1. Interprofessional Education: Facilitation and Conflict Management

2. Goals of IPE Session for Student Trainees Recognize one another’s roles in healthcare Learn team-building and collaborative roles in the context of a patient case Identify characteristics of functional teams Review strategies for team-building and conflict resolution

3. Outline of Student Session

4. IPE Faculty Roles Recognize one another’s professional roles Collaborate to achieve trainee learning objectives Facilitate small group (team-based) case discussion and decision-making Give feedback to your teams Summarize and reflect on learning

5. Today’s Learning Objectives By the end of session, you will: Recognize one another’s professional roles Identify characteristics of functional teams Identify characteristics of effective IPE facilitation Roleplay facilitation of role recognition among learners

6. Learning Objective 1: Identify characteristics of effective IPE facilitation As you watch this video, identify the characteristics of effective and ineffective IPE facilitation. What was done well in facilitation? What could be improved, and how? What are consequences of poor facilitation? Consider how you might improve your own IPE facilitation style.

7. Facilitator Roles Directing/Forming: set climate, clarify roles and goals, build group identity Coaching/Storming: legitimize concerns, invite feedback, accept and expect tension Norming/Performing: offer resource, share leadership, consult and coach (1 on 1) Delegating/Separating: adjust style, let go, anticipate termination

8. Role Recognition

9. Learning Objective 2: Facilitate role recognition among learners Watch the video and… Consider what would you do as a facilitator

10. Pitfalls in Facilitating Role Recognition Usual Facilitation IPE Facilitation Pitfall Solution/Remedy/ Prevention

11. Role Recognition Sets climate for team work Gives equal voice to every team member Corrects misperceptions or assumptions Opens learning conversation for cross- fertilization Establishes common vocabulary for learning Anticipates future conflicts

12. Team Dynamics and Conflict Consider power dynamics and hierarchy Were ground rules established? Is diversity strength or hindrance? What are underlying assumptions? (gender, status, seniority, age, education) What is antecedent for decision-making?

13. Managing Potential Conflict Proactive Observe team behavior Use tools (e.g., MBTI) Establish trust early (e.g., personal histories) Reactive Acknowledge potential conflict Facilitate problem-solving: respect, support, process Team effectiveness exercise Member strength/weakness exercise 1. Zwarenstein M, et al. Cochrane Database Syst Rev. 2009;(3):CD000072. 2. Reeves S, et al. Cochrane Database Syst Rev. 2008;(1):CD002213.

14. Learning Objective 3: Dynamics and Processes Watch the video and observe: What team dysfunctions are apparent? What escalated conflict? Which stakeholders were affected by the process? Where dysfunction could be addressed? How might you act as a facilitator for this team?

15. Dynamics and Processes What team dysfunctions are apparent? What escalated conflict? Which stakeholders were affected by the process? Where dysfunction could be addressed? What would you do if you were the facilitator for this team?

16. Dynamics and Processes *http://ipe.utoronto.ca/educators/competencies.html Inattention to Results Avoidance of Accountability Lack of Commitment Fear of Conflict Absence of Trust Status and Ego Low Standards Ambiguity Artificial Harmony Invulnerability

17. Address Conflict and Dynamics Build trust Understand motivation Personal stories of origin (autobiographies) 2. Establish ‘conflict culture’ (safety) Profile team and members (Thomas-Killman) Conflict norming 3. Manage meetings (‘Death by meeting’) Use ‘Lightning rounds’ Encourage voices

18. Address Conflict and Dynamics Get commitment Remove assumptions Get ‘buy in’ and ‘clarity’ Commitment ≠ Consensus Use cascading communication 5. Establish accountability Common thematic goals (‘patient outcome’) Peer to peer communication Facilitator leadership (strength/weakness exercise) Keep scoreboard (list milestone accomplishments)

19. Ask for Team Assessment ≈ Reflection How did we do today as a team? What enabled/supported our collaboration? Were team members heard and respected? If not, how can we improve? Did anything interfere with ability to contribute? What else might improve our interaction? REFLECT

20. Provide Your Feedback to IPE Team Feedback should Start with team self-assessment Be based on direct observation Be clearly stated and prefaced Be regular Be balanced Be specific Use ‘teach-back’ to ensure message is received

21. Faculty Exercise (Role Play) Break into groups of 6 to 8 Two will be faculty mentors, the rest will be trainees from the 3 professions (one scribe) Faculty: using the script, go through case with your trainees and facilitate case discussion using steps described After 10 to 15 minutes Scribe will list record strengths and weaknesses of the process Report findings to large group

22. Summary IPE involves: 1.Creation of IP teams 2.Facilitation 3.Role recognition 4.Conflict management 5.Building trust 6.Reflection