Andreas A. Theodorou M.D. Interim Co-Director, Interprofessional Education and Practice U of A Health Sciences Center Chief Medical Officer The University of Arizona Medical Center Professor and Associate Chair, Dept. of Pediatrics Chief, Pediatric Critical Care Medicine U of A College of Medicine
INTRODUCTION
Origin of Andy’s Error
Inadequate training
Poor medical team interaction
Inadequate supervision
Poor communication:
Attending to Resident
Poor patient outcome
Preventing Andy’s Error
Inadequate training
Good medical team interaction
(Pharmacist review of order)
Inadequate supervision
Poor communication:
Attending to Resident
Adverse Event Prevented!
March 27, 1977 Tenerife Island
Safety: System vs Technology
J. Brian Sexton found that
improvements in aviation
safety were due to improving
interpersonal skills
Over 70% of aviation accidents
occur due to flight crew
communication issues
Re-certification now involves
evaluation of interpersonal
skills!
“Crew Resource Management”
http://www.aviationteamwork.com/
The New Yorker: The Checklist December 10, 2007 Atul Gawande
Adverse event but minimized harm…
Purdue U Commencement Address Chesley Sullenberger, 2011
This constant pursuit of excellence isn't just about ego; it's not about individual achievements; it's about achieving the best result – and when you have a team that works well together, it provides the same satisfaction as when you're a member of a winning sports team. When everyone is doing their share in a collaborative way, it just feels right. I experienced this on January 15. My crew - First Officer Jeff Skiles and Flight Attendants Donna Dent, Sheila Dail and Doreen Welsh - and I never stopped working together to solve the challenges we faced.
We never gave up. We never lost faith in ourselves or each other. In a similar fashion, for each of you, no matter how dire a situation is, know that further action is almost always possible - and when you're part of a well-trained team, your chances of getting through a challenge or a crisis are immeasurably better than when you're not. When we are true to our ideas and work together, there is little we cannot accomplish.
History of IPEP
2001 2003 2000
To Err Is Human:
Building a Safer
Health System
To Err Is Human: Building a Safer
Health System (IOM, 2000)
The first of IOM “Quality” reports
“the burden of harm conveyed by the collective impact of all of our health care quality problems is staggering.”
44,000-98,000 people die each year from mistakes
It was a call to action!
INSTITUTE OF MEDICINE To Err is Human: Building a Safer Health System (2000)
“…it is not acceptable for patients to be harmed by the health care system that is supposed to offer healing and comfort…”
“Failure of Communication” listed under causes of errors
History of IPEP
2001 2003 2000
To Err Is Human:
Building a Safer
Health System
Crossing the Quality
Chasm: A New
Health System for
the 21st Century
INSTITUTE OF MEDICINE Crossing the Quality Chasm: A New Health System for the 21st Century March 2001
“Bringing state-of-the-art care to all Americans in every community will require a fundamental redesign of the entire health system…”
A NEW HEALTH SYSTEM…
Safe
Timely
Effective
Efficient
Equitable
Patient-Centered
INSTITUTE OF MEDICINE Crossing the Quality Chasm: A New Health System for the 21st Century March 2001
Redesign Imperatives:
Reengineered care processes
Effective use of information
Knowledge and skills management
DEVELOPMENT of EFFECTIVE TEAMS
COORDINATION OF CARE across patient-conditions, services sites of care over time
History of IPEP
2001 2003 2000
To Err Is Human:
Building a Safer
Health System
Crossing the Quality
Chasm: A New
Health System for
the 21st Century
Health Professions
Education: A Bridge
to Quality
INSTITUTE OF MEDICINE Health Professions Education: A Bridge to Quality (7/2003)
“Although the academic environments of the various health professions generally are not interdisciplinary, practice environments are increasingly so, posing a serious disconnect…”
“…collaboration among clinicians in practice settings draws upon each profession’s strength and therefore optimizes care for patients.”
