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IPE/IPP From Theory to Practice
Combined Sections Meeting 2017 5/19/2018 IPE/IPP From Theory to Practice CAPCSD Conference, April 20, 2017, New Orleans, LA Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Learning Objectives Define IPE and IPP List 3 ways attendee can implement IPE and IPP principles in their programs Outline appropriate methods for assessing the impact of IPE Property of the Interprofessional Professionalism Collaborative (IPC)
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WORLD HEALTH ORGANIZATION (WHO)
WHAT IS IPE AND IPP? WORLD HEALTH ORGANIZATION (WHO) Interprofessional Education (IPE) “…TWO OR MORE PROFESSIONS LEARN ABOUT, FROM, AND WITH EACH OTHER TO ENABLE EFFECTIVE COLLABORATION AND IMPROVE HEALTH OUTCOMES.” “…MULTIPLE HEALTH WORKERS FROM DIFFERENT PROFESSIONAL BACKGROUNDS PROVIDE COMPREHENSIVE HEALTH SERVICES BY WORKING WITH PATIENTS, THEIR FAMILIES, CAREGIVERS, AND COMMUNITIES TO DELIVER THE HIGHEST QUALITY OF CARE ACROSS SETTINGS.” Interprofessional Practice (IPP) The World Health Organization’s (WHO) definition of interprofessional education (abbreviated IPE) which states that IPE is an activity where two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes. Framework for Action on Interprofessional Education and Collaborative Practice, WHO 2010. Framework for Action on Interprofessional Education and Collaborative Practice, WHO 2010
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WHAT IS IPE AND IPP? CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION (CAIPE) Interprofessional Education (IPE) “…OCCURS WHEN STUDENTS OR MEMBERS OF TWO OR MORE PROFESSIONS LEARN WITH, FROM AND ABOUT EACH OTHER TO IMPROVE COLLABORATION AND THE QUALITY OF CARE.” Interprofessional Practice (IPP) “…IS COLLABORATION IN PRACTICE BETWEEN MEMBERS OF TWO OR MORE PROFESSIONS.” The Center for the Advancement of Interprofessional Education (CAIPE) 2013 publication, Introducing Interprofessional Education provides a glossary of terms related to interprofessional interactions. The publication also provides definitions contrasting interdisciplinary, interprofessional, and multidisciplinary. Common terms used in team-based care. Collaborative practice is working in partnership between professions and/or between organizations with individuals, families, groups and communities. Interdisciplinary care is sometimes used as an alternative to interprofessional care or to refer to care provided between branches of the same profession, typically medicine. Interdisciplinary research typically refers to systematic investigation conducted in collaboration between members of different academic fields. Interprofessional care is a collaborative response to the needs of individuals, families, groups and communities by members of two or more professions. Interprofessional education occurs when students or members of two or more professions learn with, from and about each other to improve collaboration and the quality of care. Interprofessional learning occurs between students or members of two or more professions to enhance knowledge and competence during interprofessional education, or, informally in educational or practice settings. Interprofessional practice is collaboration in practice between members of two or more professions. Interprofessional teamwork engages members of two or more professions with complementary competences in sustained collaborative practice towards common goals. Interprofessional research refers either to systematic investigation into interprofessional education and practice and/or conducted between professions. Multidisciplinary education is sometimes used interchangeably with multiprofessional education (see below) but may also refer to education between branches of the same profession or between academic disciplines. Multiprofessional education is occasions when professions learn side by side for whatever reason. Introducing Interprofessional Education, CAIPE 2013
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Combined Sections Meeting 2017
5/19/2018 From Theory to Practice: A Tool Kit for Assessing Interprofessional Professionalism in Education and Practice Loretta Nunez, MA, AuD, CCC-A/SLP, FNAP American Speech-Language-Hearing Association CAPCSD Conference, April 20, 2017, New Orleans, LA Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Disclosures Relevant financial or nonfinancial relationship(s) within the products or services described, reviewed, evaluated or compared in this presentation Loretta Nunez Has a financial relationship with ASHA as a staff member Has a non-financial relationship with the Interprofessional Professionalism Collaborative (IPC) Co-authors of the IPP Tool Kit have a nonfinancial relationship with the Interprofessional Professionalism Collaborative (IPC) Property of the Interprofessional Professionalism Collaborative (IPC)
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Framework for Interprofessional Competencies and Assessment
