Transcript Aberdeen Interprofessional Healthcare Education

Interprofessional Education in Aberdeen: The
use of undergraduate team working to
improve understanding of care of the elderly
M Gibson and L Diack
www.ipe.org.uk
Background
 Nearly 50 years since the government called for the
development of interprofessional education in the NHS†
 Since then there have been a number of short-term
initiatives developed
 Well developed and well organised but had short life
spans mainly due to:
 changes in the lead staff
 lack of funding and/or
 timetabling difficulties
†Zwarenstein et al. J. Interprofessional education: effects on professional practice and health
care outcomes (Cochrane Review). In: The Cochrane Library, Issue 4
Hammick M. (2000) Interprofessional education: evidence from the past to guide the future.
Medical Teacher; 22:461–7
• In recent years in England many of these issues have
been tackled with the help Department of Health funding
• Leading to initiatives such as the New Generation project
at Southampton and Portsmouth universities
• Until recently in Scotland there has been little in the way
of development or funding for interprofessional
education in health and social care
• It is now acknowledged that multidisciplinary working in
the NHS is necessary to ensure the best quality of care
for patients
• There is well documented evidence of the benefits of
different
health
professionals
working
together†
• To ensure the best possible care for a patient close
liaison is needed between all health and social care
professionals involved in that patient’s care
• Good communication between hospital-based staff and
the primary care team is essential
†Davies C. Getting health professionals to work together [editorial]. BMJ 2000;
3220:1021-2.
Aims and objectives
• The aim of this initiative was to generate an appreciation
of interprofessional team working within the setting of
the NHS
• This was to be achieved using multidisciplinary
workshops within an undergraduate student population
 with a particular reference to interprofessional
communication in the treatment of an elderly patient
• The primary care team responsible for the welfare of a
patient can include a wide range of different
professionals including:
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nurses
health visitors
midwives
pharmacists
social workers
general practitioners
physiotherapists
occupational therapists
dieticians
clinical psychologists
Workshops
In each workshop, groups of up to 10 first year students
from all health and social care courses in Aberdeen:
 Nursing
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Medicine
Occupational Therapy
Pharmacy
Physiotherapy
Diagnostic Radiography
Dietetics
Social Work
took part in tutorials to explore the different roles of their
future professions based on a case study of an elderly
patient
Case study
Students given the following information:
• An 80 year old woman living alone, fell on Saturday afternoon
while leaving the local village post office. The postmistress
dialled 999 and the patient was admitted to hospital. The
patient was diagnosed to have sustained a hip fracture, had
this fixed surgically and was fit to be discharged in 10 days
time
• Students “brainstormed” the health and social care needs
of patient
•
What health and social work professionals would be most suited
to providing each aspect of the care?
•
How might overlaps be resolved?
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Principles of group working
• Groups mixed on the basis of students’ disciplines
• As many professions represented in any one group as
was logistically achievable
• Tutors also drawn from across the range of courses
involved in this initiative
• Session emphasised small group learning
• Interactive
• Tutor took on the role of facilitator
• Students brainstormed ideas, made notes on suggestions
and provided their views on the content and process of
the session
By the end of the workshop it was expected that students
should be able to:
1. Describe the likely range of health and social care
needs of the patients in one or two case studies
2. Discuss the contribution of different health and social
work professions to meeting the care needs of these
patients
3. Identify overlaps in care provision and discuss how
these might be resolved
4. Work productively and responsibly as part of a multidisciplinary group
5. Recognize the importance of: mutual respect,
recognition of the contribution and skills of other
professionals, and good communication, in multidisciplinary working
Feedback
• Feedback from both
extremely positive
students
and
facilitators
was
• Data from a subsequent RIPLS-based† shared learning
questionnaire demonstrated overwhelming support for
the initiative and a strong desire to have more
interprofessional
content
across
the
entire
undergraduate healthcare curriculum
† Parsell G, Bligh J (1999) The development of a questionnaire to assess the readiness of
health care students for inter-professional learning (RIPLS) Medical Education 32 (2): 95-100
Students’ Comments
Helped to improve
(our) communication
skills and increase
confidence
Communication
between diverse
professionals;
very important
within hospital
and community
Highlighted the need for
communication and mutual
respect
COMMUNICATION
Awareness of
integration/overlap of
professions and how
communication is
paramount
We now have a
respect for the
amount of
communication
needed
Good to work as part
of a team rather than
on our own
Good to meet others
from different
university
It provided an
opportunity to
increase our
views of other
professional
roles
Interesting to meet other
healthcare students and build up
experience of teamwork and
confidence within a group
TEAM WORK
We feel
that things
like this
should
happen
more often
Realised the importance
of respect between
people in a team
We got an insight into
other HPs’ roles and
learned how they link
together in a real life
situation
It was hard to
answer
questions as we
haven’t been on
placement
May have been slightly more productive when
everyone was further into their courses and
knew more about their own identities. So
hopefully there will be a programme in the
future to build on what we have learned today
SUGGESTIONS
Such session should
perhaps be repeated
with the same groups
after placements to find
out how experiences and
views have changed
We think we would
benefit from it being a
regular occurrence
Logistical Issues and Future Work
• The major issues that arose from the organisation of these
workshops were the huge logistical problems of moving large
numbers of students to different locations and difficulties of
timetabling these sessions into the curriculum
• Sessions have been running for 3 years now so this is less of
an issue but is still a consideration for any new
interprofessional initiatives
• To help overcome these logistical difficulties and to allow for
further extension of the interprofessional initiative a decision
was made to develop and pilot an online course in early 2004
• It is aimed to evaluate and embed this course from Spring
2006
Changing attitudes
• Provisional data from a “RIPLS-based” questionnaire completed
by medical and pharmacy students (with no previous exposure
to interprofessional teaching) indicate a changing attitude
between first and final years of courses:
 Fewer final year students demonstrating willingness to learn with
other healthcare professions (compared with first year students,
P<0.05)
 Fewer final year students agreeing that learning with other
healthcare professions is beneficial for patient care (compared
with first year, P<0.05)
• These findings demonstrate the importance of a continuous
interprofessional education programme throughout all phases of
the courses to address the above concerns
Conclusions
• The findings of this initiative demonstrate the benefits of
working together in an undergraduate multidisciplinary
healthcare team to improve communication and
understanding of interprofessional working in a
healthcare environment
• It is hoped that this initiative for first year
undergraduates will provide the foundation for a strong
and growing interprofessional healthcare programme in
Aberdeen
Acknowledgements
Scottish Executive Health Department
for providing the funding for the current ongoing project
The staff at the School of Medicine (University of Aberdeen)
and Faculty of Health and Social Care (The Robert Gordon
University) for their assistance and cooperation, without which
the initiative would not be possible