INSTITUTE OF MEDICINE Health Professions Education: A Bridge to Quality (7/2003)
Five Core Competencies
Provide patient-centered care
Employ evidence-based practice
Apply quality improvement
Utilize informatics
Work in Interdisciplinary Teams -cooperate, collaborate, communicate, and integrate care teams to ensure that care is continuous and reliable.
INSTITUTE OF MEDICINE Health Professions Education: A Bridge to Quality (7/2003)
A New Vision for Health Professions Education
All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.
Literature support for IPE Increasing
Tworeviewersindependentlyassessed theeligibilityof potentially relevant studies, andextracteddatafrom, andassessedstudyqualityof,
included studies. A meta-analysisof study outcomeswasnot possiblegiven thesmall number of included studiesand theheterogeneity
in methodological designsand outcomemeasures. Consequently, theresultsarepresented in anarrativeformat.
Main results
Weincluded six studies(four RCTsand two CBA studies). Four of thesestudiesindicated that IPE produced positiveoutcomesin the
following areas: emergency department culture and patient satisfaction; collaborative team behaviour and reduction of clinical error
rates for emergency department teams; management of care delivered to domestic violence victims; and mental health practitioner
competenciesrelated to thedelivery of patient care. In addition, two of thesix studiesreported mixed outcomes(positiveand neutral)
and two studiesreported that theIPE interventionshad no impact on either professional practiceor patient care.
Authors’ conclusions
This updated review found six studies that met the inclusion criteria, in contrast to our first review that found no eligible studies.
Although thesestudiesreported somepositiveoutcomes, due to thesmall number of studies, theheterogeneity of interventions, and
themethodological limitations, it isnot possible to draw generalisable inferencesabout thekey elementsof IPE and itseffectiveness.
MorerigorousIPE studies(i.e. thoseemployingRCTs, CBA or ITSdesignswith rigorousrandomisation procedures, better allocation
concealment, larger samplesizes, and moreappropriatecontrol groups) areneeded to providebetter evidenceof theimpact of IPE on
professional practiceand healthcareoutcomes. Thesestudiesshould also includedatacollection strategiesthat provideinsight intohow
IPE affectschangesin health careprocessesand patient outcomes.
P L A I N L A N G U A G E S U M M A R Y
Training health and social careprofessionalsto work together effectively
Health and social careprofessionals, such asdoctors, nurses, physiotherapistsand social workers, need to work together effectively to
takecareof patientseffectively. Unfortunately, professionalsmay not alwayswork well together. Training and educational programmes
havebeen developed asapossibleway to improvehow professionalswork together to takecareof patients. Interprofessional education
(IPE) is any type of educational, training, teaching or learning session in which two or more health and social care professions are
learning interactively.
This review found six studies that evaluated the effects of IPE. Four of these studies found that IPE improved some ways in how
professionalsworked together and thecare they provided. It improved theworking culture in an emergency department and patient
satisfaction; decreasederrorsin an emergencydepartment; improved themanagement of thecaredelivered todomesticviolencevictims;
and improved theknowledge and skillsof professionalsproviding care to mental health patients. But two of those four studies also
found that IPE had littleto no effect on other areas. Two other studiesfound that IPE had littleto no effect at all.
Thestudiesevaluated different typesof IPE and werenot of high quality. It is, therefore, difficult to becertain about theeffect of IPE
and to understand thekey featuresof IPE to train health and social careprofessionalsto work together effectively.
B A C K G R O U N D
Thisisan updatetoapreviousCochraneIPEreview (Zwarenstein
2000) which found no studies that met the inclusion criteria.
Since the publication of that review, interest in IPE as a means
to cultivatecollaborativepracticeand enhancecarehascontinued
to grow amongst policy makers, educators, and researchers(Barr
2002; DoH 2001; Health Canada2003; McKeown 2005).
