FIRST SYMPOSIUM FOR INTERPROFESSIONAL EDUCATION IN AFRICA

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FIRST SYMPOSIUM FOR INTERPROFESSIONAL EDUCATION IN AFRICA.

Africa Interprofessional Education Network (AfrIPEN) University of Namibia, Windhoek, Namibia

21-22 SEPTEMBER 2017

SYMPOSIUM PRESENTATIONS

www.afripen.org

http://www.afripen.org/

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PLENARY PRESENTATIONS

A-01 All together better health: Building strong partnerships for IPE

Prof John Gilbert (University of British Columbia & University of Dalhousie, Canada)

A-02 Capacity building for IPE and sharing educational resources

Prof Jill Thistlethwaite (University of Technology Sydney, Australia)

A-03 Organisational reform to facilitate IPECP (incl touching on policies)

Prof John Gilbert (University of British Columbia & University of Dalhousie, Canada)

ORAL PRESENTATIONS

B-01 Key influences to effective interprofessional collaborative child protection decision making and practice: social workers’ perceptions

Nhlanganiso Nyathi (Anglia Ruskin University, United Kingdom)

B-02 Interprofessional collaboration between speech-language and occupational therapy students in a low-resourced community

Maretha Bekker, Renata Mosca (University of Pretoria, South Africa)

B-03 The value of exposing students to Inter-Professional collaboration (IPC) activities at a community-based rehabilitation centre

Juanita Bester, Maatje Kloppers, Faeza Bardien-Salie, Liesbet Koornhof, Sue Statham(Stellenbosch University, South Africa)

B-04 A one year review of the impact of a rural Interprofessional Education collaborative platform on health professions student learning

René Botha, Annemarie Joubert, Dirk Hagemeister, Ms Heidi Morgan (University of the Free State, South Africa)

B-05 Reflections on implementing a community-based learning activity as part of an Interprofessional Education Programme at the University of Witwatersrand

Abigail Dreyer, Mpho Molete, Sonti Pilusa, Juliet Nyasulu, Gaolatlhe Mothoagae (University of Witswatersrand, South Africa)

B-06 How prepared are our students for IPE? Gérard Filies, Anthea Rhoda, José Frantz (University of the Western Cape, South Africa)

B-07 Health professional students’ readiness for Interprofessional Education at the University of the Witwatersrand

Gaolatlhe Mothoagae, Patricia McInerney, Shirra Moch (University of Witswatersrand, South Africa)

B-08 Designing interprofessional modules for undergraduate healthcare sciences’ students

Carin Maree, Pippa Bresser, Mable Kekana, Karien Mostert-Wentzel, Mariatha Yazbek, Lydia Engelbrecht, Christa Viviers (University of Pretoria, South Africa)

B-09 Lessons learnt from designing and implementing undergraduate interprofessional healthcare modules

Philippa Bresser, Carin Maree, Karien Mostert, Mable Kekana (University of Pretoria, South Africa)

B-10 Facilitators’ experiences regarding inter-professional education of third year health care science students at Sefako Makgatho University

Hanlie Pitout (Sefako Makgatho University, South Africa)

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POSTER PRESENTATIONS

C-01 The research process followed to assess the IPEP-value of activities students participate in at a community-based rehabilitation centre

Maatje Kloppers, Juanita Bester, Faeza Bardien-Salie, Liesbet Koornhof, Sue Statham (Stellenbosch University, South Africa)

C-02 Faculty development: A need for successful implementation of Interprofessional Education

Anthea Rhoda, Gerard Fielies, José Frantz, Firdouza Waggie (University of the Western Cape, South Africa)

C-03 Aligning graduate attributes with the interprofessional core competencies in an interdisciplinary health science faculty

José Franz, Nondwe Mlenzana, Nicolette Roman, Gerard Filies, Anthea Rhoda (University of the Western Cape, South Africa)

C-04 Exposing students to IPE experiences - thinking out of the box

Gerda Reitsma (North-West University)

C-05 How to use community primary care clinical placements as a medium for Inter-professional Education in Botswana

Mmoloki Molwantwa, Detlef Prozesky, Mpho Mogodi (University of Botswana)

C-06 The Collaborative Care Project Jana Muller (Stellenbosch University, South Africa)

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Surname First name Country Town Organisation / Institution Email address Mobile

Amalba Anthony Ghana Tamale University for Development Studies, School of Medicine and Health Sciences [email protected] '+233206940090

Angula Penehafo Namibia Oshakati University of Namibia [email protected] '+264812489408

Bekker Maretha South Africa Pretoria University of Pretoria [email protected] +27739467435

Bester Juanita South Africa Bellville Stellenbosch University [email protected] +27832344791

Boruett Norbert Kenya Nairobi Masinde Muliro University of Science and Technology [email protected] +254722774221

Botha René South Africa Bloemfontein University of the Free State (UFS) [email protected] +27833819695

Botma Yvonne South Africa Bloemfontein University of the Free State [email protected] +27845803427

Bresser Philippa South Africa Pretoria University of Pretoria [email protected] '+27835367033

Dreyer Abigail South Africa Parktown University of the Witwatersrand [email protected] +27740845481

Filies Gerard South Africa Cape Town UWC [email protected] '+27836925923

Frantz Jose South Africa Bellville University of the Western Cape [email protected] '+27716073404

Gathoo Kaashifa South Africa Parktown University of the Witwatersrand [email protected] +27732638578

Gilbert John Canada Vancouver University of British Columbia/Dalhousie University [email protected] '+16045621492

Hedimbi Marius Namibia Windhoek University of Namibia [email protected] '+264812534870

Khanyola Judy Kenya Nairobi ICAP at Columbia University [email protected] '+254700100692

Kloppers Maatje South Africa Bellville Stellenbosch University [email protected] +27741420077

Lukolo Linda Ndeshipandula Namibia Windhoek UNAM [email protected] '+264812742772

Maree Carin South Africa Pretoria University of Pretoria [email protected] +27832866696

Meyer Lindsay-Michelle South Africa Cape Town Stellenbosch University, Ukwanda CRH [email protected] '+27833915250

Molwantwa Mmoloki Botswana Gabarone University of Botswana [email protected] +26774096000

Mosca Renata South Africa Pretoria University of Pretoria [email protected] '+27742659085

Mothoagae Gaolatlhe South Africa Johannesburg Wits University [email protected] +27722631164

Muller Jana South Africa Worcester Stellenbosch University [email protected] '+27835041046

Nuuyoma Vistolina Namibia Keetmanshoop University of Namibia [email protected] '+264811275709

Nyathi Nhlanganiso United Kingdom Peterborough Anglia Ruskin University [email protected] '+447905000000

Pitout Hanlie South Africa Pretoria Sefako Makgatho Health Sciences University (SMU) [email protected] +27721710462

Reitsma Gerda South Africa Potchefstroom North-West University, Potchefstroom Campus [email protected] +27839900260

Rhoda Anthea South Africa Bellville University of the Western Cape [email protected] '+27827757748

Sibanda Bongi United Kingdom London Queen's University Belfast [email protected] '+4479040000000

Sibanda Lovemore Zimbabwe BULAWAYO HEALTHCARE [email protected] '+263774000000

Snyman Stefanus South Africa Cape Town Stellenbosch University [email protected] '+27825571056

Soko Grace Tahuna Malawi Lilongwe Christian Health Association of Malawi [email protected] +265991892941

Thistlethwaite Jill Australia Sydney University of Technology Sydney [email protected] '+61418629072

Waggie Firdouza South Africa Cape Town University of the Western Cape [email protected] +27827773568

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WHO/PAHO Collaborating Centre on Health Workforce Planning & Research

All Together Better Health: Building Strong Partnerships for IPE

First Symposium for Interprofessional Education in Africa21-22 September 2017 UNIVERSITY OF

NAMIBIA, WINDHOEK, NAMIBIA

John H. V. Gilbert, C.M., Ph.D., LLD., FCAHS

Senior Scholar, WHO Collaborating Centre on Health Workforce Planning & Research, Dalhousie University.