Combined Sections Meeting 2017 5/19/2018 Framework for Interprofessional Competencies and Assessment Property of the Interprofessional Professionalism Collaborative (IPC)
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Roles & Responsibilities Interprofessional Communication
IPEC Competencies IPEC, 2016 DOMAINS Values & Ethics Interprofessional Education Collaborative (2016) Core competencies for interprofessional collaborative practice: 2016 update. Washington D.C.: Interprofessional Education Collaborative The IPEC competencies for Interprofessional Collaborative Practice were revised in 2016 to further emphasize the importance of public health in team-based care to improve the health of populations. The competencies comprise a total of 39 behaviors categorized in 4 domains including values & ethics, roles and responsibilities, communication, and teamwork. Roles & Responsibilities Interprofessional Communication Teams & Teamwork 8
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Transdisciplinary Professionalism
Combined Sections Meeting 2017 5/19/2018 Transdisciplinary Professionalism “A shared social contract that transcends all the professions but is connected to all the professions by a unifying set of beliefs and behaviors that they profess to the public…” (IOM 2014, p. 74 In 2014, the Institute of Medicine (IOM) now known as the National Academy of Science, Engineering and Medicine, held a workshop as part of the Global Forum on Innovation in Health Professional Education and published a report of the workshop, Establishing Transdisciplinary Professionalism for Improving Health Outcomes. Leaders at this workshop described “transdisciplinary professionalism” as a common set of values and beliefs that all health professions are acculturated to as part of their professional education and that these unifying beliefs and behaviors represent a shared social contract with the public. Transdisciplinary professionalism is not intended to mean transdisciplinary practice. Disciplinary boundaries are not transcended at the level of knowledge, skill, or competencies in care unique to a specific profession. Transdisciplinary professionalism or interprofessional professionalism includes elements of professionalism that are uniquely relevant to collaboration across health professions. Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Interprofessional Professionalism (IPP) Definition Interprofessional Professionalism Collaborative (IPC), 2011 “Consistent demonstration of core values evidenced by professionals working together, aspiring to and wisely applying principles* of, altruism and caring, excellence, ethics, respect, communication, accountability to achieve optimal health and wellness in individuals and communities.” So let’s take a look at the definition of Interprofessional Professionalism that took nearly 2 years for the Interprofessional Professionalism Collaborative (IPC, 2011, 2012) to craft. All of the terms used in this definition needed to reflect a common meaning and purpose to all of the IPC member health professions for the definition to be accepted. Part of the definition was derived from the work of David Stern; reflecting those core values that are common to all of the health professions and the concept of multiple health professions working collaboratively (team-based care) toward outcomes of optimal health and wellness in individuals and communities. Evolution of our thinking process led us to the development of the construct of interprofessional professionalism. Identified as a part of the IPC’s purpose and vision that connects education and quality care. Definition of Interprofessional Professionalism (IPP) alone was not sufficient to communicate the construct. IPP behaviors needed to be observable and measureable if we were to be able to translate the construct into practice. *Stern DT. Measuring Medical Professionalism. Oxford University Press. New York, NY; 2006:19. Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 The National Center for Interprofessional Practice and Education provides guidance for Assessment and Evaluation of IPE and IPP. Information on selecting an assessment tool Collection of 47 tools (many open access) Practical guides for developing an assessment plan and assessing interprofessional collaborative practice. Resources available from National Center for Interprofessional Practice and Education (Nominal charge to purchase) What is Teamwork in Interprofessional Collaborative Practice? A PRACTICAL GUIDE: VOLUME 1, January 31, 2017 Assessing Interprofessional Collaborative Practice Teamwork, A PRACTICAL GUIDE: VOLUME 2, January 31, 2017 Steps for Developing an Assessment Plan, A PRACTICAL GUIDE: VOLUME 3, January 31, 2017 Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Role of Assessment Measuring teamwork, collaboration, and/or interprofessional professionalism is an important aspect of measuring team performance in education or practice. Considerations for assessing