Thecontinued interest in IPEisunsurprising, given theincreasing
complexityof theorganisation and deliveryof healthcare. Anum-
ber of factors, such asan ageing population and the shift of the
burden of illnessfrom acuteto chronic care, requireanumber of
different healthandsocial careprofessionstobeinvolvedin thede-
liveryof care. Asaresult, theneed for good interprofessional com-
munication and collaboration to help coordinate patient care in
an effectivemanner iscritical. Despitethisneed, research indicates
that such communication and collaboration can beproblematic.
For example, studies have shown that effective interprofessional
collaboration can be undermined by boundary infringements, a
2Interprofessional education: effects on professional practice and health care outcomes (Review)
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Literature support for IPE Increasing
“Instructional reforms should :adopt competency-driven approaches to instructional design”
“…promote interprofessional and transprofessional education that breaks down professional silos while enhancing collaborative and non-hierarchical relationships in effective teams”
History of IPEP
Since the IOM reports there have been numerous organizations and funding agencies that have joined the IPE campaign
- IHI
- Hartford Foundation
- Robert Wood Johnson Foundation
- Josiah Macy Jr. Foundation
- WHO –Framework for Action on IPE
- Canadian Interprofessional Health Collaborative
- American Interprofessional Collaborative
- International Partners in Action
CORE COMPETENCIES
IPEC’s Charge to Expert Panel
“…recommend a common core
set of competencies relevant
across the professions to address
the essential preparation of
clinicians for interprofessional
collaborative practice.”
Interprofessional Education Collaborative Expert Panel (IPEC).
(May 2011). Core competencies for interprofessional
collaborative practice: Report of an expert panel.
IPEC Sponsors:
American Association of Colleges of Nursing
American Association of Colleges of Osteopathic Medicine
American Association of Colleges of Pharmacy
American Dental Education Association
Association of American Medical Colleges
Association of Schools of Public Health
IPEC’s Charge to Expert Panel
Susan Mackintosh, DO, MPH Western University of Health Science, College of
Osteopathic Medicine of the Pacific
Thomas A. Cavalieri, D.O., Dean, Endowed
Chair for Primary Care Research, University
of Medicine and Dentistry of New Jersey, School of
Osteopathic Medicine
Interprofessional Education Collaborative Expert Panel (IPEC).
(May 2011). Core competencies for interprofessional
collaborative practice: Report of an expert panel.
IPEC Sponsors:
American Association of Colleges of Nursing
American Association of Colleges of Osteopathic Medicine
American Association of Colleges of Pharmacy
American Dental Education Association
Association of American Medical Colleges
Association of Schools of Public Health
Interprofessional Collaborative Practice
Competency Domains
Values/Ethics for Interprofessional Practice Work with individuals of other professions to maintain a climate of mutual respect and
shared values.
Roles/Responsibilities Use the knowledge of one’s own role and those of other professions to appropriately
assess and address the healthcare needs of the patients and populations served.
Interprofessional Communication Communicate with patients, families, communities, and other health professionals in a
responsive and responsible manner that supports a team approach to the maintenance
of health and the treatment of disease.
Teams and Teamwork Apply relationship-building values and the principles of team dynamics to perform
effectively in different team roles to plan and deliver patient-/population-centered care
that is safe, timely, efficient, effective, and equitable.
World Health Organization View
The History of IPEP
Arizona Health Sciences Center Response to IOM
2011 Today 2006
Created
Interprofessional
Education Program
“IPE”
Expanded to include
Interprofessional
Education & Practice
“IPEP”
IPEP at the
University of Arizona
Establishing a new
paradigm for educating
and training health care
workers to improve the
access, quality and cost
of health care to patients,
families and
communities.
Mission
To provide opportunities for health professions students and
trainees to learn and practice together in interprofessional
teams in order to enhance the health of their patients, families
and communities.
Vision
Interprofessional education and practice are the norm
throughout the Arizona Health Sciences Center with the
training of teams of health care professions students and
trainees and the continuing education of teams of health
care professionals.
Learning activities are student
centered, use problem/project-
based material, and extensively
use patient-oriented clinical
scenarios and simulations
that are relevant for practice.
