1. IDEAS@WORK: The design, delivery, and evaluation of an online course and associated learning activities in Interprofessional Education, using disaster management content Janet Maher August 9, 2010

2. Background 2006-08: IDEAS Network –Designed and pilot-tested an online course in interprofessional education for pre-licensure students in medicine, nursing, respiratory therapy, medical lab technology, medical radiation technology, and social work –Evaluation included responses to a day-long disaster simulation, showing improved readiness for interprofessional collaboration and self reports of improved competency in disaster management –Follow-up discussion included recommendations to consider similar program for in-service professional development

3. Background (continued) 2008-10: IDEAS@WORK –Collaboration with 5 partner health facilities [2 academic hospitals, 2 community hospitals, 1 rehab/chronic care hospital] in Greater Toronto –Each partner to provide 20 study participants in a minimum of 3 disciplines to complete 6 hour on-line course in interprofessional education, using Disaster Management concepts. –Additional learning activities included a face to face table top session to teach triage/patient distribution across a health care system and involving intra- and inter-organizational communication; one of the 5 sites also tested a multi-player internet e-simulation or ‘game’ for triage/patient distribution. Both of these activities were based on a mass casualty scenario.

4. Method Needs Assessment April, 2009, assessed –Readiness at each site for online learning –Experience in emergency preparedness –Local technical issues Course Design May to November, 2009 –3 Units with estimated work time of 2 hours each –Focus on strategies to increase surge capacity –Facilitated by local experts from each site Evaluation Plan April to December, 2009 –Ethics approval at Centennial and each participating site –Self reports on pre and post course surge and interprofessional care capacity, post- course satisfaction for online course and associated activities, using previously validated tools –Key informant interviews with administrators at each site

5. Method (continued) Usability testing, November 2009 –One volunteer at each site reviewed overview and first 2 online units –Amendments to simplify access Course and learning activity delivery, January to May, 2010 –Participants recruited with invitation to complete online course over 6 weeks (January to March 31, 2010) –Table top sessions scheduled at convenience of sites 2 to 4 weeks after completion of online course –E-Simulation scheduled at one site same day as Table Top exercise Post-Activity Administrator Telephone Interviews, May, 2010 –2 Leaders at each participating site canvassed on impacts of learning experience and lessons for future programming

6. Project Objectives To assess the validity of curriculum for selected health professions for the three delivery options; To measure participant outcomes in disaster management competency and IP practice; To measure participant satisfaction with the course and its delivery and make recommendations for best practices in IP workplace education; To make recommendations for program sustainability.

7. Learning Objectives Describe elements of surge capacity State the importance, relevance and urgency of planning for surge capability Understand the roles and relationship of various sectors within government, health and private sectors in managing surge capacity Understand hazard identification and prioritize risk assessment for their particular institution Review their institution’s Code Orange and analyze their institution’s preparedness

8. Learning Objectives (continued) Understand Incident Management Systems and how it is relevant in Code Orange conditions Contribute to an institutional Code Orange Plan through development of individual departmental, service or unit plans Be able to develop and prepare situational awareness reports (SitRep)

9. Learning Objectives (continued) Apply surge capacity theory and system knowledge to three types of conditions (mass casualty, pandemic and aging population) Participate in a collaborative team-based learning environment

10. Results Demographic Survey –72 participants at 5 sites completed all survey tools 63 women, 9 men, age 25-61 51% clinicians, majority nurses 49% risk managers, educators, infection control and security personnel 21% new to online learning 28% formal IP learning, remainder some informal IP learning Pre and Post Course Competency –Average Pre-Course Competency 28/70 or 40% (SD 10.3) –Average Post-Course Competency 42.5/70 or 61% (SD 10.9) Significant at p=.0001

11. Results (continued) Online Course Satisfaction Survey –Mean score 57.2/75 or 76.2% (SD 8.1) Highest scored items related to knowledge about surge capacity management and course design Lowest scored items related to embedded video, length of time to complete modules and online discussions Considerable variation in satisfaction at the 5 sites (one site less ‘geared’ to need and concept of surge capacity) Table Top Survey –Mean score 48.1/55 or 87.4% (SD 5.3) 49 participants at 4 sites; all individual items received a mean score of 4 or more [out of 5]

12. Results (continued) E-Simulation Survey –Mean score 55.2/70 or 79% (SD 7.8) 14 participants at 1 site; lowest means scores on communication during the e-simulation Summary of Results –Increased self-reported competency in surge capacity at all sites [p>.01 ] –Modest gains in interprofessional skills at all sites [p>.01 ] –Table top and E-Simulation activities important in consolidating and practicing the skills learned in the online course

13. Conclusion There is value in incorporating some elements of this program in staff orientation to a broad range of staff There is value in seeking continuing medical education credit for the program with and without the associated learning activities Table-top created a realistic sense of urgency and was a very effective way to learn about surge capacity strategies, build IP skills and organizational capacity for surge situations E-Sim, tested for the first time in this study, provided an intense, realistic surge situation and opportunity for learners to apply lessons of online course component, but needs improved communication mechanism for online’ teams’

14. Conclusion (continued) Staff must work effectively in teams for emergency and disaster preparation. However it is difficult and expensive to bring interdisciplinary and intersectoral groups together. –This study demonstrates that online learning, especially when combined with a short table-top exercise can be a convenient, effective way to support both surge capacity and IP competency development. –There is increasing recognition that blended approaches to learning are highly effective when situated within well-planned student-centred course design –Important next research step is to determine best mix of online and face-to-face learning for clinicians and administrators

15. Contact us Project Lead –Sandra Murphy, RN, PhD, Dean, School of Community and Health Studies Evaluation Team –Janet Maher, PhD, Senior Research Officer, Applied Research and Innovation Centre –Lynda Atack, RN, PhD, Professor, School of Community and Health Studies –Trish Dryden, RMT, MEd, Associate Vice President, Corporate Planning and Research –Patrick Gignac, PhD, Associate Professor, School of Community and Health Studies –Marie Rocchi, BSc Pharm, M DEd, Faculty of Pharmacy, University of Toronto Contact: janet.maher@utoronto.ca