University of Virginia Educating for Interprofessional Practice John Owen EdD, MSc; Valentina Brashers MD, FACP, FNAP CoDirectors for UVA Interprofessional Education

UVA 4 Step Model: Educating for Interprofessional Practice 1.Clinically-relevant IPE based on Collaborative Care Best Practice Models (CCBPMs) 2.IPE required and integrated throughout the learning continuum 3.Longitudinal assessment of IPE competencies 4.Commitment to continued rigorous IPE research and dissemination of results

Step 1: Collaborative Care Best Practice Models (CCBPMs) Creates IPE simulations based on clinical guidelines for selected illness experiences, patient populations, and care settings Clearly defines measurable learning objectives and observable collaborative skills Integrates profession-specific skills alongside interprofessional competencies Establishes IPE as a core activity during clinicals/clerkships

Clerkships/Clinicals IPE Simulation Experiences Goals of Care/ End of Life Rapid Response/ Critical Illness Chronic Progressive Illness Transitions in care for the cognitively impaired Illness experience CancerSepsisDuchenne muscular dystrophy Alzheimer’s disease Guidelines &search=palliat ive+care#Section &search=survivi ng+sepsis ov/content.aspx?id=156 45&search=muscular+d ystrophy ov/syntheses/synthesis. aspx?id=16414&search =alzheimer Patient population Adult PediatricGeriatric Care settingInpatient unitICUOutpatientHospital to home then home to assisted living Target learners Required for all 3 rd year students (n=260) IP Competencies Communication Professionalism Shared problem solving Shared decision making Communication Professionalism Shared problem solving Communication Professionalism Shared problem solving Shared decision making Conflict Resolution Communication Professionalism Shared problem solving Shared decision making Conflict Resolution

Introduction to Teams (roles, leadership, communication) Written Team-Building Case (sharing of information, shared problem solving, shared decision making) Simulation Case #1 Post-op patient with deteriorating mental status and fever (physical exam, CAM, labs, triage decisions; active listening, shared problem solving, conflict resolution) Simulation Case #2 Patient after transfer to ICU for sepsis (Surviving Sepsis Guidelines - fluids, vasopressors, etc); active listening, shared problem solving, conflict resolution) 4 medical and 2 nursing students View simulation remotely and discuss checklist of essential behaviors Debrief Rapid Response/ Critical Illness (Littlewood, Tullman, Wright) Clinical Logs; Evaluations

Step 2: IPE required and integrated throughout the learning continuum (Curricular map moves IPE from fringe to core)

Faculty/clinician IPE activities Project Team Meetings Faculty development for IPE facilitation Continuing interprofessional education (CIPE) for clinicians for team-based care and for precepting students Participation in conferences Consultants Focus groups Website resources (in progress)

Step 3: Longitudinal assessment of IPE competencies Pre- and Post-testing of all medical and nursing students before and after clinicals/clerkships – Team Skills Scale (Hepburn, Tsukuda, and Fasser) – Collaborative Behaviors Observational Assessment Tools (CBOATs) – Interprofessional Teamwork Objective Structured Clinical Examinations (ITOSCEs) Commitment to Change assessments for CIPE

Step 4: Commitment to continued rigorous IPE research and dissemination of results Ensures that IPE projects are well designed and carefully evaluated with measurable outcomes Expands pool of involved faculty and clinicians Guides expansion into areas of need and innovation Leverages existing and new SOM, SON, and Health System research projects to support new clinical IPE grant proposals Nursing Student RR ITOSCE

SUMMARY UVA 4 Step Model: Educating for Interprofessional Practice 1.Clinically-relevant IPE based on Collaborative Care Best Practice Models (CCBPMs) 2.IPE required and integrated throughout the learning continuum 3.Longitudinal assessment of IPE competencies 4.Commitment to continued rigorous IPE research and dissemination of results