OUR PARTNERS
James E. Rogers
College of Law
University of Arizona
School of Social Work
Tucson Component
Arizona State University
Campus Health
Service
University of Arizona
Disability Resources
Center
University of Arizona
Sonoran University Center of Excellence
in Developmental Disabilities Education,
Research and Service (Sonoran UCEDD)
ARIZONA HEALTH SCIENCES CENTER
Arizona Health
Education Centers
Program (AHEC)
Arizona Center on
Aging (ACOA)
Arizona Simulation and
Technology Center
(ASTEC)
Arizona Telemedicine Program
Participating Students
Interprofessional Education
Medicine, Nursing, Pharmacy, Public Health
Law
Social Work (Arizona State University)
Communication
Physician Assistant (Northern Arizona University)
Activities for Learning: Engage 200 – 500 students at each event
Large group Presentations
Small Mixed Group Discussion
Panel (experts/individuals)
Case discussions/scenarios
Videos/Pre-activity readings
Table top exercises
Clicker-response system
Simulations
Technology: Telemedicine/video conference/CoveritLive
Interprofessional Education
Planning Process: Components
Interprofessional Education
Schedules
Students
Activity (content experts)
Facilitators
Training or orientation
Logistics (activity, settings, etc.)
Evaluation and debrief
/
The Challenges
Schedules - all the colleges are different
What topics?
What year students?
Which colleges should participate based on event content and objectives?
What format?
No room large enough on AHSC!
Funding – money and time
Students could view some activities as “soft” topics
Administration/other faculty do not see the value
The Resources Miracle
Budget 2005 to present
Beg, borrow, donate around $5,000/year for refreshments
Deans “allow” key faculty to participate in planning
COM provides ~ half-time administrative support
Budget Miracle 2011
AzAHEC has extra funds available for practice development
(changed program to IPE&P)
Proposal developed/funded ~$1.2 million (2 years)
IPEP Core Student Activities
Professionalism for Patient Safety
Pandemic Flu- An Exercise in Emergency
Preparedness
CPR Team Behavior Simulations
Disabilities
IPEP Core Student Activities
Professionalism for Patient Safety
Students learn that communicating across
professional cultures presents new
challenges. They gain an awareness of and
respect for the perspectives and skills each
profession brings to a health care team.
Disruptive behaviors are defined
and modeled and students learn
the the impact on patient safety.
They learn the value of a team in
problem-solving
2011: My knowledge of professional scope of practice and roles of health care professionals
BEFORE
7
44
31
18
0 0
16
42 39
3 0
21
53
24
2
Very Low SomewhatLow
Neither Lownor High
SomewhatHigh
Very High
0
10
20
30
40
50
60
Pe
rce
nt
(N=
15
8)
Medicine (N=61) Nursing (N=31) Pharmacy (N=66)
2011: My knowledge of professional scope of practice and roles of health care professionals
AFTER
2 2
14
66
17
0 0 6
49 46
2 0 6
68
24
Very Low SomewhatLow
Neither Lownor High
SomewhatHigh
Very High
0
10
20
30
40
50
60
70
80
Pe
rce
nt
(N=
16
3)
Medicine (N=64) Nursing (N=33) Pharmacy (N=66)
2011: My understanding of the barriers to effective communication among health care professionals
BEFORE
2
19
37 35
8
0 3
38
53
6 2
15
44
32
7
Very Low SomewhatLow
Neither Lownor High
SomewhatHigh
Very High
0
10
20
30
40
50
60
Pe
rce
nt
(N=
16
7)
Medicine (N=65) Nursing (N=34) Pharmacy (N=68)
2011: My understanding of the barriers to effective communication among health care professionals
AFTER
0 0
11
76
14
0 0 6
61
33
0 0
9
62
29
Very Low SomewhatLow
Neither Lownor High
SomewhatHigh
Very High
0
10
20
30
40
50
60
70
80
Pe
rce
nt
(N=
16
7)
Medicine (N=66) Nursing (N=33) Pharmacy (N=68)
My understanding of disruptive behaviors and
the impact on teamwork BEFORE activity
Interprofessional Education
My understanding of disruptive behaviors and
the impact on teamwork AFTER activity
Interprofessional Education
My appreciation for the potentially adverse impact of disruptive behaviors on patient care and safety (Professionalism 2011)
1 5
30
44
20
0 0 5
46 49
0
10
20
30
40
50
60
Very Low SomewhatLow
Neither SomewhatHigh
Very High
Pe
rce
nt
BEFORE (N=166) AFTER (N=164)
Communication and Culture
Student Comments:
I really liked the message of all of the exercises. Working
together in health-care teams is essential for the best patient-
centered medicine.
