1. 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)

2. 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)

3. 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

4. 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

5. 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
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6. 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)

7. 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)

8. 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

9. 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.
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10. 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.
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11. 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
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12. 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
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13. 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)

14. 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
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15. 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
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16. 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.
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17. 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.
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18. 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.
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19. 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.
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20. 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
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21. 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.
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22. 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)
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23. 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)

24. 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.
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25. Interactive Session Case vignette Small group discussion
Plenary discussion

26. Combined Sections Meeting 2017
5/19/2018
School-based case vignette
CASE VIGNETTE I
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27. Combined Sections Meeting 2017
5/19/2018
CASE VIGNETTE II
Adult health care case vignette
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28. Combined Sections Meeting 2017
5/19/2018
CASE VIGNETTE III
Public health case vignette
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29. 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 )
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30. 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)

31. 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)

32. Combined Sections Meeting 2017
5/19/2018
CONTACT INFORMATION
Web
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