1. Multiprofessional medical education Experience and future development at KAROLINSKA INSTITUTE, Stockholm Sweden Anna Kiessling, MD Head at Centre for Clinical Education Danderyd University Hospital

2. Why interprofessional teamwork? Paradigm shift in clinical care Results in more comprehensive and ”sensible” clinical desicions Results in mutual learning

3. Kiessling A, Participatory learning – a swedish perspective. Heart (2004)

4. “The KI history of Interprofessional Education” 1997 - Merge of Karolinska Institute and the former Stockholm College of Health Sciences 1998-2001 - “The Centre of Clinical Education project” at the four major hospitals with clinical education in Stockholm 2002 Centre of Clinical Education become permanent units at all four hospitals

5. Aims To bridge professional borders - aiming at an interdisciplinary view of clinical education To co-ordinate undergraduate studies and clinical reality To combine education in primary and secondary care To further integrate theoretical and practical knowledge

6. Cornerstones Clinical Education Ward (or Educational Open Clinic) -learning by working together Clinical Training Centre -specially equipped unit for training of manual, communication and collaboration skills Faculty for interprofessional teaching -provide meeting and creative energy to create an interdisciplinary view of clinical education

7. Danderyd University Hospital Karolinska Institute CEW CTC Medical library Unit for health care development Sophiahemmet University College of Nursing CCE CPR and ACLS Interprofessional faculty Director of studies for assistant physicians Coordinator for student work placement in the hospital Primary Care

9. Orthopedic ward Routine clinical setting Eight patients Six to seven students Two teams Two week rotation Tutors from all programmes CEW

10. The students´object To care independently for the patients´ medical treatment, nursing and rehabilitation To develop professional competence To increase knowledge of other professionals´ competence To practice communication and teamwork

11. Individual professional identity (Median before and after training period unclear - clear, 0 - 10) Spring 2004

12. Individual competence in communication and teamwork Median before and after training period (0-10; low extent-high extent) Spring 2004

13. Student comments ”It´s been great with own responsibility and problembased learning” ”Very rewarding! It strengthens my wish to become a nurse. I made the right decision!” ”It´s so important to co-ordinate the work with the patient and with other professionals and to have the same goals” ”Communication. How difficult it can be and how wonderful it can be when it works” ”Trust other professions´ competences!”

14. Student comments ”Early mobilisation is very important!” ”It has been unbelievable pleasant, fun, instructive, messy and sometimes stressful. Great to work with other professions” ”I learned a lot about other professions and realized that we complement each other very well. We became true friends” ”I felt like a real doctor for the first time” ”I dared to be responsible” ”I got an increased self confidence”

17. Key notes in interprofessional teamwork Language Knowledge Communication Aim

19. Conclusion Learning by working together is an efficient method to increase collaborative and professional competence

20. Future trends at KI Interprofessional education and teambuilding for tutors in the work place To reach a balance between: Competence separation Competence integration