It opened my mind. Working with healthcare professionals I will
be working with was great.
Hearing people at my table reflect on what they felt was
currently wrong in today’s system, be it communication or
hierarchies, and so on.
http://www.pharmacy.arizona.edu/videos/pharmtalk/pharmtalk-
interprofessional-education
IPEP Core Student Activities
Pandemic Flu
During a simulated pandemic,
interprofessional teams of students
must collaboratively reach a decision
about complex social, psychological,
ethical, legal and public health
problems.aa
Major topics
• Limited resources
• Duty to service
1$
Pandemic Flu: An Exercise Disaster
Preparedness (Nov 2012)
12/11/12$
1$
Pandemic Flu: An Exercise Disaster Preparedness (Nov 2012)
Student Attendance
College Year/Semester Invited Absent Actual
TUC COM 2nd / 1 114 4 110
TUC COP 3rd 98 13 85
TUC CON BSN 2nd 13 2 11
TUC CON DNP varies 1 0 1
TUC CON MEPN 1st / 2 69 1 68
TUC COPH varies 92 9 83
TUC COL varies 42 3 39
TUC ASU SW varies 13 7 6
TUC Total 442 39 403
PHX COM* 2nd 46 0 46
PHX CON MEPN 1st / 1 17 0 17
PHX UA DNP 1 0 1
PHX COPH 5 0 5
PHX ASU SW 11 5 6
PHX COP 3 0 3
PHX NAU PA 1st 25 0 25
PHX TOTAL 108 5 103
TOTAL 550 44 506
Students$(N$=$281$for$Surveys)$$
Pandemic Flu Nov, 2012
My understanding of the ethical issues that arise during a pandemic flu outbreak (BEFORE and AFTER the activity)
3$
Pandemic Flu Nov, 2012
My expectations about the roles and responsibilities of government agencies during a pandemic flu outbreak (BEFORE and AFTER the activity)
3$
Pandemic Flu Nov, 2012
My appreciation of the type of difficult decisions that need to be made when medical and other resources are in short supply (BEFORE and AFTER the activity)
2$
Pandemic Flu Nov, 2012 My understanding of the degree of collaboration among professions that is necessary during a pandemic flu outbreak (BEFORE and AFTER the activity)
What Students Liked: Pandemic Flu 2008 and 2009
That we used an actual scenario for an interprofessional exercise, working together instead of talking about working together was much more effective. I enjoyed being able to work with non - nursing students (public health) and wished we had a law student.
It really opened my mind to how much difficult decision making and ethics are involved in something that seems simple and intuitive on the surface. When investigated even a little deeper, it clearly is not.
I enjoyed the ability to get information from my group to help make a decision. The team I worked with was very sharp and everyone contributed and was heard.