Professor Emeritus, University of British Columbia.

DR. TMA Pai Endowment Chair in Interprofessional Education & Practice, Manipal University.

Adjunct Professor, University of Technology, Sydney

Founding Chair, Canadian Interprofessional Health Collaborative

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A Framework for What?

Implementation of Integrated Health Workforce Strategies

Education System

Health System

Health WorkforcePlanning & Policymaking

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Framework IAn Intersectoral Policy Platform for the Education of Health Professionals

Develop a clear work plan.

Use a robust evaluation framework.

Fund equitably, and accountably.

Collaborate with all concerned parties.

Provide space and complete administrative support for the initiative.

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Framework IISome Critical Success Factors

Promote IPE/IPP/IPC as a key health workforce strategy at governmental, institutional and organizational levels.

Seek out, and encourage, strategic and innovative partnerships.

Facilitate new knowledge creation, exchange and application about IPE, IPP & IPC across all constituencies.

Share responsibility between actors and agencies.

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Collaborative Practice-Ready

Health Workforce

Optimal Health Services

Governancemodels

Structuredprotocols

Shared operatingresources

Shared decision-making processes

Supportivemanagement

practices

Facilities

Spacedesign

Personnelpolicies

Collaborative Practice

Communicationsstrategies Built

environment

Conflictresolution

policies

ENVIRONMENTAL MECHANISMS

INSTITUTIONAL SUPPORT MECHANISMS

WORKING CULTUREMECHANISMS

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Framework IIISome Procedures to Reach Objectives

Facilitate connections between important stakeholders.

Focus work in appropriate groups.

Establish networks to support multi-site research.

Use an IPE Competency Framework to develop a core for building IPP and IPC.

Create an active, virtual social network.

Support student led organizations.

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Framework IVCreating an Intersectoral IPE/IPP/IPC Policy Platform for Success

Engage, encourage, and reward the practice community.

Prioritize the wide range of complex activities associated with IPE/IPP/IPC.

Implement a clear business plan in order to ensure long-term sustainability.

Select strategic “homes” for start up and ongoing programs.

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Framework V: How we’ll get there

Adopt global definitions of IPE/IPP/IPC that encompasses every health and human service discipline. Leave no room for multiple interpretations.

Adopt a common set of principles to which every discipline can adhere.

Adopt one set of core competencies, regardless of discipline and geographic location.

Foster & build a strong research program.

Build IPE/IPP/IPC into accreditation programs.

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Present & Future Health

Workforce

Collaborative Practice-Ready

Health Workforce

Staff training

Champions

Institutionalsupport

Assessment

Learningoutcomes

Logistics &scheduling

Programmecontent

Compulsoryattendance

Contextuallearning

Adult learningprinciples

Sharedobjectives

Interprofessional Education

Managerialcommitment

EDUCATOR MECHANISMS

CURRICULAR MECHANISMS

Learningmethods

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Framework VI: Future Directions

Governments must recognize the importance of implementing meaningful interprofessional policies

Courses and projects specific to IPE/IPP/IPC should be offered in the workplace

Quality improvement approaches should be implemented to support IPE/IPP/IPC in enhancing practice, delivery of services and patient care

Practicing professionals should mentor students on IPE/IPP/IPC, and students should share their knowledge of IPE/IPP/IPC with mentors

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Develop IP leadership and planning groups

Build incentives for IP teaching/learning

Provide mechanisms for IP communication and coordination

Framework VII: Modify Structures to Support Collaboration

Answer the Question: What’s in it for me?

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FragmentedHealth System

Strengthened Health System

Remunerationmodels

Riskmanagement

Accreditation Regulation

Professionalregistration

Capitalplanning

FinancingCommissioning

Fundingstreams

Health & EducationSystems

HEALTH SERVICES DELIVERY MECHANISMS

PATIENT SAFETY MECHANISMS

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Framework VIII: Future Collaborative Opportunities

Competencies

Curricula

Assessment

Faculty Development

Accreditation

Research & Evaluation

Joint IPE/IPP/IPC E-Library

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IP Collaborative Strategies Practice Education (PE) An Old Idea - A Central Tenet?

“For the things we have to learn before we can do them, we learn by doing them.”

(Aristotle, Nicomachean Ethics (350 B.C.E))

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For a Framework to SucceedThe Major Lesson Learned

“Commit to sustain”

The Reality

The only cash flow is an institution’s cash flow, build on what exists

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Global IPE/IPP/IPC: Putting it together1997 All Together, Better Health, London, UK

2004 All Together, Better Health II, Vancouver, Canada

2006 All Together, Better Health III, London, UK

2007 Collaborating Across Borders I, Minneapolis, USA

2008 All Together, Better Health IV, Stockholm, Sweden

2009 Collaborating Across Borders II, Halifax, Canada

2010 All Together, Better Health V, Sydney, AUS

2011 Collaborating Across Borders III, Phoenix, USA.

2012 All Together Better Health VI, Kobe, Japan

2013 Collaborating Across Borders IV, Vancouver, Canada

2014 All Together Better Health, VII Pittsburgh, USA

2015 Collaborating Across Borders, V Roanoake, USA

2016 All Together Better Health, VIII, Oxford, USA

2017 Collaborating Across Borders VI Banff, Canada

Additional Regional meetings over the years in:SwedenFinlandNorwayDenmarkUnited KingdomAustraliaNew ZealandJapanSouth AfricaMiddle EastMalaysiaThailandIndiaand others

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Building a Framework Means

Sharing a Vision

“The best time to plant a tree is 20 years ago, the second best time is now.” (Proverb)

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Capacity building for IPE &

sharing educational resources

Professor Jill Thistlethwaite

Sydney, Australia

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Are we ready….????

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Capacity is…

The maximum amount that something can

contain

The amount that something can produce

Specific ability of an entity (person or

organisation) or resource, measured in

quantity and level of quality over an

extended period

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The tipping point could be

A major patient safety incident

New national champion

Change in accreditation standards

Change of organisational leadership

What is yours?

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When the tipping point is reached

Change is required

Need to consider capacity

Practice and education move together

Importance of faculty development

Resources required

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• Blue sky thinking for IPE…?

• Perhaps….but quicker to learn

from each other

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Design

thinking

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Education

&

Personal Professional Organisational

Community

Learners

Practice

&

Patients

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PERSONAL CAPACITY

Values and identity

Life experience

Resilience (?)

Commitment and motivation

Interpersonal skills

Leadership

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(INTER)PROFESSIONAL

Identity & abilities

(IP)practice and (IP)education experience

Hierarchies & collaborations

Networks

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Becoming/being

interprofessional

feelingthinking

doing values

Inspired by Hammick et al (2009)

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ORGANISATIONAL

Rationale for change – why now?

Governance & infrastructure

Workforce quantity and quality

Culture change

Faculty development – skilled facilitators

Teamwork & collaborative skills

Interprofessional ethos & processes

Logistics & resources

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ORGANISATION

Dedicated IPE unit?

How links to faculties and departments?

How to integrate…

IPE as a required component of the

curriculum

Similar processes and governance to other

learning/courses

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Champions!

From each profession

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COMMUNITY

Who/what is the community?

Awareness of stakeholders

Culture, beliefs & values

Learning opportunities & placements

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LEARNERS

Capacity to learn in crowded curricula

Numbers and mix

Equitable experiences

Timing

Serve as change agents?

