An Overview of IPL in MedicineTien K Khoo

MRCP(UK), PhD

Griffith University IPL framework

• 3-phase implementation– Phase 1 (Y1)

• Introduction to health professions

– Phase 2 (Y2-Y4)• Simulated professional

team experience

– Phase 3 (Y4)• Real service professional

team experience

MBBS/ MDYEAR PHASE ACTIVITY Compulsory

activity (Yes/No) EvaluationAssessed activity

(Yes/No)PARTICIPANTS

2013 1 Health Professional Literacy Yes Yes No 159

2 Advanced Communication Skills Yes Yes No 151

2 CLEIMS 3 Yes Yes Yes 1462 CLEIMS 4 Yes Yes Yes 153

3Chronic Disease Wellness Program (Robina Health

Precinct)No Yes Yes 4

2014 1 Health Professional Literacy Yes Yes No 151

2Advanced Communication

Skills Yes Yes No 1512

Neuropsych Workshop Yes Yes No 85

2Mental Health Practice

Workshop No Yes No 2

2 CLEIMS 3 Yes Yes Yes (151)2 CLEIMS 4 Yes Yes Yes 143

Phase 1: PBL• Y1-2 MBBS/ MD degree• PBL: Learning objectives

A 70 year old widow, fractured neck of femur, post-operative delirium with ongoing cognitive decline.

“Describe the roles, practices and expertise of effective members of each of the other major health professions, in this case focusing on psychologists” “Describe the support services available for individuals with a dementing illness, and their carers”

Phase 2 - CLEIMS • Clinical Learning through Extended Immersion in

Medical Simulation (CLEIMS)• Extended simulated patient care experience over

a week and are joined at realistic points in the story by students from other professions.

• Narrative contrivances and guided reflection to enhance fulfilment of interprofessional learning outcomes

• Year 3: One patient• Year 4: Eight patients

BMC Med Educ 2014; 14:90

Phase 2: CLEIMS

• Expectations & objectives need to be outlined

• Guidance required; combination of resource sessions (didactic seminars and skills workshops)

• Alignment of student professions crucial (incl level of study)

• Test-retest useful to reinforce learning

Phase 3: Chronic Disease Wellness Program

• 2013 pilot project - Y4 elective/ selective placements

• Robina Health Precinct; outpatient facility primarily catering for chronic diseases (COPD, diabetes, renal failure, heart failure) and rehabilitation (stroke, MS, orthopaedic).

• 2 students per placement embedded into specific multidisciplinary teams with a focus on interprofessional practice

Phase 1-3: Reflective journals• Reflective journals• Modified Krathwohl scale

Phase 3: Chronic Disease Wellness Program

IPE through e-learning• Health Challenges for the 21st Century (PBH1205), School of

Public Health/ Medicine– 10 CP, part of Foundation Course

• 15% IPL Quiz based on e-learning module of half-interviews on 18 health professions.

• Two sets of MCQ; 20 questions• Formative MCQ completed prior videos & summative MCQ.• 2nd assessment = marked component

• Also part of Communication Skills for Oral Health (DOH1008) course, School of Dentistry– 5 CP

IPE through e-learning

• Example MCQ:There is a change in weather and Belinda’s asthma flares up. She has been using her current

medication but it is not helping. Which health professional listed below would be most appropriate for Belinda to consult in order to get advice on her asthma situation and more appropriate treatment?

A) A pharmacist to change Belinda’s regular prescription to a stronger prescribed medicine that gives her better asthma relief

B) A radiographer to capture x-ray images of her lungs to rule out the changes are not related to a lung infection and provide a referral to a medical specialist for treatment.

C) An asthma nurse practitioner, a specialist nurse trained to assess asthma and to prescribe medication for asthma

D) A social worker to advise Belinda on available financial support for asthma treatment and provide an asthma action plan.

E) An occupational therapist to advise Belinda how to change her home environment to reduce stimuli that will exacerbate her asthma and prescribe an appropriate alternative medicine.

IPE through e-learning• PBH(MED)1205: Data analysis in progress– 336 students who participated in 2013– 287 (85.4%) complete data sets

Survey of IPE e-learning packagePOSITIVE•What was good about the online package?– Able to access anywhere– Can do it on my own time– Really outlined well a lot of health professionals– Clear and easy to follow– Entertaining video-aided learning– Allowed me to go over what was said in lectures– Helped me learn about different roles– Concise

Survey of IPE e-learning packageNEGATIVE•What was bad about the online package?– Dependent on internet activity– Didn’t always load properly– Detail was a bit unclear– Some questions were too broad and ambiguous– A lot of information to take in

Survey of IPL lectures (PBH1205)POSITIVES•What was good about IPL lectures?– Provided insight– Professional lecturers– Building knowledge and skills on health professionals;

more interesting then previous topics– Multiple viewpoints– Very interactive and personalised, much more

effective than normal

Survey of IPL lectures (PBH1205)NEGATIVES•What was bad about IPL lectures?– Not too much, most what they taught was

common knowledge– Didn’t attend

Financial optimisation• Example: CLEIMS Y4 (School of Medicine) Cost

of hardware, consumables, academic staff, facilitators, simulated patients; AUD$31,000/ run

• 4 runs per year = $124,000/ year– cost per medical student/ year = ~$827– Following IPE ‘buy-in’ from other schools;

dietetics, pharmacy, physiotherapy/ exercise physiology;• Cost per health school student/ year = ~$460*

*based on per student participation

45% cost impact

Challenges• Readiness to change – Program level

• Readiness to engage – Individual level

• Resources

• Incentives for change– “How do you raise the need for change within your

institution?”– “What will you be saying to your head of school/ dean/

PVC/ director?

Acknowledgement

• ALL COLLEAGUES involved at the School of Medicine, especially;– CLEIMS team– Communication skills team– PBL team (incl facilitators)– Health IDEAS– Pit Chan, Fiona Ellem & Gary

Rogers