interprofessional collaborations include: context such as the clinical setting and team structure purpose of the assessment (team- or individual-level) content such as attitudes or perceptions vs. behaviors method that will be used such as observation, interview, survey selecting an assessment tool with sound psychometrics and one that is a good fit with the assessment goals Steps for Developing an Assessment Plan A PRACTICAL GUIDE: VOLUME 3 January 31, 2017 Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 The IPP Tool Kit Interprofessional Professionalism Collaborative (IPC, 2017) There are numerous assessment tools available for assessing either individuals or teams. The majority that are available focus on assessing attitudes or perceptions. There is a need for assessment tools and research that examines individual or team behaviors associated with collaborate education or practice. A tool kit for developing and assessing interprofessional professionalism (IPP) was developed by the Interprofessional Professionalism Collaborative (IPC), a group Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Interprofessional Professionalism Collaborative Team Jennifer Adams, PharmD Amer Assoc of Colleges of Pharmacy Luke Mortensen, PhD, FAHA, FNAOME Amer Assoc of Colleges of Osteopathic Medicine John Bentley, PhD University of Mississippi John H. Nishimoto, OD, MBA, FAAO Marshall B. Ketchum University Jody Frost, PT, DPT, PhD, FNAP Education Consultant and Facilitator Loretta M Nunez, MA, AuD, CCC-A/SLP, FNAP American Speech-Language-Hearing Assoc Catherine Grus, PhD American Psychological Association Elisabeth J "Libby" Ross, MA American Physical Therapy Association Dana P Hammer, PharmD, PhD Health Professions Education Consultant Colette L Scott, MEd National Board of Medical Examiners Neil Harvison, PhD, OTR/L, FAOTA Amer Occupational Therapy Assoc Jeffery Stewart, DDS American Dental Education Association Kathy McGuinn, MSN, RN, CPHQ Amer Assoc of Colleges of Nursing Katherine McOwen, MS Association of American Medical Colleges John Tegzes BSN, MA, VMD, Diplomate ABVT Western University of Health Sciences IPC Members and co-authors of the IPC Tool Kit Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 IPP Tool Kit Interprofessional Professionalism Construct Interprofessional Professionalism Assessment (IPA) Case scenarios written, video, role play activities Descriptions of health professions Guidance for using the Tool Kit in education and practice The IPA Tool Kit includes the following components Information about the construct of interprofessional professionalism (IPP) The Interprofessional Professionalism Assessment (IPA) and its development and pilot study results Case scenarios for applying the IPA instrument and activities to foster IPP Descriptions of health professions Guidance for faculty and practitioners to use the components of the Tool Kit in education and practice Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 IPA Instrument Defines 6 categories consistent with the IPP construct (altruism and caring, excellence, ethics, respect, communication, accountability) 26-item instrument based on observable behaviors 5-point Likert response format from SD to SA with N/O (No opportunity to observe in this environment) Comments available for each category 2 global summary questions for IPP strengths and areas for improvement A quick overview of the pilot instrument includes the following components. 6 categories are defined based on the definition of IPP. Each defined category has at least 4 well-defined observable behaviors that can be rated. Raters score these observable behaviors based on a 5-point Likert scale from SD to SA. Note that there is a rating with no opportunity to observe in this environment. Raters may comment on each category of behaviors and there are two global summary questions regarding overall IPP strengths and areas for improvement. Property of the Interprofessional Professionalism Collaborative (IPC)
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Examples of IPA Behaviors
Combined Sections Meeting 2017 5/19/2018 Examples of IPA Behaviors Altruism and Caring Places patient/client needs above own needs and those of other health professionals. Excellence Contributes to decisions about patient care regardless of hierarchy/profession-based boundaries. Ethics Reports or addresses unprofessional and unethical behaviors when working with members of other health professions. Some of the categories for these behaviors overlap with those of the IPEC core values, although these were developed separately from IPEC’s core values (communication, respect, values and ethics, team-based care). Note how these behaviors reflect an interprofessional orientation and address team behaviors associated with professionalism rather than individual health professions. Property of the Interprofessional Professionalism Collaborative (IPC)
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More Examples of IPA Behaviors