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Education

Curricular space

Defined learning outcomes

Learning activities to meet outcomes

Reliable & valid assessment processes that

are FEASIBLE and have educational impact

Faculty recognised for IP work and research

Committees are interprofessional

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Networking

Coordination

Collaboration

Teamwork

Differing forms of interprofessional work (Reeves et

al, 2010, p 44)

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Changing a college curriculum is like

moving a graveyard--you never know how

many friends the dead have until you try to

move them!

Calvin Coolidge or Woodrow Wilson

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SPACE….

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PATIENTS

Shared decision making

Composition of healthcare team

Communication

Health literacy

Patient held records

‘No decision about me, without me’

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Vancouver declaration

Involve patients:

In curriculum design

As active educators

As assessors

As evaluators

As partners

In research

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TIPS

Avoid ignoring the dissenters – rather

engage

Embed IPE into existing courses/rotations

rather than adding extra - thread/spiral

through the curriculum

Not all students will have exactly the same

experiences – that is ok

Do not need to have all the professions

together every time

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Educational resources

In this open era – many available free

online

Scenarios

Faculty development activities

Context important

Authenticity important

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National Center for Interprofessional Practice

and Education

https://nexusipe.org



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Assessment

‘International consensus statement on the

assessment of interprofessional learning

outcomes’

Rogers G, Thistlethwaite JE et al. (2017)

Medical Teacher

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Collaborative Practice and Interprofessional Education

Transforming the Landscape of Healthcare - Ohomairangi te

Hauora Manaaki

All Together Better Health IX

Conference

in Auckland, New Zealand SAVE THE

DATE!

3-6 September

2018

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Organizational Reform to Facilitate IPECPFrom Practice to Policy - and Back Again: Doing things right, for the right reasons

First Symposium for Interprofessional Education in Africa21-22 September 2017 UNIVERSITY OF NAMIBIA, WINDHOEK, NAMIBIA

John H. V. Gilbert, C.M., Ph.D., LLD., FCAHS

Senior Scholar, WHO Collaborating Centre on Health Workforce Planning & Research, Dalhousie University.

Professor Emeritus, University of British Columbia.

DR. TMA Pai Endowment Chair in Interprofessional Education & Practice, Manipal University.

Adjunct Professor, University of Technology, Sydney

Founding Chair, Canadian Interprofessional Health Collaborative

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Today’s Meta-narrative

• The Issue

•Key Principles of Policy Making

• Strategies for Implementing Policies

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The Curricular Conundrum

“Changing a college curriculum is like moving a graveyard

- you never know how many friends the dead have until you try to move them”

Attributed to Calvin Coolidge

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Policy: A definition

Policy is a decision-making framework, or course of action, to achieve a desired effect or change.

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The Fundamentals of Policy Making

It’s All About

Regulation & Legislation

Policy is Politics

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Policy MakingAlways Knight’s Move

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Key Principles of Policy Making 1

• Policy doesn’t follow a linear pathway.

• Policy is a battle among various actors who want to please distinct constituencies.

• Policy disputes include struggles about the relative influence of all the interested parties.

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• Policies are maintained by policy monopolies/networks

• Policy monopolies/networks include a diverse set of actors

• Conflict plays out in stalemate that allows only incremental reforms in the policy area.

• Efforts at reform launched from outside these networks are usually easily ignored.

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• Opportunities for policy reform, occur on schedules that only sometimes line up with the development of the problem trying to be solved.

• Changes in politics, policy, or problems can create an “open window”, but the key element to focus on is the possible reconfiguration of a policy monopoly.

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• Policies reflect, and then shape, dominant social constructs.

• By indicating that certain actors as “worthy”, organizations legitimize political and social action on their behalf; more important, it enables those actors to mobilize on their own behalf.

• The worthy are frequently the ones with the most money and the longest history

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The Communication Problem of Policy Making

The struggle to be heard takes precedence

over the accuracy of what is being said.

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Policy Making - An Old Idea

“For the things we have to learn before we can do them, we learn by doing them.” (Aristotle, Nicomachean Ethics (350 B.C.E))

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Preparation:

Prepare well for changing policies.

Planning:

Plan carefully for policy change.

Strategies for Implementing Policies 1

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Personal contact:

Establish and maintain contact with those who influence or make policy.

Pulse of the community:

Take the pulse of the community of interest to understand what colleagues will support, what they will resist, and how they can be persuaded.

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Positivism:

Where you can, choose tactics that emphasize the positive.

Participation:

Involve as many people as possible in strategic planning and action.

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Publicity:

Use the media, the Internet, your connections, and your imagination to keep colleagues informed of the effort and the issues, and to keep a high profile.

Persistence:

Policy change can take a long time.

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From Principles to Implementing

With all the technology in the world – remembercheese cake making must come before cheese cake distribution.

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� Articulate the issues

� Consult

� Mediate

� Compromise

� Agree

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“And it ought to be remembered that there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. Because the innovator has for enemies all those who have done well under the old conditions, lukewarm defenders in those who may do well under the new”

Niccolò Machiavelli (1532), The Prince

Organizational Reform: “The more things change, the more they stay the same”

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Making change is like riding a bicycle

if you stop peddling you will fall off.

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Organizational Reform– The Policy Reality

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Key influences to effective interprofessional child protection decision making and practice: social workers’ perceptions

Dr Nhlanganiso Nyathi

Senior Lecturer and Course Leader

[email protected]

Cambridge | Chelmsford

London | Peterborough

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What this presentation aims to achieve:

1.To share research findings on key influences to effective interprofessional

collaborative child protection decision making and practice

2.To draw links between interprofessional collaboration and interprofessional

education.

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What the background and context of the study was:

Failings in collaborative working between professionals and families – since Maria Colwell 1973

inquiry.

Lack of conceptual clarity about the collaborative approach.

Lead social worker statutory role the collaborative approach.

Ongoing social work reforms.

Personal inspiration

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What the aim of the study was:• To explore social work practitioners’ knowledge and understanding of the

interprofessional collaborative child protection decision making and practice.

• To inform new directions for child protection practice and training, the lead social

worker role, and ongoing social work policy reforms.

What the research questions were:1. What factors do social workers perceive as key to effective interprofessional

collaborative child protection practice?

2. How do social workers perceive decision making during interprofessional collaborative

child protection practice?

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Who the key contributors to existing literature are:

• Serious case reviews and the triennial analysis of serious case reviews in 2011-2014 (Sidebotham

et al, 2016)

• Models, impact and influences of multi-agency working (Atkinson, Jones and Lamont, 2007)

• Literature information sharing (Frost and Robinson, 2007)

• The relationship between the external environmental and other strategic influences (Anning et

al, 2010)

• Importance of trust, clear vision and aims, multi-level vision and goals - from meta-level;

individual agency goals to individual professional goals; collaborative advantage and meta-

strategy (Huxham, 1993; Huxham and Vangen, 2003; Vangen and Huxham, 2006)

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Collaborative partnership working between professionals and family members:

• The experience of family members involved child protection (Smithson and Gibson, 2016)

• Family members’ participation in the child protection system (Healy, Darlington and Yellowlees, 2012)

• Professionals’ use of power (Dunbrill, 2011)

• Relationship between professionals and family members (Healy and Darlington, (2009)

• Working with aggressive and violent family members (Ferguson, 2005; Littlechild, 1997; 2005; Neil,

2014; Stanley and Goddard, 2002)

Whole family focus (Featherstone, White and Morris, 2013; 2014; Morris, 2013; Falkov, 2013)

Needs and voice of the child (Archard and Skiveness, 2009; Allnock and Miller, 2013)

Involvement of fathers (Brandon, 2012; Featherstone, 2003; Ferguson, 2016; Scourfield, 2003; 2014)

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Lead social worker influences (McCray, 2010; Pawson et al, 2003; Sidebotham, et al, 2016; Trevithick, 2008)

External factors (Smith and Mogro-Wilson, 2007; Mattessich, Murray-Close and Monsey, 2001; Munro, 2005;

2011)

Decision making influences (Horwath and Morrison, 2004; 2007; Horwath, 2013; Broadhurst et al, 2010;

Stalker, 2015; Parton, 1998; Titterton, 2005; Goddard et al, 1999; White, 2009)

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What conceptual framework(s) the study drew from:

Combined elements of two systems models:

Social Care Institute for Excellence (SCIE) learning together systems model (SCIE, 2012)

• used to identify factors in the work environment that support good practice, and those that

create unsafe conditions in which poor safeguarding practice is more likely to occur.

