Moving toward the Development of Interprofessional E-Cases

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Moving toward the Development of
Interprofessional E-Cases
N. Posel, S. Faremo D. Fleiszer
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• Good things, when short, are twice as good. 
• Baltasar Gracian, The Art of Worldly Wisdom

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Presentation Overview

• Interprofessionalism in healthcare
• Relevant learning theories and the development of
  interprofessional e-cases
• Design features of the e-case model currently in
  development at McGill university
• The process of utilization

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Interprofessional Practice
The healthcare system is in need of
reform...improvements will come when health care
providers work more effectively in teams and when
they have the competencies to practice in
increasingly accountable and technological
environments. (Stephenson, 2002)
Interprofessionalism in Healthcare
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Sometimes.
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Gaps and Overlaps

• Gaps
• Can impact on safety and quality of care
• Overlaps or redundancies
• Can impact on access, efficient use of resources
  and consistencies among professionals

Interprofessionalism in Healthcare
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Interprofessional Practice
Health professionals must work interdependently
in carrying out their roles and
responsibilities.with an appreciation of each
professions unique contributions to health care.
(ONeil and the Pew Health Professions
Commission, 1998)
Interprofessionalism in Healthcare
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Professionalism in the Current Clinical Setting

• Uni - professional socialization has already
  occurred
• Competencies and expertise are defined and in
  use
• Professional boundaries have generally been
  determined and refined

Interprofessionalism in Healthcare
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Interprofessionalism in the Clinical Setting
Attitudes Perceptions Building Trust and
Respect
Knowledge Transfer Sharing
Skills Areas of Expertise Redefining
Boundaries
Interprofessionalism in Healthcare
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Interprofessionalism in the Clinical Setting

• Practitioners, learners, patients, their
  families the environment

• Develop common, complementary and collaborative
  competencies

Interprofessionalism in Healthcare
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Theoretical Framework

• Adult learning
• Autonomous, active and self-directed
• Motivated by the relevant and the practical

• 2. Professional socialization
• Domain specific knowledge
• Reflective practice
• Zones of proximal development

Learning Theories
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Theoretical Framework

• Communities of learning and practice
• Cooperative learning within a collaborative
  environment
• Situated and experiential learning

• 4. Cognitive Apprenticeship
• Knowledge transfer
• Modeling
• Coaching, scaffolding, fading and reflection

Learning Theories
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Interprofessional e-Cases

• Approximate actual situations in which
  interprofessional teams practice within a
  real-life, clinically meaningful environment
  (DEon. 2005)

• Be sufficiently complex that they cannot be done
  alone, thus reinforcing collaborative
  competencies (Steinert, 2005)

• Allow participants to move towards interdependent
  collaboration using the case scenario to accent
  teamwork, communication and enriched quality of
  patient and family care (Barr, 2005)

Learning Theories Design Features
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Design Features

• Flexibility
• The case scenario allows the team determine who
  leads each case and which professionals are
  included
• Virtual but real environment
• Realistic and meaningful environment
• Multimedia (including audio and video)
• Hyperlinks, prompts and access to teaching
  modules
• Ability to archive, reuse and repurpose
• Teaching Learning
• Access to expert summaries and rationales

e-Case Model in Development at McGill
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Design Features

• Initial uniprofessional approach
• Highlight existing attitudes and perceptions
• Reinforces unique professional knowledge
• Permits sequencing
• Integration of individual care plans into an
  interprofessional care plan or blueprint
• Highlights group dynamic
• Synthesis
• Identification of gaps and overlaps

e-Case Model in Development at McGill
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The Process for e-Case Development Clinical
Setting
2. Group Discussion Formalization of the initial
interprofessional group, (professions and case
leader) Interprofessional meeting(s) to review
uniprofessional care plans Inclusion of the
patients voice Assignment of roles and
responsibilities Input of uni-professional plans
into the computer model for the e-case
Blueprint

• 4. Summary Evaluation
• Evaluation of patient and professional progress
• Treatment, post treatment, discharge planning and
  follow-up
• Outcome measurement efficacy review
• Plan archived for patient and student education

1. Presentation of Clinical Scenario
Presentation of e-case Group discussion about
the professions and case leader(s) required for
the specific case scenario with associated
rationales Review of professional perceptions,
attitudes and beliefs specific to the case
scenario Initial uni-professional assessment,
determination of action items, rationales,
timeframes sequencing
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The Process for e-Case Development Academic
Setting
3. Evaluation Students access, review
compare a. The uniprofessional expert care
plan and rationales with their own b. The
interprofessional expert care plans and
rationales with their own
2. Roundtable Students participate in an
interprofessional group to review the case. For
each group a) A case leader(s) is chosen b)
Uniprofessional care plans rationales are
reviewed integrated into interprofessional care
plan c) The e-case generates an
interprofessional blueprint
1. Presentation of the Case to the Learners Small
uni-professional student groups study the e-case
scenario Each group develops a uniprofessional
care plan
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Presentation of the Clinical Scenario
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Development of Uni-professional Care Plan
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An Example of Uni-professional Care Plan
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e-Case Blueprint
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Moving toward the Development of
Interprofessional E-Cases
Nancy Posel Nancy.posel_at_mcgill.ca