1. Interprofessional learning and teaching in evidence-based practice
Arlene Smaldone, PhD, RN

2. Interprofessional Education

3. Interdependence of health professions’ education and practice needs

4. Learning within professional silos

5. Interprofessional teamwork, an IOM Core Competency

6. Teaching and learning evidence-based practice skills
2007 IOM convened Roundtable on Evidence Based Medicine
To help transform the way evidence on clinical effectiveness is generated and used to improve health and health care
Goal – by 2020, 90% of clinical decisions will be supported by accurate, timely and up to date clinical information reflecting best available evidence
Institute of Medicine (US). Evidence-Based Medicine and the Changing Nature of Healthcare: 2007 IOM Annual Meeting Summary. Washington (DC): National Academies Press; Appendix C

7. Evidence-based practice is ideal for interprofessional education approach
Content and skills consistent across disciplines
Good practice for professional environment

8. EBP Education has been well studied
Synthesis of 16 systematic reviews that examined effects of teaching evidence based health care (Young et al. 2014, PLOS ONE)
10 SRs: Undergraduate and postgraduate
6 SRs: Postgraduate and continuing professional development
Only 6 studies examined interprofessional EBP education

9. Interprofessional EBP studies
6 studies (1998 and 2014)
Canada, UK, Hong Kong
Variety of study designs
All reported attendees from ≥2 disciplines
None reported EBP faculty by discipline
Program intensity
Most one day or less

10. Interprofessional EBP content
Formulating PICO questions (2)
Searching the literature (3)
Critical appraisal skills (3)
Appraisal of systematic reviews (1)
Apply evidence to decision-making (1)
Identify strategies to implement evidence in local context (1)

11. Training programs in EBP
Focus on a narrow spectrum of knowledge and skills
Curriculum related to development, implementation and evaluation of evidence based clinical practices and policies and their implementation in clinical settings is often omitted
Most EBP education delivered in discipline specific silos
Few utilize interprofessional education approaches
Of these, most examined only immediate outcomes
Only one study examined longer term outcomes at 6 months
Knowledge and EBP core skill retention
No change in decision-making behaviors

12. Teaching Evidence Assimilation for Collaborative Health Care
Unusual regarding
Broad scope
Level 1: acquisition of EBP skills with focus on care of individual patients
Level 2: how EBP skills are applied to development of national policies and learn how to adapt for use in local settings
Level 3: knowledge translation to maximize value of research in system wide improvement initiatives
Interprofessional learning environment
Simulate the practice setting

13. TEACH: Interprofessional evolution over time
Data extracted from workshop registrations, small group enrollments, assigned tutors and plenary sessions by disciplines
2015 – added questions regarding interprofessional experience to workshop evaluation survey
Analyzed data
Descriptive statistics
Qualitative content analysis

14. TEACH participants *
*2009 Nurses and librarians included in “other”

15. Greater diversity in TEACH attendees over time
Year
Attendees
Other
Disciplines
2009
19.0%
Includes nurses and librarians
2010
6.0%
Researchers; medical and library science students
2011 82
18.3%
Researchers; medical student; Physical therapist; Pharmacist; Administrators; Epidemiologists
2012 45
24.4%
Researcher; medical student; Administrators; Epidemiologists; Dentist; Nutritionist; Social worker
2013 74
31.1%
Researchers; graduate students; Pharmacists; Administrators; Dentist; Nutritionist; Social worker
2014 59
28.8%
Researchers; Administrators; Nutritionist; Social worker; Genetic counselor; Physician assistants; Social worker

16. TEACH enrollment track by year (2009-2016)

17. TEACH small group facilitators (2009-2016)

18. TEACH Plenary Sessions (2009-2016)

19. 2015 what conference attendees said…..
While the majority of 2015 participants had received prior education in EBP, less than half had received this education with interdisciplinary educators (35%) or with attendees from other professions (45%)
Majority reported improved knowledge (94%), competence (90%) and performance (90%) as a result of TEACH participation
What attendees reported liking best
“the interdisciplinary interaction and ideas shared”
“problem focused, patient-centered and multidisciplinary…”

20. Conclusions Interprofessional EBP education not common
Having participants and faculty from several disciplines doesn’t make education interprofessional
Environment conducive to sharing of perspectives and mutual trust
Acquisition of skills doesn’t guarantee implementation of evidence into practice

21. What you should expect

22. Implementation of projects sparked during TEACH
Location
Type
Project Leader
Project Type
Outcomes 1
NYC
Community hospital
Clinical leadership
Reducing heart failure readmission
Initiated protocol; heart failure readmission reduced in year 1 2
Canada
Pediatric diabetes care
Pediatric sepsis
Emergency care protocols
Protocols developed and disseminated 3
Philadelphia
Academic medial center
Nursing (CNS)
CAUTI

23. What will your long term outcomes be?