Falkov’s systemic family focussed model (Falkov, 2012) helps to understand the processes that underlie and

influence how:

• Adult/parental mental health illness affects children mental health and development,

• Adult/parental mental health illness can affect parenting and parent-child/family relationships,

• Parenting and parenting and parent-child/family relationships can influence adult/parental

mental health illness,

• Children’s mental health and development needs can influence adult/parental mental health

illness,

[Model influenced SCIE’s working together strategy: Think Child, Think Parent, Think Family: A Guide

to Parental Mental Health and Child Welfare].

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How the study was designed:• Constructivist-interpretivist qualitative research design adopted in order to interpret and understand meanings

of social workers’ constructed perceptions

• Research methods involved - semi-structured interviews with social workers (16) and direct, non-participant,

observations of child protection meetings (20)

• Both samples were purposively selected through a saturation to enhance rigour and trustworthiness in this study

(Brown, et al, 2006; Lincoln and Guba, 1985; Shenton, 2004).

• Research ethics approval granted by a Local Authority Ethics Governance Research Committee

• Data analysis – interpretive descriptive thematic analysis (Bazeley, 2013; Sandelowski, 2000; Thorne, Reimer

Kirkham, and O’Flynn-Magee, 2004).

• Triangulation protocol used to compare findings for convergence/divergence and enable rigor and

trustworthiness

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What the study found:1. Four broad influences to collaboration were identified, namely;

• Multi-level relationship influences – professionals, lead social workers and family members

• Multi-level organisational influences - professionals, lead social workers and family members

• External influences - multiple

• Decision-making - discretional intuitive multiple professional judgements and decision making

criteria

2. Centrality and predominance of relationship influences established

3. Barriers and enablers of each of the influences which can be systematically identified

5. Evidence of overlapping systemic interaction between various influences

6. Influences can be systematically identified and systemically understood [see the visual unified

conceptual model next slide] .

Overall convergence of interview and observation findings

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A conceptual model for interprofessional collaboration

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What participants said about

multi-level relationship

influences: Communication and information sharing

‘being open and honest’ (SW15); ‘working

together in an open and in a transparent

manner’(SW15)

Relationships between professionals, lead

social worker and family members:

‘other professionals have their own thresholds’

(SW16)

Clear and shared vision and goals:

‘not seeing the bigger picture’(SW06);

‘professionals who don’t have an understanding of child

protection’ (SW09)

Professionals’ relationship with family members

‘aggressive people coming to the meeting’ ( SW02);

‘sometimes it can feel a bit collusive’ (SW06)

‘paying attention to what they’re saying’ (SW13)

Professionals’ role clarity:

‘for other professionals it’s a secondary

function’ (SW11)

‘relevant joint training and closer

working’(SW10)‘

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What social workers said about

lead social worker’s relationship

influences

Lead social worker ’s understanding and role

clarity

‘a lot of time doing the mundane chores’ (SW02);

‘just thrown in the deep end of the pool’ (SW15)

Lead social worker relationship with other professionals:

kind of be the glue that binds everyone together’ (SW12);

‘have different perspectives and see things differently’

(SW06)

Lead social worker communication and

information sharing with other professionals

‘sharing of information in a timely manner’

(SW08)

Professionals’ relationship with family members:

‘aggressive people coming to the meeting’ ( SW02);

‘sometimes it can feel a bit collusive’ (SW06)

‘paying attention to what they’re saying’ (SW13)

Lead social worker relationship with family

members:

‘I think there is sometimes an emotional resistance

to some element of a case’ (SW10)

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What social workers said about family members’ relationship influences

Family members’ relationship with

professionals:

‘some professionals are over friendly, they

become too involved’ ( SW02)

Family members’ role clarity and understanding:

‘I suppose if they can’t acknowledge what the concerns are (SW07);

‘obviously there’s stigma with social services’ ( SW03)

Family members’ communication and

information sharing:

‘a working relationship which means that the

changes that you make are going to empower

them’( SW10)

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What social workers said about external influences

Other external factors:

‘staff shortages; ’

‘bureaucracy and red tape’

‘amount of travelling Legislation, policies and procedure

‘sometimes policies and procedures can be quite

stringent and inflexible’ (SW06)

Lack of resources due to economic austerity:

‘have to do is think a bit more out of the box…we’re relying

more on charities to help us out’ (SW15)

‘But we have huge pockets of deprivation and

poverty’(SW06)

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What social workers said about

decision making influences

Level of need and risk

‘the one that I think is going to reduce the risk first is

actioned first’( SW10)

‘risk is the biggest thing that influences what you need to

do’ (SW012)

‘what’s important will be driven by what’s risk and what’s

needed’ (SW05)

Multiple decision making criteria:

‘one’s the most urgent is the priority’ (SW09)

‘what’s feasible as well’ (SW05)

‘availability of resources’

‘Individual professional’s state of mind’

Consensus between professionals and

family members

‘the family knows best what needs to

improve first…it’s about coming to a

consensus’ (SW06)

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What are the main conclusions that can be drawn from this study: The main conclusion that can be drawn from this study is that social workers’ perceptions (as the lead professionals) are

that:

• Multi-level relationship, organisational, external and decision making influences are key to effective collaboration

• Collaborative influences, can be systematically identified and systemically understood, conceptually, hence

conceptual model presented earlier.

• Joint interprofessional training is identified as one of the key enablers in order ensure positive multi-level

relationships, shared vision, role clarity and information sharing for effective collaboration to occur.

Key recommendations for future policy and practice:• Focus on barriers and enablers to multi-level relationships, organisational, external and decision making influences

in relation to professionals, lead social worker and service users.

• Interprofessional education and training should promoted as a pre-requisite for effective collaboration

• The visual systemic conceptual model can be used to integrate, illustrate and communicate the systemic

relationships and influences to ensure conceptual clarity.

• Further research is recommended in the following areas: views of non-social work professionals as well as service

users regarding the same question.

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Key references:Anning, A., Cottrell, D., Frost, N., Green, J. and Robinson, M., 2010. Developing multi-professional teamwork for integrated

children's services: research, policy and practice. 2nd ed. Maidenhead: McGraw-Hill Open University Press.

Featherstone, B., White, S. and Morris, K., 2014. Re-imagining child protection: towards humane social with families. Bristol:

Policy Press

Falkov, A. 2012. The Family Model Handbook: an integrated approach to supporting mentally ill parents and their children.

Hove: Pavilion Publishing.

Huxham, C. and Vangen, S., 1996. Working together: Key themes in the management of relationships between public and

non-profit organizations. International Journal of Public Sector Management, 9 (7), pp.5-17.

Nyathi, N and Akister, J., 2016. A Practitioner’s perception of interprofessional collaboration influences in safeguarding

children. Childhood Remixed (6).

SCIE., 2012. Learning together to safeguard children: a ‘systems’ model for case reviews [online]. Available at:

http://www.scie.org.uk/ publications/ataglance/ataglance01.pdf

Sidebotham, P, Brandon, M, Bailey, S, Belderson, P, Dodsworth, J, Garstang, J, Harrison, E, Retzer, A and Sorensen, P.,

2016. Pathways to harm, pathways to protection: a triennial analysis of serious case reviews 2011 to 2014: Final report

http://www.scie.org.uk/

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1

How do you feel when you have to go to home affairs/licensing dept/municipality?Will it be a one stop for all your needs?

