Core Concepts of Interprofessional Education and Practice.
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Transcript of Core Concepts of Interprofessional Education and Practice.
Core Concepts of Interprofessional Education and Practice
Emergence
Quality and safety
Chronic care
Rising costs
Patient-centeredness
Media coverage
Interprofessional education
Definitions
IPE
“occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (Barr et al 2005)
Definitions
MPE
“Occasions when members of two or more professions learn alongside one another: in other words, parallel rather than interactive learning” (Barr et al 2005)
Disciplines and professions
Disciplines – psychology, anthropology, economics, geography, political science,.
Professions – medicine, nursing, social work
IPE aims
• improving interprofessional communication • enhancing teamwork knowledge/skills• resolving interprofessional rivalry • improving quality (relationships, patient care)
IPE principles
• collaborative
• egalitarian
• group-directed
• experiential
• reflective
Types of IPE
Formal learning
Serendipitous learning (e.g. informal interactions between learners)
IPE foci
1. preparing individuals for collaboration
2. cultivating collaboration in groups or
teams
3. improving services & quality of care
Interactive learning methods
• exchange (seminars)
• problem-focused (problem solving)
• practice learning (student placements)
• simulation (role play)
• e-learning (internet interaction)
IPE outcomes
level 1 – reactions
level 2a – attitudes/perceptions
level 2b – knowledge/skills
level 3 – individual behaviour
level 4a – organisational behaviour
level 4b – patient/client benefit
Kirkpatrick 1967 (modified by Barr et al 2000, 2005)
environment
• group balance (professional mix)
• group size / stability
• reflection -learners & facilitators
-reflecting ‘in action’ and ‘upon action’
• creation of conductive environment-equal status of learners
-cooperative/supportive atmosphere
• awareness: heterogeneity of learners-profession, power, status, prestige
Interprofessional practice
Key factors
Individual willingness
Equitability (shared planning/decision-making)
Organisational/managerial support
Open systems of communication
Regular interaction/negotiation
Education/training
Underpinning issues
Joint activity
Working together on an agreed task
Equality, co-operation
Synchronous/asynchronous
Collaborating with an ‘enemy’
Networking
Coordination
Collaboration
Teamwork
Forms of interprofessional practice
Reeves et al., 2010
Notion of ‘exchange’
IP collaboration is not an altruistic act
Requires 'pay-off' for individuals/parties
Need to make exchange explicit
(Hudson 1987)
Risk
Unpredictable activity
Uncertain outcomes (possible failure)
Possibility of ‘cultural suicide’
(Brookfield 1993)
Competing interests…
“When individuals and groups come
together, even if they are form the same
organisation, and particularly if they are
from different organisations, there is
representation of different and often
competing interests [which] can generate
tensions and conflicts”
(Beattie et al 1996)
Professionalization
Creation of professional boundaries
Hierarchical division of labor
Imbalances of power/status
Time-space issues
Stairs separating teams can reduce interactions by 30% (Handy 1999)
Heavy profession-specific workloads can limit time for meetings
Emergence of ‘knotworking’ (Engeström et al. 1999)
Common problems
-Insufficient time for interaction/negotiation
-Lack of teambuilding activities
-Confused team roles (generic working)
-Vertical management
-Others..???