Interprofessional Education & Collaborative Practice Issues for Allied Health Virtual day of Allied Health & Rehabilitation December John H.V. Gilbert, C.M., Ph.D., FCAHS Principal & Professor Emeritus, College of Health Disciplines, University of British Columbia. Adjunct Professor, The National University of Malaysia Adjunct Professor, Dalhousie University Co-Chair, Canadian Interprofessional Health Collaborative

Overview of Presentation  The WHO (2010) Study Group Report  Interprofessional Education  Collaborative Practice  Health & Education Systems

Improved Health Outcomes Health & Education Systems Local Context Present & Future Health Workforce Optimal Health Services Collaborative Practice Collaborative Practice-Ready Interprofessional Education Local Health Needs Strengthened Health System Fragmented Health System Health Workforce

Present & Future Health Workforce Collaborative Practice-Ready Health Workforce Interprofessional Education

High Level IPE Strategy 1 “Interprofessional” Use the right word - Use the word right IPE A three-part definition “Learning With, From and About, For the purposes of collaboration, To improve the quality of care”* Quality: Structure, Process, Outcome** *WHO (2010) Framework for Action on Interprofessional Education & Collaborative Practice – following the CAIPE definition (2002) **Donabedian A. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 1966, 44: 166–206.

Present & Future Health Workforce Collaborative Practice- Ready Health Workforce Staff training Champions Institutional support Assessment Learning outcomes Logistics & scheduling Programme content Compulsory attendance Contextual learning Adult learning principles Shared objectives Interprofessional Education Managerial commitment EDUCATOR (TEACHER) MECHANISMS CURRICULAR (LEARNER) MECHANISMS Learning methods

High Level IPE Strategies 2 Framing IPECP for Teaching & Learning

High Level IPE Strategies 3 Design and implement system-wide; Build knowledge about what works in specific situations and contexts; Develop adult learning competency based approaches to IPE e.g.: PBL, CBL, Simulation

Curricular Reform A Lesson Learned “Changing a college curriculum is like moving a graveyard - you never know how many friends the dead have until you try to move them.” (Variously attributed to either Calvin Coolidge or Woodrow Wilson)

Collaborative Practice- Ready Health Workforce Optimal Health Services Collaborative Practice

Collaborative Practice-Ready Health Workforce Optimal Health Services Governance models Structured protocols Shared operating resources Shared decision- making processes Supportive management practices Facilities Space design Personnel policies Collaborative Practice Communications strategies Built environment Conflict resolution policies ENVIRONMENTAL MECHANISMS INSTITUTIONAL SUPPORT MECHANISMS WORKING CULTURE MECHANISMS COLLABORATIVE PRACTICE

Collaborative Practice Strategies 1 The Patient Not Just Another Hockey Puck People Process Technology Information

Patient Care Quality Improvement B.C IPECP Collaborative Strategies 2 Understand the Patient’s Concerns

IPECP Collaborative Practice Strategies 3 Design and implement system-wide. Build as a key health workforce strategy. Develop coordinated collaborative connections between all educational & practice partners.

IPECP Collaborative Practice Strategies 4 Design appropriate space, and complete administrative support. Build a clear work plan. Develop equitable funding, and accountability.

IECP Collaborative Practice Strategies 5 Set teaching, learning and practice in an appropriate framework. Evaluate and measure. Monitor outputs, outcomes, and impacts. Assign responsibility appropriately and effectively.

IPECP Collaborative Strategies 6 Practice Education (PE) An Old Idea - A Central Tenet? “For the things we have to learn before we can do them, we learn by doing them.” (Aristotle, Nicomachean Ethics (350 B.C.E)) 19

IPECP Collaborative Strategies 7 Engage, encourage, and reward The Practice Educator Facilitator AssessorEvaluator Communicator

Fragmented Health System Strengthened Health System Health & Education Systems

Fragmented Health System Strengthened Health System Remuneration models Risk management AccreditationRegulation Professional registration Capital planning Financing Commissioning Funding streams Health & Education Systems HEALTH SERVICES DELIVERY MECHANISMS: Structure & Process PATIENT SAFETY MECHANISMS: Outcomes

Interprofessional Collaborative Practice Some Real Problems interpersonal differences e.g. age, gender, culture fear of change e.g. place, time, persons stereotypic rivalry e.g. me, him/her, them power, income and status e.g. salary vs. fee-for- service language e.g. gender, profession, social class, jargon models of practice e.g. medicine, nursing, social work management structures e.g. acute care, community management priorities e.g. money, space, people

IPECP: The Global Network The American Interprofessional Health Collaborative (AIHC), The Australasian Interprofessional Practice and Education Network (AIPEN), The Centre for the Advancement of Interprofessional Education (CAIPE), The Canadian Interprofessional Health Collaborative (CIHC), The European Interprofessional Education Network (EIPEN) The Japan Association for Interprofessional Education, (JAIPE) and The Nordic Interprofessional Education Network (NIPNET).

What we have learned