1. Kesinambungan belajar berbasis IPE pada tahap akademik dan penerapannya pada tahap profesi Diantha Soemantri Koordinator Kurikulum Terintegrasi Rumpun Ilmu Kesehatan Universitas Indonesia

2. “ It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be interprofessional “ (WHO, 2010, p.36) “ It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be interprofessional “ (WHO, 2010, p.36)

3. Main concepts of IPE IPE in academic stage (current implementation) IPE in profession stage (future plan) PRESENTATION OUTLINE

4. MAIN CONCEPTS OF IPE

5. The need for an interprofessional education Educational and Health System according to WHO (2010)

6. Collaborative practice Perbaikan patient care & safety Perbaikan outcome pada pasien penyakit kronik Penurunan angka clinical error Peningkatan kepuasan pasien Compliance terhadap terapi yang lebih baik WHO (2010). Framework for Action on Interprofessional Education and Collaborative Practice

7. Interprofessional education Sargeant (2008): “Contact … is not enough to build an effective team. Teamwork is a sophisticated social activity requiring cognitive (knowledge), technical (skills), and affective (attitude) competencies and education for developing these”

8. Components of Interprofessional Education Program (WHO, 2010) How to organize an interprofessional education

9. “International environmental scan” Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91  Only 38% reported that IPE is MANDATORY  Only 66% reported that the students know the LEARNING OBJECTIVES of IPE program  Only 37% reported that the learning objectives are ASSESSED  Only 31% reported that there is a TRAINING for staff involved in IPE program  30% reported that IPE program is not EVALUATED

10. IPE IN ACADEMIC STAGE Current implementation

11. in Universitas Indonesia… A learning module in which students sit together listening to the same lecture or reading the same book is not adequate Multiprofessional education Informally, students can interact with each other in this module, most probably superficially

12. in Universitas Indonesia… Therefore, multiprofessional education must be accompanied with interprofessional education Interprofessional education  specifically aims to equip students with the ability to collaborate and work in a healthcare team effectively

13. in Universitas Indonesia… Health sciences MedicineNursingPharmacyDentistry Public health Resource sharing Efficiency of resource use Closer relationship and more effective communication between professions Added competency: the ability to collaborate and work in a team in providing health care services

14. Structure of Health Sciences Faculties curriculum Study program (profession specific) modules Faculty compulsory modules University compulsory modules Multiprofessional & interprofessional learning modules

15. Shared learning modules COMPETENCYMODULECREDIT (in SKS) Ethics and LawEthics and law in health profession2 Basic biomedical sciences 3 (theory) + 1 (practical) CommunicationEffective communication in healthcare services 2 Disaster managementDisaster Management2 Research 3 Teamwork and collaboration of healthcare team (preclinical and clinical) 2 (preclinical) + 1 (clinical) MPE IPE

16. Universitas Indonesia (2013) Canada (2010)IPEC (2011) Group dynamicsInterprofessional communication Interprofessional communication practices Concept of collaboration and healthcare service system Patient/client/family/comm unity-centred care Roles and responsibilities Conflict managementRole clarificationValues and ethics Interprofessional communication & leadership Team functioningInterprofessional teamwork & team based practice Roles of each professionCollaborative leadership Obstacles & strategies for interprofessional collaboration Interprofessional conflict resolution Interprofessional competency domains in the “Teamwork & Collaboration of Healthcare” Module

17. Module: Teamwork and collaboration of healthcare team Teaching methods – Introductory lecture – Collaborative learning – Question based learning – Case based discussion – Plenary presentation Teaching methods – Introductory lecture – Collaborative learning – Question based learning – Case based discussion – Plenary presentation Assessment system Self reflection Tutor & peer assessment Written exam (in group) Group project Assessment system Self reflection Tutor & peer assessment Written exam (in group) Group project

18. Mean score comparison of RIPLS (Readiness for Interprofessional Learning Scale) in year 1 Health Sciences students Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague Input from students: “Continuity of program from academic to professional stage” “Real world application of interprofessional collaboration principles”  hospital? community?

