Solutions for taking forward interprofessional learning

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Solutions for taking forward interprofessional
learning
CUILU one ending is another beginning

• The Combined Universities Interprofessional
  Learning Unit Sheffield Hallam University and
  University of Sheffield

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• Joint initiative between Sheffield Hallam
  University and The University of Sheffield
• Funded by the Department of Health and the South
  Yorkshire Workforce Development Confederation
• One of four national leading edge pilot sites for
  Interprofessional Learning.

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Aim of project plan
To consider a strategic approach to the embedding
of interprofessional learning in the
pre-qualifying preparation of health and social
care professionals
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CUILU
Major Activities
Interprofessional Teaching Approaches
Interprofessional Capability
Patient Participation in Education
Supporting Students Interprofessional Mentorship
The Interprofessional Learning Environment (identi
fication and quality enhancement)
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The Beacon Sites
  Barnsley District General Hospital NHS Trust
(Childrens services)    Doncaster and
Bassettlaw NHS Trust (Emergency and Critical Care
services)    South East Sheffield Primary Care
Trust    Sheffield Teaching Hospitals NHS
Foundation Trust Communicable Diseases
services   Rotherham General Hospital NHS Trust
Stroke Unit (Rockingham Ward)
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Quality Indicators for the learning environment

• Utopia meets pragmatism
• Patients are at the centre and are partners
• Culture is collaborative and sharing
• Students are welcomed and enabled to practise
• Practitioners work together for students
• Students learn together
• Students are helped to learn about different
  professional roles
• Success seems to depend on champions

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The Interprofessional Learning Practice Placement
Audit Tool

• Means of identifying and monitoring quality of
  IPL environments
• Developed in collaboration with Forging Ahead
  from initial work on nursing audit across both
  universities
• Exploration of interprofessional placements in
  non-traditional settings potential for
  placement expansion via interview study in four
  voluntary sector organisations

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Key points

• Voluntary sector provides a rich source of
  interprofessional learning experience
• The tool offers a process for the identification
  of potential placements
• Participants would welcome a formalised system of
  quality management of placement provision
• Improve communication between providers and
  education departments
• Further work required to explore potential for
  uni-professional focused placements

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• The articulation of interprofessional learning
  outcomes

• Employed strategies of grounded theory
  methodology
• Analysis of QAA benchmark statements medicine,
  dentistry, PAMs including nursing and social work
• Mapping tool developed with four key domains
• Generation of domains of interprofessional
  working, learning outcomes and capabilities the
  Interprofessional Capability Framework
• Validated in phase 2 with lay participants,
  students and practitioners

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• A competency describes what individuals know or
  are able to do in terms of knowledge, skills
  attitudes
•  A capability describes the extent to which an
  individual can apply, adapt, synthesise new
  knowledge from experience and continue to improve
  their performance.

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Interprofessional Capability Framework
Potential for all qualifiers to be developed and
assessed as capable inter -professional workers
Interprofessional skills expected of all
undergraduates of health and social care 16
Capabilities and 3 staged learning levels derived
from QAA benchmarks Mapped to NMC, GMC, KSK etc
Ethical Practice Knowledge for
Practice Interprofessional Working Reflection
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Teaching and Learning Processes IPL seminars

• Devised collaboratively and included
• Simulation
• Patient stories
• Scenarios
• Learning tasks
• Reflective discussions
• Lay participant assessment of student performance
• Evaluation

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An Emerging Pedagogy

• The centrality of the patient/service user
• Making it real
• Facilitate student reflection
• Promote interprofessional capability as an
  outcome
• Take a team approach
• Make the learning active - be bold and
  adventurous
• See mistakes as both understandable and
  opportunities for learning

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CUILU
Public Patient Involvement in Interprofessional
Learning
NHSU will approach learning from the
perspective of the patient and of healthcare
improvement, rather than that of providers. Our
vision for NHSU puts the need of patients and
their carers at the very centre of the learning
that will underpin the provision of high quality
care. Learning for Everyone- development plan
for the NHSU (2002)
The move toward interprofessional learning and
patient partnership is reflected in current
education programmes UKCC (2000) and DoH
(2002)
Service users were the most commonly and
enthusiastically cited source of learning content
for collaborative practice. Learning for
Collaborative Practice with other professions and
agencies Research Report for the Development of
Degree in Social Work. Whittingdon (2003)
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Phase 1 Interviews