The respect shown to students for their current knowledge.
http://vimeo.com/55035876 2012 State-wide Pan Flu minicourse
IPEP Core Student Activities
CPR Team Behavior Simulations
Working with a sophisticated patient
simulator, small groups of students practice
vital team skills such as closed-loop
communication, constructive intervention,
knowledge sharing, re-evaluation and
summarizing, and mutual respect. • Leading experts provide orientation where the
latest evidence in the field provided
• Use modern teaching tools (simulators)
• Learn effective team dynamics
• It is NOT about knowing exactly the correct
medications and approaches to use – rather the
focus for student learning is on team dynamics in
a critical situation
All roles in “Code” team assigned –
Team leader rotates among professions
Very low Very high
0
10
20
30
40
50
7
25
43
20
51 1
11
60
27
Legend
Before
After
AHSC Interprofessional Healthcare
Professional & Medical Aspects of Cardiopulmonary Resuscitation
Team Dynamics & Crisis Management Skills
My knowledge of the elements of effective team dynamics
in responding to a clinical crisis
Pe
rce
nt
Very low Very high
0
10
20
30
40
50
7
24
45
16
8
1 1
15
54
29
Legend
Before
After
AHSC Interprofessional Healthcare
Professional & Medical Aspects of Cardiopulmonary Resuscitation
Team Dynamics & Crisis Management Skills
My knowledge of different roles & responsibilities of various
health care providers during CPR
Pe
rce
nt
Q6. To what extent did the CPR Simulation exercise make you
think about the importance of clear communication during a crisis
incident like cardiac arrest?
0 0
8
20
72
02
10
26
62
0 02
21
77
0
10
20
30
40
50
60
70
80
90
Not At All 2 3 4 A Great Deal
Perc
en
t
Nursing Students M edical Students Pharmacy Students
Simulation for “Students” vs “Residents” http://www.youtube.com/watch?v=iyJLJYHhy08&context=C4466627ADvjVQa1PpcFOA0IejryH9q1KfZXNd7EKp1LSDrgODcYI=
http://www.youtube.com/watch?v=r3AIocJjvl o http://astec.arizona.edu/insitu
IPEP Core Student Activities
Disabilities
Students work in small groups to
solve patient-based problems
faced by people with disabilities.
During a panel discussion, people
living with disabilities respond to
student solutions and offer their
own real-life perspectives.
This event brought together over
300 students from the Colleges of
Public Health, Pharmacy,
Medicine, Nursing, Law and Social
Work.
Disabilities Exercise: Points of Emphasis
The healthcare “team” may also
include social workers, lawyers,
administrators and public health
professionals
Try to understand how the person
views their disability, condition, &
quality of life
Difference between social construct of
disability and medical construct
Persons with different disabilities
shared their stories
The Disabilities Activity consisted of two parts: the live activity on
April 4, 2012 and the pre-activity tasks online in the D2L site. All
student materials (pre-activity and live activity including location
information) were housed in the course site in D2L. Facilitator
information was also available in the D2L Disabilities course site.
Disabilities Exercise: 6 Cases were reviewed by students
CASE #1: JACOB (Autism) Jacob is a six-year old boy with autism.
CASE #2: FRANK (Deafness) Frank is an 18-year-old teenager with a hearing disability.
CASE #3: EDWARD (Visual Impairment) Edward is a 36-year-old man who has been blind since childhood.
CASE #4: RACHEL (Mobility Impairment) Rachel is a 44-year-old woman with multiple sclerosis. Her disease has progressed so that she uses an electric wheelchair to get around.
CASE #5: ROSA (Intellectual Disability) Rosa is a 64-year-old woman with an intellectual disability.
CASE #6: JAMES (PTSD Disability) James is a veteran of the US Army who has been diagnosed with PTSD.
EDUCATION
PRACTICE
Resident Physician Orientation June 28, 2012
Learning Objectives
Identify who your team members are at UAHN.
Demonstrate that, as resident physicians, you
understand that your role on the health care team
involves working cooperatively with care providers
across the spectrum and with patient and their families.
Place the interest of patients and populations at the
center of interprofessional health care delivery.
Learning Objectives
Describe your understanding of the importance of
communication skills, including listening, in providing
quality care to individuals.
Use the full scope of knowledge, skills, and abilities of
available health professionals and healthcare workers to
provide care that is safe, timely, efficient, effective,
equitable, and patient centered (STEEEP).
