Presentation Overview
1.Interprofessionalism in healthcare2.Relevant learning theories and the
development of interprofessional e-cases
3.Design features of the e-case model currently in development at McGill university
4.The process of utilization
Interprofessional Practice
“The healthcare system is in need of reform…...improvements will come when health care providers work more effectively in teams and when they have the competencies to practice in increasingly accountable and technological environments.” (Stephenson, 2002)
Interprofessionalism in Healthcare
Gaps and Overlaps
Gaps:
Can impact on safety and quality of care
Overlaps or redundancies:
Can impact on access, efficient use of resources and consistencies among professionals
Interprofessionalism in Healthcare
Interprofessional Practice
“Health professionals must work interdependently in carrying out their roles and responsibilities….with an appreciation of each professions unique contributions to health care.” (O’Neil and the Pew Health Professions Commission, 1998)
Interprofessionalism in Healthcare
Professionalism in the Current Clinical Setting
Uni - professional socialization has already occurred
Competencies and expertise are defined and in use
Professional boundaries have generally been determined and refinedInterprofessionalism in Healthcare
Interprofessionalism in the Clinical Setting
Attitudes & Perceptions – Building Trust and Respect
Skills & Areas of Expertise – Redefining Boundaries
Interprofessionalism in Healthcare
Knowledge – Transfer & Sharing
Practitioners, learners, patients, their families & the environment
Interprofessionalism in the Clinical Setting
Interprofessionalism in Healthcare
Develop common, complementary and collaborative competencies
Theoretical Framework
Learning Theories
1.Adult learning: Autonomous, active and self-directed
Motivated by the relevant and the practical
2. Professional socialization; Domain specific knowledge
Reflective practice
Zones of proximal development
Learning Theories
3.Communities of learning and practice Cooperative learning within a
collaborative environment
Situated and experiential learning4. Cognitive Apprenticeship
Knowledge transfer
Modeling
Coaching, scaffolding, fading and reflection
Theoretical Framework
Interprofessional e-Cases
Learning Theories & Design Features
1. Approximate actual situations in which interprofessional teams practice within a ‘real-life’, clinically meaningful
environment (D’Eon. 2005)
2. Be sufficiently complex that they cannot be done alone, thus reinforcing collaborative competencies (Steinert, 2005)
3. Allow participants to move towards interdependent collaboration using the case scenario to accent teamwork, communication and enriched quality of
patient and family care (Barr, 2005)
Design Features
e-Case Model in Development at McGill
1. Flexibility The case scenario allows the team determine
who leads each case and which professionals are included
2. Virtual but ‘real’ environment Realistic and meaningful environment Multimedia (including audio and video) Hyperlinks, prompts and access to teaching
modules Ability to archive, reuse and repurpose
3. Teaching & Learning Access to expert summaries and rationales
Design Features
e-Case Model in Development at McGill
4. Initial uniprofessional approach Highlight existing attitudes and perceptions Reinforces unique professional knowledge Permits sequencing
5. Integration of individual care plans into an interprofessional care plan or ‘blueprint’
Highlights group dynamic
6. Synthesis Identification of gaps and overlaps
3. Integrated Interprofessional Care Plan Review of the e-case computer generated ‘Blueprint’/interprofessional care plan
Group analysis of gaps and overlaps
Group revision to interprofessional care plan
Refine action items, mandates and outcomes measures (to determine efficacy)
Delegate roles and responsibilities & support
Formalize care plan as an ongoing document
4. Summary & EvaluationEvaluation of patient and professional progress
Treatment, post treatment, discharge planning and follow-up
Outcome measurement & efficacy review Plan archived for patient and student education
1. Presentation of Clinical Scenario Presentation of e-case
Group discussion about the professions and case leader(s) required for the specific case scenario with associated rationales
Review of professional perceptions, attitudes and beliefs specific to the case scenario
Initial uni-professional assessment, determination of action items, rationales, timeframes & sequencing
2. Group Discussion Formalization of the initial interprofessional group, (professions and case leader)
Interprofessional meeting(s) to review uniprofessional care plans
Inclusion of the patient’s voice
Assignment of roles and responsibilities
Input of uni-professional plans into the computer model for the e-case ‘Blueprint’
The Process for e-Case Development: Clinical Setting
The Process for e-Case Development: Academic Setting
1. Presentation of the Case to the LearnersSmall uni-professional student groups study the e-case scenario
Each group develops a uniprofessional care plan
2. Roundtable Students participate in an interprofessional group to review the case. For each group:
a) A case leader(s) is chosen
b) Uniprofessional care plans & rationales are reviewed & integrated into interprofessional care plan c) The e-case generates an interprofessional blueprint
3. Evaluation Students access, review & compare:
a. The uniprofessional ‘expert’ care plan and rationales with their own
b. The interprofessional ‘expert’ care plans and rationales with their own
Nancy [email protected]
Moving toward the Development of Interprofessional E-Cases