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Interprofessional collaboration of speech-language

& occupational therapy students in a low-resourced

communityMaretha Bekker

Renata Mosca

UNIVERSITY OF PRETORIA

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Literature

• Terminology

• Three practice models of IPE (Bridges et al., 2011)

• MAGPIE Model (Cahill et al., 2013; Queensland-Health, 2008)

• Team members indicated the importance of

– joint communication

– each members contribution

• Attitudes of members towards themselves and others (Sheehan, Robertson & Ormond, 2007).

• Effective teamwork can lead to a better work environment especially when resources are lacking.

• IPC: responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, mutual trust and respect (Bridges et al., 2011)

•3

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Daspoort Poli Clinic

• Daspoort Clinic started as an UP Medical Student Initiative

• A clinic by students, for students and the community

• Daspoort opened 7 August 1964, 53 years ago

• In 1967 social workers, SLT and PT become involved

• Currently runs as an interdisciplinary clinic and COPC site.

• The clinic is supported by Tuks Rag (largest student driven charity organization in South Africa) and the Faculty of Health Science of the UP, in cooperation with Gauteng DoH

4

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Daspoort Poli Clinic

5

Family

OT

SLT

SW

PT

Dr

Nurses

Dietician

CHW

Dentists

Dental

Hygienists

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Supervisors’ views / context for change• To be truly CBR, change was needed

• Collaboration had to be more than referral and discussion

• The caseload is growing

• Complexity of the cases is increasing

• Time constraints: both families and professionals (Nugus et al., 2010)

• ICF considerations (WHO, 2001) & TRUE smart goals

• In a low resourced health environment, teamwork may be essential to maintain a motivated workforce (Sheehan, Robertson & Ormond, 2007)

• Quality of life outcomes

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Case overview: J.L

• Date of birth: 21 August 2012

• Age: 5 years 1 month

• Diagnosis: Not available

• J.L’s mother works part time and is busy completing her law degree at Unisa. J.L’s father is absent. J.L. has a sister who is in Grade 1. The grandparents on the mother’s side are very involved with the family.

• Recently went for an evaluation to be admitted to a school for children with special needs.

8

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Considerations before the session (J.L.)• GDD

• General movement difficulties

– oral muscles

– impact communicative intent

– speech production

– feeding

• Receptive language better than expressive

• Cognitive function should not be judged based on level of expressive language.

• Home programmes: functional and include the whole family (sibling)

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• Low postural muscle tone → difficulties with proprioceptive feedback, gross and fine motor coordination, bilateral integration, postural endurance, balance, praxis and visual-motor integration

• Client needs additional support for stability → working controlled in the midline

• Visual difficulties with co-existing visual-perceptual deficits

• Enjoy exploration (destructive active) but is moving towards constructive action

10

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Needs

• To introduce a therapeutic feeding program:

– positioning

– facilitating mouth closure

– oral movements: chewing and speech production

• Oral secretions and care

• Possible future use of AAC

• To facilitate/improve abilities (postural-motor, sensory and visual-perceptual) → improving occupations: ADLs, play, pre-school/education and social participation

• Facilitate the process of correct school placement

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Activity – water gun

• SLT will provide strategies to facilitate

- Multi step directions (receptive language)

- Vocabulary expansion (receptive language)

- Requesting (expressive language and pragmatics)

- Sequencing (cognitive/executive function)

- Directional concepts (receptive and expressive language)

• OT will provide strategies to facilitate

- Positioning by facilitating postural tone through proprioceptive feedback (optimise swallowing and coordination by the SLT)

- Increased midline stability and bilateral integration

- A firm base of support for balance and functional mobility around the home

12

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Activity – clothing pegs

SLT will provide strategies to facilitate

- Multi step directions (receptive language)

- Vocabulary expansion (receptive and expressive language)

- Requesting and responding (expressive language and pragmatics)

- Sequencing (cognitive/executive function)

- Joint attention

OT will provide strategies to facilitate

- Optimal positioning

- Midline stability to grasp the peg

- Crossing of the midline

- Visual sequencing (as part of spatial relations)

- Motor planning when positioning the peg

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Case overview: G

Date of birth: 6/03/2013

Age: 4 years 6 months

Diagnosis: Severe Microcephaly, Learning Difficulties, Communication Delay, Hyperactivity and Club foot.

Both G’s parents are unemployed. His father is blind and the mother is partially sighted. G has an older brother in Grade 1

14

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Considerations before the session (G) • Cognitive impairment → selection of activities,

importance of repetition

• Parents’ challenges limit carry over at home

• G’s mother is very positive and can assist in treatment session

• Very distractible → limits number of activities to be used in one session

• G tends to present with repetitive behaviour

• Postural stability is extremely important

• Spectacles were prescribed for G. but seldom wears them

15

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Needs

• To experience sufficient destructive activities/elements in order to progress to more constructive actions

• For G’s parents to identify new ways of how to handle and stimulate G at home

• For G to use exploration so that he can learn more about his environment → communication

• For G’s parents to decide (in collaboration with the SLT and OT) on a school which would cater for G’s needs

16

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Activity – body puzzle


- Shared attention (pragmatics)

- Increased reciprocity (verbal and non-verbal) (language and pragmatics)

- Receptive and expressive language expansion

- Word approximations (expressive language)

- Eye contact (pragmatics)


- Eye contact (pragmatics)

- Correct positioning (initially on his Mother’s lap with increased proprioceptive feedback)

- Manipulation of objects in the midline

- Constructive use of objects

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Activity - barley


- Exploratory play

- Commenting (expressive language)

- Shared attention (pragmatics)

- Sound production (speech)

- Vocabulary expansion (receptive and expressive language)

- Requesting (expressive language and pragmatics)


- Sensory stimulation by introducing a different texture

- Sensory discrimination by G having to search for plastic animals in the barley.

- The use of both hands in the activity

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Benefits of IP collaboration: SLT student (J.L. & G)• Two heads are better than one, four hands are better than

two!

• For: positioning, supporting, facilitating, behavioural challenges

• “Hands-on” collaborative sessions helped us to

- Better understand the needs and function level of the

the clients

- Increase professional skills

• Consistent: expectations

- Expectations across therapists and environments

- Facial expressions, language, approach

- For the parents and child

• Problem solving in real time

(Cahill et al., 2013; Copley et al., 2007)

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Benefits of IP collaboration: OT student (J.L. & G)• Collaboration in planning the sessions was positive.

• It felt like ‘we were complimenting’ one another.

• The SLT ‘allowed’ the OT to continue with correcting positions, providing proprioceptive input and assisting with the activity, while she focussed on the speech and language.

• Both parties learned how to work towards a common goal, by

discussion and problem solving.

• Good IPC leads to effective service delivery

• Provides the opportunity to improve interpersonal and professional skills

(Queensland-Health, 2008)

20

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Considerations after the session (J.L. & G)• Co-treating therapists must have a good working relationship

• Goals should be well known to all therapists so both parties can facilitate the desired behaviours (preparation and communication)

• The SLT was more strategy-focused and the OT was more activity based

• It was easier for the OT to select the physical activities and for the SLT to adapt these activities to reach the communication goals

• Both were focused on ensuring that the activities selected were functional and that carry-over to a home environment could be facilitated.