Combined Sections Meeting 2017 5/19/2018 More Examples of IPA Behaviors Respect Demonstrates confidence, without arrogance, while working with members of other health professions. Communication Communicates with members of other health professions in a way they can understand, without using profession-specific jargon. Accountability Accepts consequences for his or her actions without redirecting blame to members of other health professions. As you review these behaviors, note that in some cases our current health care team structure may or may not be demonstrating some of these behaviors consistently in collaborative team-based care. To effectively observe these behaviors in students in their final year prior to graduation, may be congruent with other cultural changes occurring in the health care environment associated with Triple Aim and implementation of the IPEC core competencies. Property of the Interprofessional Professionalism Collaborative (IPC)
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Interprofessional Assessment Development
Combined Sections Meeting 2017 5/19/2018 Interprofessional Assessment Development Literature Review Defined IPP Construct National Presentations with Online Survey 2010 Content Expert Review with Draft IPA Cognitive Interviews “Typical” Preceptors IPA Pilot Study IPA Dissemination Tool Kit The IPA has been in development for 10 years. – IPC formed, conducted a literature review , developed the construct of Interprofessional Professionalism (IPP), and identified more than 200 behaviors across 8 domains of interprofessional professionalism – IPC gathered input from members of IPC participating professions through focused discussions at conferences, a wiki page, and an online survey. IPC further honed and reduced the number of behaviors and domains 2010 – Draft IPA underwent a content expert review proves with a panel consisting of experts in interprofessional education and practice across health professions – IPC conducted cognitive interviews with typical preceptors to assess if the behaviors were clear/understood, observable, and aligned appropriately with the domains. Final refinements made resulting in 26 behaviors and 6 domains – The IPA was piloted with multiple academic and practice institutions across several health professions. – Results of the Pilot Study are being disseminated along with information about the development of an IPP Tool Kit to aid educators and practitioners in teaching the construct of IPP and using the IPA tool. Property of the Interprofessional Professionalism Collaborative (IPC)
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National Academies of Practice
April 8, 2016 Participation in Pilot Study by Audiology and Speech-Language Pathology 9 institutions participating 7 institutions with SLP programs 3 institutions with AuD programs 7 additional institutions obtained IRB but did not participate in the study 233 total pilot study respondents 23 from SLP (4th most responses behind OT [67], PT [44], Pharmacy [42]) 1 from Audiology Representation on the IPC Survey and session participation 2010 Content expert review panel Cognitive interviews – preceptors IPA Pilot Study 2016 Dissemination Property of the Interprofessional Professionalism Collaborative (IPC)
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IPA Pilot Study Results
Combined Sections Meeting 2017 5/19/2018 IPA Pilot Study Results Based on n = 233 preceptor respondents: Preceptors frequently reported no opportunity to observe (N/O) for several of the ethics and account-ability items. Conducted an exploratory factor analysis of behaviors with high item response rates and obtained a predicted 4-factor solution: altruism and caring; communication; respect; and excellence these four subscales had high reliability coefficients, >0.9 Pilot study results Sufficient responses for analysis were obtained for 4 of the 6 domains. Those results indicated a high reliability coefficient of > 0.9. Altruism and caring Communication Respect Excellence Preceptors frequently reported “no opportunity to observe” for several of the ethics and accountability items. Those domains are retained in the IPA as Values & Ethics and Roles & Responsibility are two of the domains for the IPEC core competencies indicating that their development are important to observe and assess. Property of the Interprofessional Professionalism Collaborative (IPC)
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National Academies of Practice
April 8, 2016 Factor Correlations *p<.05 Oblique Rotation (simple structure) – provide both factor pattern and factor structure matrices; factors are permitted to be correlated with one another in this output. Factor structure correlation between variables and the factors The factor pattern matrix contain the coefficients for the linear combination of the variables. Can see that these factors are highly correlated at the p < .05 level Because these four were statistically significant, we know that what we are testing (e.g., altruism and caring behavior) is truly characteristic of altruism and caring. The behaviors are weighting/loading on the expected domain. Following oblique rotation (GEOMIN) Property of the Interprofessional Professionalism Collaborative (IPC)