19. IPE IN PROFESSION STAGE Future Plan

20. 1 ROLE MODEL Interprofessional team in hospitals/clinics Examples of interprofessional collaborative practice in hospitals/clinics Healthcare practitioners  understand the roles of each profession, and aware of the importance of interprofessional, collaborative healthcare services Minimizing negative stereotyping and hierarchy of profession

21. 2 INSTITUTIONAL SUPPORT Adjustment of the curriculum Time allocated for interprofessional education Allocation of human and physical resources, including a number of main/affiliated hospitals, satellite/family clinic, community health centers, etc. Training for teaching staff

22. 3 ORGANIZATION Module management Organization of a high number and diverse students and teachers Individual preparedness: students, teachers Student-centered active learning

23. Some examples of IPE in profession stage (pre-qualification stage) Guest et al (2002) – Interprofessional placement – Pediatric ward in a large teaching hospital – 90 senior nursing students, 90 junior medical students  ‘buddied’ – Discuss and reflect students’ ward-based interprofessional learning experiences

24. Some examples of IPE in profession stage (pre-qualification stage) Van der Horst et al (1995) – Interprofessional community placement – Medicine, nursing, occupational therapy, physiotherapy, social work – Activities: observation of community interprofessional health teams, interviews with local community experts, interviews with the users of community health services

25. Some examples of IPE in profession stage (pre-qualification stage) Ker et al (2003) – Simulated ward environment in a clinical skills centre – Medical and nursing students  interprofessional teams – Responsibility for the ward for a shift  prepare a joint report  discuss and receive feedback from tutors

26. the way forward… Designing an instructional design for IPE program in professional (pre-qualification) stage by an interprofessional teaching team – Explicit learning objectives – Relevant activities – Valid assessment methods – Feasible timing Formation of interprofessional team of students – Medicine, nursing, dentistry, pharmacy and public health – 1 group  10 students max?

27. the way forward… Choices of placements: – Community placement Students are given a patient/family who needs an interprofessional healthcare approach, that they have to monitor and intervene during a particular period – Clinical ward placement Students team-up to observe and experience an interprofessional approach in treating patients in the ward – Simulated ward environment Similar to the clinical ward placement, but in a simulated environment  simulated patients. More opportunities for hands-on experience

28. the way forward… In each placement: – Tutors’ guidance and supervision – Discussion and reflection upon the experiences – Tutor assessment and feedback – Peer assessment and feedback Evaluation (program) – Level 1: students, teachers satisfaction – Level 2: students’ learning achievement

29. to sum up…. IPE is a must, preferably both at academic and profession stage (continuum of the early and advanced stage of education) Classroom-based teaching  main activities at the academic stage Community/hospital ward placement  main activities at the profession stage Specifically at the profession stage: IMPORTANT  not only the instructional design of the IPE program, but also the ROLE MODELING from healthcare practitioners

30. References Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework. February 2010. Guest C, Smith L, Bradshaw M & Hardcastle W (2002). Facilitating interprofessional learning for medical and nursing students in clinical practice. Learning in Health and Social Care 1: 132-138 Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core competencies for interprofessional collaborative practice: report of an expert panel. Washington, DC. Interprofessional Education Collaborative. Ker J, Mole L & Bradley P (2003). Early introduction of interprofessional learning: a simulated ward environment. Medical Teacher 37: 248-255 Modul Kolaborasi dan Kerjasama Tim Kesehatan. Rumpun Ilmu Kesehatan, Universitas Indonesia, 2012 Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education & Collaborative Practice (2010). Where in the world is interprofessional education? A global environmental scan. Journal of Interprofessional Care 24(5): 479-91 Sargeant J, Loney E & Murphy G (2008). Effective interprofessional teams: “contact is not enough” to build a team. Journal of Continuing Education in Health Professions 28(4):228-234 World Health Organization (2010). Framework for action on interprofessional education and collaborative practice. Geneva: WHO Press Van der Horst M, Turpie I, Nelson W et al (1995). St Joseph’s Community Health Centre model of community-based interdisciplinary health care team. Health and Social Care in the Community 3: 33- 42 Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference 2013, Prague