DEVELOPMENT OF IPL IN CANCER CARE WITHIN LEICESTERSHIRE

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DEVELOPMENT OF IPL IN CANCER CARE WITHIN
LEICESTERSHIRE
Forging Partnerships in Interprofessional
Education Tuesday 8th November 2005 Holywell
Park Loughborough

• ANNIE LAW
• PRACTITIONER/LECTURER

CONTACT DETAILS EMAIL annie.law_at_uhl-tr.nhs.uk or
PLaw_at_dmu.ac.uk
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What I plan to share with you

• Background to why we needed Cancer Care education
  in Leicestershire
• How we developed the programme
• Evaluations so far
• IPE or not?
• Developments in current provision
• IPE in post-reg Cancer education
• IPE in pre-reg/undergraduate education
• Role of Practitioner/Lecturer in IPE

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BACKGROUND PRE 2002
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ISSUES AND CONCERNS OF CANCER EDUCATION PRE 2002
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INFLUENCES?

• Dissatisfaction with current provision
• Increasing numbers of requests for learning
  opportunities within the Oncology Unit from staff
  working in other parts of the trust wishing to
  find out what happened to patients before or
  after surgery
• Enthusiastic colleagues to develop a cancer care
  module
• Political Dissolution of ENB, Cancer Plan,
  Nursing contribution to Cancer Care, National
  Cancer Standards

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THE BIG IDEA?

• Multiprofessional steering group
• Focus on Breast Cancer
• Seek accreditation from HEI
• Aim to commence Sept 2001

Great idea huh?
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WHAT WENT WELL?

• Everyone enthusiastic about developing module
• Learnt a lot from each other about different
  aspects of the patient journey
• Forged links across the Cancer Centre
• Valuable learning experience in curriculum
  development, accreditation process, and working
  collaboratively

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LESSONS LEARNT

• Realised early on that there would be
  insufficient numbers to focus on Breast Cancer
  and that we would then have to develop modules
  for every tumour site
• Underestimated the time scale to develop module
• Difficulties in process of HEI involvement (pre
  WDC maturity)

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NEXT STEPS

• Expanded group membership to include specialists
  from other tumour sites, other AHPs and community
  representation
• HEI link was made
• Planned module content and assessments
• Submitted module templates to HEI
• Developed relevant documentation e.g. student
  handbook etc
• Marketed module

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DATA SO FAR

• Programme has run 3 times 2002, 2003 2004
• 2005 programme currently in progress
• Number of students 46 Average 12 per year
• Professionals who have accessed the programme
• OT
• Physio
• Dietitians
• CNSs tumour site specific Palliative Care
• Haematology/Oncology nurses
• Community nurses
• Other nurses (Surgical, Medical, Patient info,
  private sector)

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EVALUATION COMMENTS

• An excellent highly enjoyable module
• Relevant interesting programme
• Excellent course with excellent speakers from a
  wide spectrum of specialities
• Clinical expertise of speakers an advantage

Group size was good allowed for peer support
group synergy. Good for networking too
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EVALUATION COMMENTS

• Good to share learning with other professions as
  we learnt more about each others contribution to
  patient care
• Tutorial support extremely valuable very
  supportive
• Clinical placements an essential part giving
  insight into all aspects of the patients cancer
  journey
• Being able to choose placements relevant to own
  needs was especially useful

Constructive comments on future content were also
given
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SO IS THIS IPE?

• If this is IPE
• Occasions when 2 or more professionals learn
  with, from about one another to facilitate
  collaboration in practice
• (CAIPE 1997)

Then no it is not IPE in the true spirit!
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SO WHAT IS IT?
Multi-professional education?

• Shared learning activities among 3 or more
  professional groups

Probably but a step towards IPE
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(No Transcript)
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DEVELOPING IPE IN POST-REG PROGRAMME

• Problem/enquiry-based learning
• Aim
• To enable learners to interact work
  cooperatively as an interprofessional team in
  order to achieve both subject-based learning
  outcomes teamwork skills to develop a
  collaborative approach to care

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Problem/enquiry-based learning example

• Scenario
• Patient with spinal cord compression (SCC) due to
  spinal metastases.
• Initial taught session on the physiology and
  impact of SCC on the patient

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Problem/enquiry-based learning example contd

• In small multi-professional groups, learners meet
  a patient/carer
• Actual patient/carer
• Videoed patient/carer
• Simulated patient/carer
• Written scenario