• Student and patient concerns

• Patient not always well enough to be involved
• Reliving the story can be traumatic
• Feeling vulnerable in sharing the story or being
  perceived as complaining
• Students worried about overburdening the patient
• The knowledgeable patient can feel threatening to
  students

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Good Practice Guidelines

• Collaboration
• Preparation
• Support
• Communication
• Debrief

• CHECKLIST
• Consider time and resources
• Information pack
• Risk Assessment
• Accessibility and hospitality
• Training and support
• Preparation of students
• Clear learning outcomes
• Debrief for students and participants
• Pay, expenses and reimbursement

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Check List

• Time and resources for working relationships, and
  developing collaboration
• Information pack
• Risk Assessment,Health Safety
• Accessibility and hospitality
• Training and support
• Preparation of students
• Clear learning outcomes
• Debrief for students and participants
• Pay, expenses and reimbursement

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Testing the Guidelines

• Stroke unit identified as beacon site of
  interprofessional learning
• The Rotherham Stroke and Disability Support Group
  volunteered to be involved in the project
• Guidelines were used to prepare volunteers for 3
  Teaching sessions
• 1. How to set goals with patient using case study
• 2. Develop a philosophy of collaborative working
• 3. Write an evaluation form for patients and
  carers to use about the care they received from
  hospital

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Interprofessional Patient Assessment Tool

• Devised as a peer review assessment tool
• for medical practitioners
• 11 item likert scaledid students work in
  collaboration
• with patient? etc
• Provided framework for engagement emotional
• process, stepping on toes, providing what was
  needed

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Hard to Reach Hard to Engage the use of
simulation

• Joe (child mannequin) - students able to practise
  working through care pathway talking to mum and
  each other and learning to cooperate together
• Doug (adult mannequin) critically ill with
  meningitisstudents learnt to work as
  interprofessional team in providing care
• Lisa (actor playing role of drug user) students
  able to rehearse communication skills in a safe
  environment
• (Mexborough Montague Hospital and Sheffield
  Hallam University Simulation
• Centres)

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Interprofessional Mentorship
Preparation of Mentors and Teachers and Exploring
Mentoring emphasise the importance of support for
student learning (ENB and DOH, 2001 BMA, 2004)
Meeting the Challenge A strategy for the Allied
Health Professionals states supervising
students is a key part of every professional
practitioners role (DOH, 200025)
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Definition of the Interprofessional Mentor
Occasions when a health or social care
professional facilitates interprofessional
learning and supervises and assesses students
within the practice setting. (CUILU, 2005)
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Interprofessional Mentorship
Same profession student
Uni-professional knowledge
supervising
facilitating
Interprofessional knowledge
Assessing
Capability Framework
Other profession student
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Interprofessional Mentorship key points

• Facilitation of interprofessional working is
  already happening
• A range of teaching processes are employed
• Interprofessional mentorship is happening but
  does not replace uni-professional mentorship
• Interprofessional knowledge is the focus
• Evaluation of interprofessional encounters takes
  place but the Interprofessional Capability
  Framework facilitates assessment of the
  encounters
• The culture and environment can impact on its
  breadth and scope
• Education and training must be addressed for
  interprofessional mentorship to become a reality

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Conclusions and Recommendations

• Beacon sites
• The Interprofessional Capability Framework
• Interprofessional mentorship
• Patient and service user involvement
• Placement expansion

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• Validation of Framework

• Provides a statement of student learning outcomes
• Draws attention to learning opportunities
• Service organisation can limit IPL
• Practice advancement
• Patient to the foreground
• Complexity tensions of skill level

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Strategic Embedding
Beacon Sites
Placement Expansion
Teaching Strategies
Capability Framework
Patient and service user involvement
Assessment
Education and training
Mentorship
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Delivering the modernisation agenda
Wanless 1 2 (February 2004) NHS Improvement
Plan (June 2004) National Standards Local Action
(July 2004) Choosing Health (2004)
Improved and more personalised care Holistic
health rather than sickness service Systematic
integration across agencies with local decision
making A changing workforce
Education of the workforce required to deliver
the agenda is interprofessional
The DoH has already funded joint programmes in
IPL these programmes will achieve national
coverage as we ensure that people learn together
so they better work together (The NHS Improvement
Plan 6.8)