do for the dental charting that we miss a big piece of the social interaction and how to make the patient trust us on a first-name basis and seem less of a service provider and more of a coordinator of their care, which is what a PCP would be. -Dentistry Student We’re really used to having people above us having the answers... and then here we want to see the overlap between knowledge in this different disciplines; the knowledge or the answers will come from that. We have to put everything we have out there because there is nobody above us helping with what the right answer is in the end. -Med Student We’re really used to having people above us having the answers... and then here we want to see the overlap between knowledge in this different disciplines; the knowledge or the answers will come from that. We have to put everything we have out there because there is nobody above us helping with what the right answer is in the end. -Med Student

The SPICE Plan Evening workshop for final year students –Session 1: Hands-on case & Observed case –Session 2: Follow-up Debrief as a large group on themes and lessons learned Validate a standardized assessment of IPE case principles –SP OSCE Checklist

Resources Sample SPICE cases  1 – Pulmonary Embolism-Depression-Homeless 1 – Pulmonary Embolism-Depression-Homeless  2 – Chronic Pain-Hep C 2 – Chronic Pain-Hep C  3 – Elderly-Polypharmacy-Hip Fracture 3 – Elderly-Polypharmacy-Hip Fracture  4 – Prenatal-Jehovah’s Witness-Vegan 4 – Prenatal-Jehovah’s Witness-Vegan Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

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