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Benefits of IPA Instrument
Combined Sections Meeting 2017 5/19/2018 Benefits of IPA Instrument Measures IPP construct through observable behaviors in practice situations. Piloted with different health professions, students, and preceptors from across the US; involves academic institutions with IPE and practice settings engaged in collaborative practice. Can be used to connect higher education and practice environments, and quality care, safety, and individual/family-centered care. May impact how students and practitioners are educated and assessed with respect to IPP. Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Where Can I Learn More? To learn more about the IPA and pilot study Holtman M, Frost JS, Hammer DP, McGuinn K, Nunez LM. Interprofessional professionalism: Linking professionalism and interprofessional care. Journal of Interprofessional Care : 25: Hammer D, Anderson MB, Brunson WD, Grus C, et al. Defining and Measuring Construct of Interprofessional Professionalism. Journal of Allied Health. Summer 2012; 41(2):e49-e53. Two articles have been published on the construct of interprofessional professionalism as noted above. Please visit the IPC website where you can learn more about the ongoing work of the Interprofessional Professionalism Collaborative. We will continue to update the website with the status of the IPC’s work, dissemination, and resource development. Property of the Interprofessional Professionalism Collaborative (IPC)
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Interactive Session Case vignette Small group discussion
Plenary discussion
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Combined Sections Meeting 2017
5/19/2018 School-based case vignette CASE VIGNETTE I Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 CASE VIGNETTE II Adult health care case vignette Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 CASE VIGNETTE III Public health case vignette Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 Interprofessional Professionalism Domain Definitions (Handout) Ethics: Consideration of a social, religious, or civil code of behavior in the moral fitness of a decision of course of action, especially those of a particular group, profession, or individual, as these apply to every day delivery of care. Respect: “Demonstrate regard for another person with esteem, deference and dignity personal commitment to honor other peoples' choices and rights regarding themselves includes a sensitivity and responsiveness to a person's culture, gender, age and disabilities the essence of humanism signals the recognition of the worth of the individual human being and his or her belief and value system.” (Arnold and Stern in Stern, 2006) Excellence: Adherence to, exceeds, or adapts best practices to provide the highest quality care. Accountability: Accept the responsibility for the diverse roles, obligations, and actions, including self-regulations and other behaviors that positively influence patient and client outcomes, the profession, and the health needs of society. Altruism and Caring: Overt behavior that reflects concern, empathy, and consideration for the needs, values, welfare, and well-being of others and assumes the responsibility of placing the needs of the patients or client ahead of the professional interest. Communication: Impart or interchange of thoughts, opinions or information by speech, writing, or signs; “the means through which professional behavior is enacted.” (Arnold and Stern in Stern ) Property of the Interprofessional Professionalism Collaborative (IPC)
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National Academies of Practice
April 8, 2016 Small Group Discussion Using the IPA instrument and definition of the attributes provided, what did you note about the team with respect to interprofessional professionalism domains and behaviors? What is the team doing well? What could the team improve upon? Property of the Interprofessional Professionalism Collaborative (IPC)
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National Academies of Practice
April 8, 2016 Plenary Session Evaluating the IPA for Education and Practice Given your discussion of the IPA how might you use it in education, practice and research with your learners? What recommendations do you have for the development of training materials to be made available as part of the IPP Tool Kit? Property of the Interprofessional Professionalism Collaborative (IPC)
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Combined Sections Meeting 2017
5/19/2018 CONTACT INFORMATION Web Property of the Interprofessional Professionalism Collaborative (IPC)
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