Project Dr Marion Helme: Senior Project Officer, LTSN Triple Project Dr Margaret Sills: Academic...

Triple Project

http://www.triple-ltsn.kcl.ac.uk

Dr Marion Helme: Senior Project Officer, LTSN Triple Project

Dr Margaret Sills: Academic Director, LTSN Subject Centre for Health Sciences and Practice

Proposals for Developing and Sustaining Interprofessional Education Initiatives in Health and Social Care

• Introduction to Triple Project

• Proposals + discussion

• Contributions to IPE from systems, complexity and social practice theories

• Where next?

Triple


Project Officers:

Dr Marion Helme and Dr Pawel Miklaszewicz

IPE : “occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (CAIPE 1997)

Triple: Three-centre Research on Interprofessional Practice in Learning and Education

Project contexts•LTSN and The UK Higher Education

Academy

•IPE in UK health and social care

•Triple: a collaborative project

Contexts: IPE in health and social care in the UKResponses to questionWhy are you doing this interprofessional teaching?

• Because we have to

• Because we believe that what we are doing will ultimately improve patient care

• Because “ it’s enormous fun and one of the most rewarding experiences we …and our students have had!”


Tripleobjectiv

esTo map

themes and issues in IPEin health and

social care

To create a website as a resource for IP teaching

To provide opportunities

to explore experiences

ofIPE


LTSN Triple Project aims and activities

‘Getting the lemons in line’: logistics – timetables, rooms, funding …

Culture, power … silos and territorialism …archeologies of grievances

Sustaining IPE initiatives beyond individual commitment

Uni-, multi-, inter-PE ?

When (level) and where (university/practice)

Assessing IPL

Incorporating stakeholder perspectives

Evaluating the impact of IPE:teaching learning practice quality of care

Themes and issues from mapping activities

Messages from and for IPE teams from Triple ‘learning from experience workshops’

“[think] about the wood as well as the trees, the dance as well as the dancers”

(Trowler, Saunders et al. 2003)


'T rees' and 'dancers'

Start sm all

Teaching activities

Infrastructure

Assessm ent of students

Evaluation

Plan meticulously

Com m ittees and boards

External examiner

Ensure support from senior staff

Include educationalists

Social activity for students and staff

Build a strong team of interprofessional enthusiasts

M essages of advice to new IPE initiatives


‘Messages’ from Triple workshop participants

“How can IPE offer understanding of conflicts and contradictions in health and social care rather than just serve as an instrument of the modernisation agenda”.

(Canterbury Christ Church University College)

My messages of advice (to new IPE initiatives) would be:

Clarify what you mean by interprofessional as in my view this excludes certain groups like users of services and carers.

Don’t assume people in health and social care know how to work effectively in an interdisciplinary way…”

(Birmingham University Mental Health IPE initiative)


… ‘Woods’ and ‘Dances’: IPE as a complex problem?

Trees and dances: working together and practising differently?

“If a patient wants to refuse therapy, there’s a difference between how a physio and an OT would deal with it” (interdisciplinary team Coventry University).

“When I was a social worker I was never called as an expert witness in child protection court cases, despite having much more knowledge of the child and family than ‘expert witnesses’ from the medical profession” (IPESO meeting).

“Clinicians and nurses are trained for outcomes. They know if they give somebody a particular drug they will get a particular outcome… They don’t like having to debate what might be effective” (IT Manager in Hospital Trust).


Proposals (December 2003): effective, sustainable teaching for IP learning and practice draws on:

• Involvement of interprofessional teaching teams in all processes (summative assessment?)

• Use of interactive learning methods• ‘Built in’ evaluation• Explicit models and purposes of IP practice –

for example, quality of care for individual patients, community practice, professional identity

• Awareness of different ways of knowing in practice

• Awareness of role of teachers/facilitators/ mentors as more than facilitation, and as ‘acting out values’ which requires critical reflection by teachers/facilitators/ mentors (especially awareness of impact of own professional bias)


Models and purposes:What is an interprofessional health and social care service? What is interprofessional practice about? (Trees and woods)

• “Presentation and intersection of different knowledges of a patient” (Opie 2000)

• Teamwork skills – communication skills, conflict resolution, networking

• Enactment of values of respect, responsiveness, trust and accountability

• “Seamless” service experienced by (individual) patients and service users and their carers (?)

• A “community practice”

• Radical change …a social movement beyond health and social care


… a community practice:

Towards Unity for Health http://www.the-networktufh.org

Consensus (Phuket Declaration) …. • Effective partnerships between individuals and communities and all sectors — private, public, professional and voluntary — are essential to creating and sustaining effective health interventions and programmes.• Global society must ensure adequate resources for the health of all its members.• Responsibility and accountability for health, particularly that of the most vulnerable, are shared by all partners across all sectors…


Critical Reflection and ReflexivityCritical Reflection identify your actions,thoughts and

feelings; write a narrative, analyse using theory, come to new personal understandings and ways of being in a situation. (Tate 2004)

ReflexivityRecognising how one’s own construct systems are used to

appraise the constructs of others. Establishing the impact you had on a situation, how was it different as a result of who you are?

Take into account the effect of the personality or presence of the researcher on the investigation (Holland 1999) / educator on the learning / practitioner on the practice.

Neighbour discussion

Please discuss with one or two neighbours

From your experience what would you change or add to these proposals?

… and write a couple of points from your discussion on the post-it notes.


Summary: Theorising IPE

• IP practice is more than good teamwork

• Teaching for IP learning is more than facilitation• Is a common language possible? • Paradoxes – working together differently • Uncertainty • Diversity • “All educational contexts represent and replicate,

within their own internal processes, external power relations…” (Vince 1996)



Systems thinking and practice


Complexity theory

Communities of practice


Concluding points for development of IPE

• Power and dialogue

• Evolution and revolution

• Boundary working and border crossing

• Is it worth it?

• Risks: colonisation and politics


• Triple Project: report and publication

• EIPEN: a European IPE network

• LTSN: Evaluating IPE– learning pack

• UK Higher Education: The Academy and “Centres of Excellence in IP Learning and Teaching” beyond health and social care – education etc

• UK: dissemination from government funded Common learning sites; development of IPE in social work programmes; health professions regulations and benchmarks

Moving on?


Project Dr Marion Helme: Senior Project Officer, LTSN Triple Project Dr Margaret Sills: Academic...

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