1. Inter-Professional Teaching Jonathan Corne East Midlands (North) School of Medicine

2. Today's Session What Why Who Where Challenges How

3. Discussion Non-physicianly examples Widening to other professions Share experience Developing new inter-professional teaching models – extending beyond the classroom

4. Inter-Professional Learning ……..is where people from different disciplines and/or professions learn from and about each other to improve collaboration and the quality of care Multi-professional education is where people learn alongside one another

5. Why? Understanding each others viewpoint/roles Understanding our own role Developing common approaches Appreciate diversity of ways of working Cross-fertilisation of ideas Improving trust and communication Growing up together Understanding the patient experience Need to manage MDTs Increase emphasis on long term conditions

7. GMC and Multi-Professional Learning Stronger links between the GP and specialist training organisers are needed to enable increased specialist training in the community and opportunities to learn from a number of positive aspects of general practice training. (Education tomorrows doctors) Knowledge of the everyday aspects of leadership and management such as leading a multi-professional team.. is required by all doctors (Educating tomorrows doctors) Trainees must have the opportunity to learn with other healthcare professionals (PMETB 6.17)

8. GMC and Inter-Professional Learning ‘..inter-professionalism is an important area in medical education, but it is more likely to be embedded into medical practice through experience..’ ‘..there is concern that poorly designed inter- professional learning could harm collaborative interactions and polarise attitudes..’

9. Where? On the ward/consulting room General practice Simulation centres Community Lecture room Workshop

10. Who GPs Physicians Patholgists Radiologists Oncologists Surgeons Cancer nurses Palliative care Physicians Radiologists Rehabilitation physicians Occupational Therapists Physiotherapists Neurologists Stroke physicians GPs Secondary care Commissioners Patients

11. Challenges Relevant to all groups Relevant to practice Understood by all Encourage interaction and discussion Making it feel natural

12. Set Objectives Understand topic Understand contribution/role of each professional Understand real world interactions Establish team working Establish informal networks

13. How to do Interactive Fun Dovetailing

14. How not to do it Formal lectures Piggy backing

15. How to Do It Problem based learning Case studies Joint professional shadowing Visits to a patient Role-play Task orientated activities Exchange placements

16. Three Examples The bad, the good and the better

17. Example 1 – Stroke Teaching GP trainees and Core Medical Trainees Afternoon session Lectures by primary and secondary care physicians Topics covered –Prevention in the community –Acute presentation –When/how to refer –Hospital care including thrombolysis –Rehabilitation –When to discharge –Infomration needed at discharge –Community follow up

18. Stroke Feedback No interaction between GPs and secondary care trainees No mixing No added benefit of joint teaching

19. Feedback - Stroke Joint Session Teaching style more suitable for hospital doctors Most information based round secondary care Session had great potential but failed to fulfil it Not relevant to primary care

20. I think that medics and GPs have different slants on same topic… I would rather have gone through how to respond to stroke in community- evidenced based initial management….how to refer to TIA clinic – via choose and book? Plus community rehabilitation ….ie what to do if called out to see somebody post-stroke and new neurology/ increased tone and query contractures….? Can we re-refer to stroke specialist OT/Physio/ for botox….what about referral for stroke rehab in somebody who has had an old stroke…eg in nursing home but not picked up before….eg if they need SALT…what about managing cognitive decline and behavioural aspects post-stroke…what services are there? I am not sure that this type of session was that helpful- sorry- although I think the level of information given was excellent.

21. Example 2 - CPCs Trainee led Involve pathology and radiology trainees Consultant facilitated Half day sessions Core Trainees Organised into specialist groups e.g.Cardiology /ITU

22. CPC’s Feedback Quotes on the feedback forms included: “Excellent – Please can we have one every four months.” “Really interesting cases for discussion” “I learnt a lot – good cases.” “Brilliant cases, thank you. It was good to have consultants there to interject but the trainee led the day very effectively”

23. CPCs Feedback

24. CPC Feedback

25. Example 3 - Management Objectives Understand the process of commissioning Integrate primary and secondary care trainees Encourage teamwork

26. Plan of Day 09.00Introduction 09.05Quiz on pre-course reading 09.30Group work – to develop service re-design 10.50Coffee 11.20Develop outline business place 12.20Lunch 13.20Dragons den 15.20Assessment of providers performance 15.30Prize-giving 15.45Summary

27. Feedback - Management Helped to give a good insight into NHS management Good to mix with core medical doctors – different perspectives and ideas Helped me understand how primary and secondary care can be intergrated Good team working – well organised

28. Feedback – Management (A Warning) Secondary care physicians seemed to blame problems on inappropriate GP referrals…. Felt that the day was spent sorting out inadequacies in primary care…..quite demoralising spending time working out ideas for them to be completely ripped apart

29. Acknowledgements Prit Chahal –Associate Postgraduate Dean Jane Little –Core Training Program Organiser

30. Discussion Questions Experiences of inter- professional education –Successes –Failures Potential for non- physicians Beyond the Classroom Where? Inter-professional involvement in organisation of medical education Integrating inter- professional involvement in routine clinical experience Inter-professional education at undergraduate level

31. Further Information www.caipe.org.uk www.eipen.org www.interedhealth.org