One Community’s Practical Plan for Development and Implementation of Interprofessional Medical Education Curriculum Dawn LaBarbera PhD, PA-C Mary Kiersma PharmD, PhD Mindy Yoder DNP, FNP-BC, RN Deb Poling PhD, RN, FNP-BC, CNE

Learning Objectives Discuss steps for creating a community consortium of interdisciplinary educators Disseminate examples of three interactive interdisciplinary activities Assist each participant in the integration of IPE within their organization or community of interest

Interprofessional education (IPE) Background Recommended by: Pew Health Professions Commission Institute of Healthcare Improvement Institute of Medicine Accrediting organizations in healthcare education Linked to reduced deaths, sentinel events and health care costs an essential component of teamwork and collaboration

Faculty University of Saint Francis: Physician Assistant, Nursing MSN and Family Nurse Practitioner Indiana University-Purdue University Fort Wayne: Nursing MSN and Nurse Practitioner Indiana University: School of Medicine Fort Wayne Medical Education Program: Family Practice Residency Program Manchester College: Doctor of Pharmacy

FWAIPEC Beginning Fort Wayne Area Interprofessional Education Consortium (FWAIPEC) Graduate Health Care Education Created August 2011 Common interest of accreditation criteria

Pilot Seminar Series Activties Three-session series piloted Spring 2012 Introductory Exercise BATHE Model of Psychosocial Interviewing Root Cause Analysis Materials available through MEDEdPORTAL www.mededportal.org/publication/9294

Session 1: Introduction to IPE and Health Care Provider Activity Pretest RIPLS administration Food Mini-lecture: Introduction to IPE and faculty Created interdisciplinary teams (10-12 students) Activity Debrief

Session 1: Educational Outcomes Become a more effective team member through interprofessional learning experiences especially in the areas of communication, role recognition and collaboration Discuss how health professionals and patients may utilize and understand the role of various providers and services

Session 2: BATHE Model of Psychosocial Interviewing Food BATHE (Background, Affect, Trouble, Handling, and Empathy) model Mini lecture presented by a clinical psychologist Continuation of interdisciplinary teams Activity Debrief Introduction to psychosocial interviewing Presented by a clinical psychologist Each student took turns in three roles: patient, provider, and observer/evaluator Students provided feedback Summary of what each team learned Question and answer session with clinical psychologist

Session 2: Educational Outcomes Apply the elements of the BATHE communication model to a mock patient interview Assess a mock BATHE patient interview and critique team members using an established rubric

Session 3: Root Cause Analysis (RCA): Lewis Blackman Case Food Introduction of RCA process Lewis Blackman video Activity Debrief Posttest RIPLS administration Teams discussed potential factors and key questions Fishbone diagram documented analyses Prioritized change needed to avoid outcome Summary presented by teams

Session 3: Educational Outcomes Work in interdisciplinary teams to apply a Root Cause Analysis (RCA) process to a real patient scenario In the RCA, identify issues and develop potential solutions

RIPLS Results 19 item survey 5-point Likert Scale (Strongly agree to strongly disagree) Pretest and Posttest 258 surveys completed 132 participants 122 participants completed both assessments Physician Assistant, Pharmacy and Nurse Practitioner students For the results, we administered the RIPLS survey as a pretest and a posttest to determine how the seminar series affected the participants. Since the PA students were required to attend all the sessions, they were the only participants who completed both assessments.

Demographics Variable Category N (%) Health Profession   Family Practice Resident 3 (2.5) Medical Nurse practitioner (NP) 32 (26.2) Other graduate nursing, non-NP Nursing, undergraduate Pharmacy 55 (45.1) Physician assistant student 23 (18.9) Gender Male 40 (32.7) Female 82 (67.2) Ethnicity Caucasian 90 (73.8) African American 8 (6.6) Asian/Pacific Islander 2 (1.6) Other 5 (4.1) We wanted to give you an overview of the demographics that were collected. Multiple health professions participated including family practice residents, medical students, physician assistant students, and nursing students that included undergraduate, graduate and nurse practitioners students. The majority of participants were Caucasian and female.

NP student Paired T-tests Question P-value Shared learning with other health care students/professionals will increase my ability to understand clinical problems 0.016 I would welcome the opportunity to share some generic lectures, tutorials or workshops with other health care students/professionals. 0.032 One of the objectives was to evaluate the change in scores for the RIPLS survey for the participants that completed both assessment. Only 2 questions had statistically significant results. The questions included Shared learning with other health care students/professionals will increase my ability to understand clinical problems I would welcome the opportunity to share some generic lectures, tutorials or workshops with other health care students/professionals. The results showed a decrease in scores from the pretest to the posttest. These results could be due to the lack of consistent participation from health professions other than the PA students.

Pharmacy student Paired T-tests Question P-value Shared learning with other health care students/professionals will increase my ability to understand clinical problems 0.029 Learning between health care students before qualification and for professionals after qualification would improve working relationships after qualification/ collaborative practice 0.015 Shared learning will help me think positively about other health care professionals 0.038 One of the objectives was to evaluate the change in scores for the RIPLS survey for the participants that completed both assessment. Only 3 questions had statistically significant results. The questions included Shared learning with other health care students/professionals will increase my ability to understand clinical problems Learning between health care students before qualification and for professionals after qualification would improve working relationships after qualification/ collaborative practice Shared learning will help me think positively about other health care professionals The results showed a decrease in scores from the pretest to the posttest. These results could be due to the lack of consistent participation from health professions other than the PA students.

PA Paired T-tests Question P-value I have to acquire much more knowledge and skill than other students/professionals in my own faculty/organization 0.020 One of the objectives was to evaluate the change in scores for the RIPLS survey for the participants that completed both assessment. Only 1 question had statistically significant results. The questions included I have to acquire much more knowledge and skill than other students/professionals in my own faculty/organization The results showed a decrease in scores from the pretest to the posttest. These results could be due to the lack of consistent participation from health professions other than the PA students.

Lessons Learned Logistics Support from colleagues Scheduling difficulties , Time management, Team assignments Support from colleagues Evaluation of the program Student encounters Education, Roles/Responsibilities, Anecdotal benefits Consortium members Better understanding of professions There were several lessons from the IPE planning meetings to the curriculum elements themselves. As expected, the most difficult piece was managing the learner’s schedules. The only time that worked was over dinner to early evening. Offering a light meal to the learners helped encourage attendance. The consortium members also learned that they were more supportive of IPE than some of their colleagues. Many faculty had scheduling difficulties which decrease faculty attendance at the sessions. Since the RIPLS analysis did not show much statistical significance, we are looking into other assessments to better evaluate the program and what students are learning. From conversations with students, they have learned a lot from attending the sessions. We are looking to add some open-ended questions to better assess student perceptions. There were several stories from students about their encounters with other health professions students. The stories tended to be of misunderstanding of education, roles, and responsibilities. One thing that surprised the students, however, was what roles they had in common for patient care. The consortium members themselves learned a great deal more about each other’s professions as well. Students and faculty could not remember their team number from one session to the next. Prior sign in sheets were provided each time so participants could look up their group numbers. Since the faculty members were not always consistent from IPE session to session, it was more difficult to keep track of some of the faculty.

Components of Success One leader Group consensus Expenses Hosting Session development Facilitators Expenses Hosting