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The way forward

• Challenges (Ho et al., 2008; Nisbet et al., 2008)

– Rotations differ

– Busy schedules

– Discrepancies in numbers between professions

– Divergent learning and assessment styles

– Limited resources

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The way forward

• 2-hour joint team orientation (Copley et al., 2007)

• Extend application MAGPIE

• Individual and group treatment

• Educators to play a stronger role (IHL)

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References

Bridges, DR., Davidson, RA., Odegard, PS., Maki, IV. and Tonkowiak, J. Interprofessional collaboration: three best practice models of interprofessional collaboration. Medical Education Online, 16:1. http://dx.doi.org/10.3402/meo.v16io.6035

Cahill, M., O’Donnell, M., Warren, A., Taylor, A. and Gowan, O. (2013). Enhancing interprofessional student practice through a case-based model. Journal of Interprofessional Care, 27.

Copley, Allison, Hill, Moran, Tait & Day. (2007). Making interprofessional education real: a university clinic model. Australian Health Review, 31(3).

Ho, Jarvis-Selinger, Borduas, Frank, Hall, Handfield-Jones, Hardwick, Lockyer, Sinclair, Novak Lauscher, Ferdinands, MacLeod, Robitaille & Rouleau. (2008). Making Interprofessional Education Work:

The Strategic Roles of the Academy. Academic Medicine, 83(10).

Nisbet, G, Hendry, GD, Rolls, G, & Field, MJ (2008). Inter-professional learning for pre-qualification health care students: An outcomes-based evaluation. Journal of Interprofessional Care, 22(1), 57-68.

Nugus, P., Greenfield, D., Travaglia, J., Westbrook, J., and Braithwaite, J.( 2010). How and where clinicians exercise power: Interprofessional relations in health care. Social Science and Medicine.

Sheenan, D., Robertson, L., and Ormond, T. 2007. Comparison of language used and patterns of communication in interprofession and multidisciplinary teams. Journal of Interprofessional Care, 21(1),

24

http://dx.doi.org/10.3402/meo.v16io.6035

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THE VALUE OF EXPOSING STUDENTS TO INTER-PROFESSIONAL COLLABORATION

ACTIVITIES AT A COMMUNITY-BASED REHABILITATION CENTRE

Juanita Bester, Maatje Kloppers, Faeza Bardien, Liesbet Koornhof en Sue Statham

Stellenbosch University

AFRIPENWindhoek, Namibie21 September 2017

Fakulteit Geneeskunde en Gesondheidswetenskappe

Faculty of Medicine and Health Sciences

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Overview

Current IPEP literature

Why the research

Methodology

Results

Service delivery model

Take home lessons learned

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Current IPEP literature

Primary Healthcare

Transformative learning

Community based education

Health prof education

ICF

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Why do this research?

Informal feedback from students at BLRC

Centre management and the type of activities positive IPE experience

So we were interested to find out:measure the change in students’ perceptions and understanding of IPC after clinical placement

establish the perceived value of ICF-model based activities for IPE for students

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Bishop Lavis Rehab Centre (BLRC)

• Community based out-patient physical rehabilitation centre in Western Cape, RSA

• Established 1993 in partnership with Department of Health, Stellenbosch University and the Bishop Lavis Community

• Inter-professional service-delivery @BLRC based on WHO ICF Model to ensure holistic patient centred treatment

• Training of four health professions at the centre with students participating in a variety of activities with fellow students

- Physiotherapy(3rd&4th years),- Occupational Therapy(3rd&4th years),- Speech,Language and Hearing Therapy(4th years) - Human Nutrition(4th years)

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Management of student activities

Part of normal service delivery

Coordinated by staff

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Methodology

First week of clinical

placement

Bef

ore

te

st

RIPLS

IEPS

Focu

s gr

ou

p in

terv

iew

Aft

er

test

Last week of clinical

placement

Within month of completion

of clinical placement

5-6 weeks

Case study

Reflection

IEPS

Case study

Activity rating

Informed consent

n=42

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Results

Benefits of working in an IP-team

Benefits for service users

Benefits for team member

Benefits for the rehabilitation

team

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Results

Benefits of working in an IP-team

Benefits for service users

Benefits for team member

Benefits for the rehabilitation

team

“I think the advantage is that through interdisciplinary teamwork you realize your role and the role of your team

members.”(OT4/1)“We learn a lot about each other’s professions and get a deeper

understanding on each other and also learn to work together...”(OT3/4)

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“We see them working together in our interdisciplinary teams and they build each other as well and they give each other ideas ...we’ve also learned to respect each other in seeing how other people respect each other, and that’s one of the reasons where it comes from.”( PT4/1)

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Daily Weekly Monthly/Once per clinical placement

Team discussion

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Team discussion

“…to listen to the other people’s perspectives and to speak about your patients not just in passing, but to

literally speak about what your target is for that week, what’s your plans for the future and where

you need help or where you think you can help someone else. So I think the discussions definitely

promote interdisciplinary team work.”(SLT4/4)

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One file per patient Team discussion

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“...it almost feels as if at Bishop Lavis the lead was taken on a relay basis and I think the medical folder is

that almost like the stick you pass on because when the physiotherapist had her session and she wrote in the

file what she did and her plan for the next session, then the occupational therapist receives the file and

get that information...it felt to me that we handed it to each other and we do our bit and then we say “ok now

you do your bit”.(OT3/1)

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Shared admin spaces

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Shared admin spaces

“I think it’s not an activity, but just having all of us in one room the whole time, it creates a sort of group

coherence ...you know your team members on a more personal level and not just patient-work, you tend to work

better together .”(OT4/4 )

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One file per patient Team discussion Socials

Shared admin spaces

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Shared admin spaces

“… as much as I was willing to collaborate before I got there, now knowing the people better on a personal

level, I’m even more willing to do this. …, you are much more understanding and accommodating when you have the personal connection as well. It definitely promotes

team work.” (SLT4/4 )

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Shared admin spaces

Joint sessions (at Rehab and Home visits)

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Shared admin spaces


“Also having joint sessions, I think that really promotes team work because you actually see what the other person is doing and how they are handling

the patient and giving input to each other in the same session…”(OT4/4)

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Shared admin spaces Groups Workshops


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“…also the groups, the stroke group or an amp group, the fact the occupational therapists, physios and

speechies facilitate together, force us to come together... So the planning that goes on behind that

force us to need one another and really use what each profession has to offer” (PT4/2)

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Duration and scheduling of placements

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Frustrations of working with others

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Frustrations of working with others

Supervision

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Take home message

• On-site role-models of IP-teamwork

• Plan and manage IPE activities as normal service delivery

• Not just sharing patients!

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Acknowledgement

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References

World Health Organization. Towards a common language for functioning, disability and health ICF. Geneva: World Health Organization, 2002. http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf (accessed 27 September 2012)Kloppers, M., Koornhof, H.E.K., Bester, J. & Bardien, F. 2015. Students’ experiences of inter-professional education through International classification of functioning-based activities at a community-based rehabilitation centre. African Journal of Health Professions Education. 2015:7(1):22-25, doi:10.7196/AJHPE.289.RIPLS McFadyen, A. K., Webster, V., Strachan, K., Figgins, E., Brown, H. and McKechnie, J. (2005). The Readiness for Interprofessional Learning Scale: A possible more stable sub--scale model for the original version of RIPLS. Journal of Interprofessional Care, 19(6), 595-603IEPS McFadyen, A. K., Maclaren, W. M., and Webster, V. S. (2007). The Interdisciplinary Education Perception Scale (IEPS): An alternative remodeled sub‐scale structure and its reliability. Journal of Interprofessional Care, 21(4), 433-‐443Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978. http://www.who.int/publications/almaata_declaration_en.pdfTalaat W, Ladhani Z. WHO, 2014. Community Based Education in Health Professions: Global Perspectives. http://www.hrhresourcecenter.org/node/5568 Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet 2010;376(9756):1923-1958. [http://dx.doi.org/10.1016/S0140-6736(10)61854-5] [PMID 21112623]Reeves S. Porque precisamos da educação interprofissional para um cuidado efetivoeseguro. Interface (Botucatu). 2016; 20(56):185-96. (Why we need interprofessionaleducation to improve the delivery of safe and effective care) DOI: 10.1590/1807-57622014.0092