Share accountability with other professions, patients, and
communities for outcomes relevant to prevention and
providing high quality, safe and cost-efficient health care.
Participating Specialties
Dermatology (1)
Emergency Medicine (16)
Endocrinology (1 Fellow)
Family Medicine (14, 1 Fellow)
Gastroenterology (2 Fellow)
General Surgery (16)
Hematology Oncology (1)
Infectious Disease (1 Fellow)
Internal Medicine (38)
Neurology (4, 1 Fellow)
Anesthesiology (7)
Cardiology (1 Fellow)
Participating Specialties
OB/GYN (4)
Ophthalmology (4)
Orthopedics (2)
Pathology (6)
Pediatrics (15, 1 Fellow)
Psychiatry (13)
Pulmon/CC (3 Fellows)
Radiation Oncology (2)
Radiology (5)
Sports Med (1 Fellow)
Surgery, General (19)
Urology (1)
Vascular & Interventional Radiology (1)
My understanding about the important role good communication plays in high quality
and safe clinical outcomes (listening & integrating)
1 3
20
42
35
1 1 6
37
56
0
10
20
30
40
50
60
None at all A little A moderateamount
A lot A great deal
Pe
rce
nt
(N
=1
90
)
BEFORE AFTER
My understanding about the potentially adverse impact of disruptive behaviors on
patient care and safety
1 4
27
37 31
0 1
10
40
50
0
10
20
30
40
50
60
None at all A little A moderateamount
A lot A great deal
Pe
rce
nt
(N
=1
90
)
BEFORE AFTER
My knowledge of how to integrate the clinical skills and expertise of other team
members
0 5
42
33
20
0 1
14
53
33
0
10
20
30
40
50
60
Not at allknowledgeable
Slightlyknowledgeable
Moderatelyknowledgeable
Veryknowledgeable
Extremelyknowledgeable
Pe
rce
nt
(N
=1
90
)
BEFORE AFTER
The degree of RELEVANCE that IP education/activities like this have to:
1 2
9
42 46
1 3
7
42 47
0
5
10
15
20
25
30
35
40
45
50
Not at allrelevant
Slightlyrelevant
ModeratelyRelevant
Very relevant Extremelyrelevant
Pe
rce
nt
(N
=1
91
)
Improving health care outcomes
Increasing patient trust in health care teams
The degree of RELEVANCE that IP education/activities like this have to:
1 2
11
41 46
1 5
16
37
42
0
5
10
15
20
25
30
35
40
45
50
Not at allrelevant
Slightlyrelevant
ModeratelyRelevant
Very relevant Extremelyrelevant
Pe
rce
nt
(N
=1
91
)
Maximizing the contributions of each team member
Decreasing disruptive behaviors
The degree of RELEVANCE that IP education/activities like this have to:
1 2
9
36
53
1 5
17
38 39
0
10
20
30
40
50
60
Not at allrelevant
Slightlyrelevant
ModeratelyRelevant
Very relevant Extremelyrelevant
Pe
rce
nt
(N
=1
91
)
Improving patient safety
Increasing job satisfaction among health care providers
The degree of RELEVANCE that IP education/activities like this have to:
1 4
18
33
45
1 2
9
36
53
0
10
20
30
40
50
60
Pe
rce
nt
(N
=1
91
)
Changing negativestereotypes aboutother professions
Improving workingrelationships withother medicalspecialities/departments
Overall, how VALUABLE was the Resident Physician Orientation
2
11
28
41
18
Not at allvaluableSlightlyvaluableModeratelyvaluableVeryvaluableExtremelyvaluable
Comments
What Did You LIKE? What Will You Use?