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Problem/enquiry-based learning example contd

• Listen to the patient/carers story
• Consider the different professionals who were
  involved
• Discuss how the care was coordinated
• Identify who made (or did not make) it work
• Discuss what would have made the care provided
  better for the patient/carer other HCPs

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Problem/enquiry-based learning example contd

• Learners then interview members of MDT
• Identify role played in care support of patient
  with cancer
• If had not been involved in the care consider
  whether their involvement could have been
  beneficial in any way
• Discuss how each professional interacts with
  others in the team
• Focus on how inter-professional team working
  issues affect patients and carers experiences
• Explore with professional groups any issues
  raised by the patient to identify how interaction
  may be done differently next time

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Problem/enquiry-based learning example contd

• Learners finally present their findings to the
  rest of the group and analyse their findings
  against national guidelines IOG Cancer
  standards

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ACTIVITY 2

• Each learner attends a tumour site specific MDT
  meeting to observe interprofessional working in
  action in their natural setting.

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• Learner is expected to
• Identify the purpose of the group
• Identify the members of the group
• Observe and reflect on the contribution each
  member plays and the team dynamics
• Reflect on how effective the MDT were in
  collaborative working
• Understand the processes to communicate the
  decision to the patient
• Define the patients role in the MDT
• Make the connection between this MDT and the MDT
  who develop and deliver the plan of care
• Compare national standards against observations

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POST-REG CANCER EDUCATION IS A COMBINATION OF
DIFFERENT MODELS OF LEARNING
IPL Mix of disciplines in a learning group as
a source of learning about interprofessional
practice
Shadowing One professional experiences the
work of another first hand

• Common learning
• Students study
• topics of common
• interest in mixed
• groups or single
• disciplinary groups

With the aim to improve the care of people with
cancer by facilitating health professionals
understanding of the lived experience of people
with cancer the contribution of each
professional group to this experience
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POST-REG CANCER EDUCATION IN LEICESTERSHIRE

• PRE 2002
• ENB 931 composed of 3 Palliative Care modules

• 2005
• Principles of Palliative Care
• Symptom Control in Palliative Care
• Helping strategies in Loss
• Bereavement
• Prevention detection of cancer
• Caring for the patient with cancer
• Caring for the patient receiving
• chemotherapy

• FUTURE
• Communicating with patients
• Caring for the patient with a Haematological
  malignancy
• Caring for the patient receiving bone marrow
  transplant

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IPE FOR PRE-REG LEARNERS IN CANCER PALLIATIVE
CARE

• Partnership between Practice HEI
• Cannot be led by education alone run the risk
  of preparing students for a practice that might
  never exist.

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IPE FOR PRE-REG LEARNERS IN CANCER PALLIATIVE
CARE

• Clinical practice ideal place for IPL where
  learners
• Deal with real life circumstances real patients
• Observe the contribution of the different MDT
  members
• Learn to work with other professional groups
• Develop knowledge skills to take on others
  roles as appropriate
• Have the opportunity to practice develop
  interpersonal, group team working skills
• Are exposed to role models of inter-professional
  working

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PLANNING IPE IN PRE-REG LEARNERS

• Met with Liz Anderson
• Presentation to directorate MDT education group
• Currently meeting with individuals to identify
  potential IPL champions across LNR Cancer
  network

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PLANNING IPE IN PRE-REG LEARNERS

• Away day in March 2006 to identify potential IPL
  opportunities in practice and learn from others
  who have implemented IPL in cancer Palliative
  Care
• Develop implement IPL opportunities
• Evaluate effectiveness of IPL in Cancer
  Palliative Care

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ROLE OF PRACTITIONER/LECTURER IN IPE

• Partnership between NHS university
• Learners taught by those with practical recent
  experience of nursing practice
• Combine patient care teaching
• Aware of real issues affecting MDT in practice

Core role
Theory
Practice
Link
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SUMMARY

• Belief in multi-professional shared learning was
  a key influencing factor in the development of
  Cancer Care education programmes in Leics.
• The natural progression of this is to implement
  IPL activities within the current programme

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SUMMARY

• IPL for pre-reg learners is currently being
  explored in clinical placements in cancer
  Palliative Care.
• To ensure its success we will need
• Commitment enthusiasm from the MDT
• Involvement of users to plan, deliver evaluate
  IPL activities
• Close sustained partnership between HEIs the
  NHS supervisors from a range of professional
  groups

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• An exciting stimulating time ahead

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