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A one year review of the impact of a rural Interprofessional Education collaborative platform on

health professions student learningDr René Botha, Prof Annemarie Joubert, Dr Dirk Hagemeister, Ms Heidi Morgan, Mrs Mimmie

Wilmot

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T: 051 401 9111 [email protected] www.ufs.ac.za

CONTENT

• Contextualisation

• Literature

• Methodology

• Results and discussion

• Conclusions

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KOPANANG LE FODISE

Community Outreach

CBECooperative Education/

Experiential training

VolunteerismInternship

Community BENEFICIARY StudentService GOAL Learning

WIL

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KOPANANG LE FODISE

Community Outreach

CBECooperative Education/

Experiential training

VolunteerismInternship

Community BENEFICIARY StudentService GOAL Learning

WIL

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PRIMARY HEALTHCARE

• Promotes equity;

• Community participation;

• Social and economic development; and

• Client-centred approach.

In a rural context • Resource availability,• Physical-, demographic-, economic-, social- and cultural obstacles• Shortage of healthcare service providers and • Minimal access to specialist care• Transport challenges,• Distances, and• Increased cost

Primary care is the first line of health care that a patient

receives, including disease treatment, referral to more

specialised care and prevention through individuals, families

and communities health education.

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INTERPROFESSIONAL EDUCATION

“Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes.”

The key competencies:

1. Role clarification,

2. Patient/ client/ family/ community-centred care,

3. Team functioning and

4. Interprofessional communication.

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INTERPROFESSIONAL EDUCATION

4x4h IPE orientation

Student groups

Group facilitators

1. Introduction to IPE

2. Key competencies

3. Role / Value clarification

4. Simulation

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PIONEERS

4 March 2016:24 students3 facilitators

Trompsburg

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PIONEERS


Trompsburg

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PIONEERS


Trompsburg

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MEZIKOLB / KOLMEZI

Personalising

Immediate

Concrete Experience

is the basis for

Observation and Reflection

which are assimilated into the

Formation of Abstract Concepts and Generalisation

from which Implications for actions are deduced

and followed by

Testing implications of Concepts in New

Situations

which leads to

Connecting learning (Kiely 2005:8)

Contextual border crossing

Dissonance

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AIM AND RESEARCH QUESTION

To evaluate the impact of a rural IPE collaborative platform placement on health professions students’ learning.

What are students’ learning experiences of a rural IPE collaborative platform following a defined interprofessional programme?

Ethical approval

HSREC 201/2016

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METHODOLOGY

• Student groups

• Digital story of rural IPE experiences, consisting of

– Images, video, text, and audio and

– A five-minute narrative

• Purposive sampling (at least three professions)

Digital storytellingBarrett (2005); Condy (2015)

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WHY DIGITAL STORIES?

Paulo Freire's theory of education for critical consciousness:

Describes an individual's critical understanding of the world and how individual,

social and political circumstances influence the understanding of one's reality.

• Digital stories allows students to

– Expand their understanding of others,

– Build empathy,

– Advocacy

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METHODOLOGY

• Student groups

• Digital story of rural IPE experiences, consisting of

– Images, video, text, and audio and

– A five-minute narrative

• Purposive sampling (at least three professions)

Digital storytellingBarrett (2005); Condy (2015)

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VALUE OF DIGITAL STORIES?

• Ill structured question vs. ……

Digital story of rural IPE experiences…

• Interprofessional Collaborative Competency Attainment Survey

(ICCAS)

– Assess self-reported competencies

– Combination of different IPE assessment tools

– 20 elements

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METHODOLOGY

A qualitative content and thematicBless et al. (2013: 352); Frey et al. (1999)

Direct analysis of textual and audio dataBless et al. (2013: 352); Brink et al. (2012: 201); Du Plooy-Cilliers (2014: 191, 232-245)

Steps of content analysis were used proposed by Du Plooy et al. 2014:170-171; Cresswell (2009: 184)

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RESULTS: THEMES

• Metaphor - Use of metaphors to describe student

experiences

• Critical consciousness - Used to describe an individual's

critical understanding of the world and how individual,

social and political circumstances influence the

understanding of one's reality.

• Professional socialisation – Uses socialisation in a broad

sense as “the process by which persons acquire the

knowledge, skills, and disposition that makes them more

or less effective members of society”.

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RESULTS: THEMES AND CATEGORIES

Themes CategoryMetaphor Tree

JourneyTravellersPopulationsIgnite the fireFrozen landWindmillWaterStrangersAvengersDr ZeusPuzzleAdventureFlight

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Themes CategoryCritical consciousness Professional development

PraxisTransformationPersonal developmentChallengesCommunity responseEthical dilemmaExpectationsCommunity perceptionEmpathy (anger)Assumption

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Themes CategoryProfessional socialisation Interprofessional learning

Common goalsValuesFacilitationCommunity empowermentAchievementReflective practiceKey competency

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21

20

34

10

22

13

11

11

12

11

0 10 20 30 40

Achievements

Challenges

Collaboration

Common goals

Community response

Key competencies

Professional growth

Personal growth

Reflective practice

Transformation

STATEMENTS PER CATEGORY

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RESULTS KEY COMPETENCIES

“Communication where we were instructed to collaborate and to make a

poster combining vital opinions. Lastly on our fertiliser molecule was the

community centred approach we had to have during the screening of the

locals ensuring any referrals were not to be missed. While screening the

learners we, as an interdisciplinary team can use our strengths to our

advantage. It was an exciting space to be in. We were reminded of how

important it is to have a holistic approach when treating a patient, and

that everyone is equally important. We now also have a better

understanding about what each professional’s role is in the multi-

disciplinary team”.

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RESULTS ACADEMIC

“We realised that not all students know about diabetic diet so it was nice

that they could learn from me.”

“The medical students let go of their stethoscopes, started exercising

muscles and got a glance in the world of optometry.”

“To be able to learn new skills from our peers, even if it was something

simple as how to take blood pressure, how to assess posture…”

“By combining our knowledge, skills and our screening tools, we reached

new heights professionally as well as personally.”

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DISCUSSION: CREATING THE HOLISTIC GRADUATE

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CONCLUSIONS

• Gain key interprofessional competencies

• Interprofessional academic learning

Cognitive learning Psycomotor learningAffective learning

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CONCLUSIONS

• Gain key interprofessional competencies

• Interprofessional academic learning

Cognitive learning Psycomotor learningAffective learningA holistically developed

student

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Framework for Action on Interprofessional Education and Collaborative Practice (Adopted from WHO 2010

CONCLUSIONS

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Questions?

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Reflections on implementing a

community-based learning activity

as part of an interprofessional

education programme

Kaashifa Gathoo, Abigail Dreyer, Mpho Molete, Juliet Nyasulu, Gaolatlhe

Mothoagae, Amme Tshabalala, and Sonti Pilusa

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Objectives and learning outcomes

1. Team work

2. Ability to conduct a community mapping

exercise

3. Ability to execute a community needs

assessment

4. Community feedback and demonstration of

accountability

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Choice of sites

◦ Close proximity to medical school

◦ Represent the diverse community

◦ Reflect inequity

◦ Explore a long term relationship

Wits Medical School

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Reflection on Implementation

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Was “everything awesome” ?