AIDET
Interactive nature
Consult scenario
Escalation scenario
Interactive nature
Meeting other residents
Communication emphasis
Patient centered focus
Developed Longitudinal Curriculum
• Enhanced Large Scale Events (Expanding to
Phoenix)
• Beginning of Joint Orientation
Began Faculty Development Program
Began Shaping the Practice Culture
• Medical Resident Orientation
Developed Internal and External Marketing and
Dissemination
• Co-sponsored CAB III
OUR RECENT ADVANCES
Piloted 3 Faculty/Preceptor Training Workshops
• Teams and Teamwork, Communication, IP
Pedagogy
• About 15 participants in each workshop
• Identified best practices for progressing faculty
and preceptor audiences
• Ready for use after incorporating constructive
feedback
IPEP Faculty Development
Longitudinal Curriculum
• Team-based action learning for transfer to practice
• IP student team developmental simulation each of 4 semesters
using University of Toronto model - exposure, immersion,
competence.
• Transition from simulated practice 1st 2 semesters to IP practice in
clinics managed by IP student organization with faculty guidance
• Focus on rural and underserved patients, populations, and
communities.
Practice Focus in Longitudinal Curriculum
PILOTS INCLUDE THESE ELEMENTS:
IP teams focused on health care quality & safety,
and/or community-based activities, especially for rural
and underserved populations.
Innovative use of eLearning & teaching technologies
(including D2L for pre & post learning activities)
Social media for teambuilding & communication
Simulation & evaluation
Proposed Pilots for Academic Year 2012-13
OUR RECENT ADVANCES
National Coordinating Center for Interprofessional Education and Collaborative Practice Barbara F. Brandt, PhD, Center Director Associate
Vice President for Education University of Minnesota Academic Health Center
- HRSA awarded 4 million over 5 years
- Link Education to Practice – The Triple Aim
- U of A one of Initial 6 partner institutions
- http://www.ahceducation.umn.edu/nexus-ipe
Build Necessary Infrastructure
• Dedicated Staff
• Secure Stable Funding (AHSC Deans and
University of Arizona Health Network)
• Plans for IP Education Building on Tucson campus
Develop the Program’s Long-Term Evaluation
Faculty Recognition/Promotion for IPEP Activity
Keys to Sustainability
Lessons Learned To Date
Students want to meet peers from other professions to understand their perspective about a health care or public health issue
Students want to discuss and solve things together, face-to-face
Most students are engaged in the small group discussion
Very important to have trained and skilled facilitators! • Now have detailed training sessions and facilitator guides
Faculty must also be aware and supportive of IPE to be effective facilitators
Students enjoy seeing faculty from their colleges participating as speakers/facilitators
Lessons Learned (continued)
Logistics, time of day, length of exercise, and snack breaks are important considerations
Setting and logistics are critical for small group interaction (moved away from large ballroom)
Must have clear objectives
Technology is a must…but don’t depend on it
Planning effective learning activities is time consuming
All activities must be evaluated and debriefed
Lessons Learned (continued)
…and an IPEP curriculum takes
substantial resources!
IPEP Blog and Website
IPEP Social Media and Connections
Transformative Change from the Classroom to Practice Collaborating Across Borders (CAB) IV, June 12-14, 2013in beautiful Vancouver, British Columbia, Canada www.cabiv.org
Leadership Team
Faculty Representatives & Program Staff
COLLEGE REPRESENTATIVES
Andreas Theodorou, COM,
Cathy Michaels, CON
Interim Co-Directors
Dan Derksen, COPH
Mindy Fain, COM
Jeannie Lee, COP
John Murphy, COP
Ted Rigney, CON
Doug Taren, MEZCOPH
Ronald Weinstein, COM/ATP
PROGRAM FACULTY
Yvonne Price, COM
Ernie Schloss, MEZCOPH
Lynne Tomasa, COM
PROGRAM STAFF
Theresa LeGros, IPEP
Carol McCabe, IPEP
We offer our team of consultants for interprofessional programs,
efforts and events.
Expanding Interprofessionalism
Teaming up for better health care
ipep.arizona.edu
facebook.com/IPEP.UA
@IPEPcafe
youtube.com/IPEPcafe
FOR MORE INFORMATION