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Reflection after the design

◦ Poor communication

◦ Coping with complexities

“It’s really difficult holding this all together, there is so much to do, there are so many tools we could use,

how do we decide what is best?” [Faculty]

◦ Collaborating widely

“All teamwork is not collaboration and collaboration is multidimensional” [Faculty]

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Reflection during preparation

◦ Expectations

“Who is supposed to do this?” [Faculty]

◦ Availability

“So, when can they meet? …I can’t do that time”[Faculty]

◦ Generosity

“…absolutely! we can provide that, and make sure they get some tea and are welcome” [Site]

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Reflection after the learning activity

Faculty Experience

Growth/Learning (from each other + from students)

CommunicationStrengths

Site Experience

Growth/Learning (from faculty + from students)

CollaborationValues and interest

Student Key competencies/ Outcomes

TeamworkShared leadership

ValuesInsight

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Responses from Faculty and Site

“I also discovered a lot of sites that I was not aware of within a very close proximity of the university.” [Faculty]

“ I was surprised at the creative suggestions that students proposed. We can use this in our proposal to the Board” [Site]

“A key element to the success was that we brought together our strengths. It was so refreshing to work together and contribute your part to the whole.” [Faculty]

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Conclusions

◦ One activity – one day

◦ Value vs values

◦ The learning organisation

◦ Team learning

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Take Home Message

“Reflection begins at

home”

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How Prepared are Students for IPE?

By: Gérard C. Filies, José Frantz & Anthea Rhoda

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Background:

• It is the responsibility of training institutions to prepare a workforce that is ready to work collaboratively and the vehicle advocated for this is interprofessional education(WHO, 2010)

• In response, the Faculty of Community and Health Sciences at a university in South Africa, developed a model that would systematically prepare students from first to final year for interprofessional education activities and build the relevant competencies (Frantz & Rhoda, 2017 ).

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Study Population:

• 1st year students –Primary Health Care module

• Pharmacy, Nursing, Social Work, Sports Sciences, Dietetics, Natural Medicine, Physiotherapy, Occupational Therapy, Oral Health and Dentistry

• N=295 – convenient sampling

• Senior students

• Nursing, Occupational Therapy, Physiotherapy, Pharmacy, Social Work and Sports Sciences

• N=282

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Design:

• Quantitative data – survey research - explaining phenomena by collecting numerical data (Aliaga & Gunderson, 2002)

• Method to gain quick data about general information about population of interest

• Readiness for IPL – compare to seniors –determine IPL over study period

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Data Collection Tool:

• 15-item Likert scale, Readiness for InterprofessionalLearning Scale (RIPLS), adapted from Parsell and Bligh (1999)

• 1, strongly disagree to 5, strongly agree

• Survey divided into three main areas namely: team-work and collaboration, professional identity and roles and responsibilities

• RIPLS questionnaire was confirmed to be valid and reliable and can be used to assess interprofessionalreadiness (Parsell & Bligh, 1999).

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Data Collection:

• Pilot study – 1/13 groups – negatively loaded statements

• Completion of demographic information• Administration of process – facilitators

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Analysis:

• Statistical Package for the Social Sciences (SPSS) software.

• It is fairly user-friendly and extremely flexible in terms of the desired results required of an assortment of research studies.

• Muijs (2004) SPSS is in all probability the most common statistical data analysis software package used in educational research

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Results:

• Demographic information:

– Mean age of the students in the first year group was 21,22 while the mean age for the senior students was 23,46.

– The gender composition was unequal with female students comprising 73, 2% (n=216) and male students were 25, 1% (n=74) of the first year student sample group.

– The senior student gender composition was also unequal with female students comprising 78, 4% (n=221) and male students were 21, 3% (n=60).

• The significant threshold was set at p=0.5

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Results:• A strong link existed here between the positive outcomes of

teamworking and the acceptance of a team-based approach to learning. Positive responses to items in this subscale implied that students understood that health professionals needed to acquire specific team-working and collaborative skills, be effective communicators as well as be contributors of professional knowledge to an interprofessional team. Although both student groups understood the importance of developing a positive professional identity within the context of a team approach to health care, the senior students rated this more important. Roles and responsibilities had no significant difference between the two groups

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Conclusions:

• The staggered curriculum implemented by the university is allowing students to systematically over time develop an understanding for IPE.

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Presentation by: Gaolatlhe Mothoagae

Wits University, CHSE

Presented at:UNAM

AfrIPEN Symposium

21 September 2017

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Outline Introduction

The journey: planning process >>> implementation

Lessons learnt

Challenges

Conclusion and Way Forward

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Introduction

In 2017, Wits FHS showed commitment to incorporating IPE into undergraduate curricula across all professional disciplines

Granted 3 days of ‘protected time’ for IPE

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The Programme: WHO? MODEL?Degree +

Year

GEMP

2

BCMP

2

BDS

4

BPHAR

M4

OT

4

PT

4

SPA

3+4

BIOK

4

ORAL Hyg

3

NURS

3

654329 34 25 61 40 54 27 37 8 39

4 different settings, rotational basis model (654/4 = 163) 4 team leaders led 4 teams

The Programme Model

Learning Objectives based on the IPEC Core Competencies

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The Programme: WHAT? WHERE? Group Setting Activities

STREAMING

DECISIONS

Hospital (Casualty,

Ortho and Neuro wards)

Patient assessments followed by patient management

discussions. Livestreaming from CMAH to the eZone

JOZI MAPPING 23 Community Facilities:

Schools, OAHs, Shelters

for Women and

Children’s Homes

Strengths-Based Community assessment followed by report

back to a panel at the site. Group and individual feedback

and reflections done via Videos, PadLet and Sakai

MASS

CASUALTY

Medical School Theoretical and practical sessions on disaster management

activities in partnership with ER24. Table-top activities,

evacuation procedures and command centre experiences.

Debriefing was done at the end of the activities

BUILDING

HEALTHY

COMMUNITIES

Medical School

Wits Education Campus

Table Top Activities: Health Promotion scenarios - produce

HP material (video/poster) for a specific target group.

‘IPE Card’ games: use song, dance or role playing to respond

to IPE-related questions

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The Programme: WHEN?

27 July 10 August 24 August

Streaming

Decisions

D B A

Mass Casualty C A B

Building Healthy

Communities

A C D

Jozi Mapping B D C

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JOZI MAPPING

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MASS CASUALTY

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ST

RE

AM

ING

DE

CIS

ION

S

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We are family!

Dentists, Nurses, BCMP.

We are family!

OT’s, Physio’s, Speechies & me.

We are family!

Doctors, Bio’s & Oral hygiene.

We are family!

Take me to the pharmacy!

That is how we change our degree

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Key learning Knowing about other professions

Knowing roles of other professions

Learning from each other

Collaboration and teamwork

Communication and learning to listen

Creativity

Group dynamics

Ownership of learning and co-responsibility

Decision making

Discovery about ‘self ’

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Challenges and Lessons Learnt Timing of the programme

Attendance monitoring

Communication/briefing sessions

Student groupings (level of students)

Clarity of learning objectives

Availability of all professions

Group numbers

Relevance of activities for students in all disciplines

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Conclusion Objectives of the programme were met

A large scale IPE programme with protected time has benefits

Resources (human and capital) key for success of the programme

Staff commitment and buy-in and support from HoS/HoDs is essential

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Way Forward

Planning for 2018 is already in progress with 4 potential days identified

Engage with student to ensure buy-in and participation

Continue and expand on the current offerings: MDT Sessions SCORPIOS Clinical IPE sessions at teaching hospitals and CBE sites Student groups involved in projects such as Trinity Health Services

Continue the conversation!!!!!!!!!!!!!!!!!

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THANK YOU CMJAH Management

ER24

The eZone team

Wits Education Campus

Team leaders and team members

Facilitators

Everyone who contributed to the success of the programme

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DEVELOPMENT OF

INTERPROFESSIONAL HEALTHCARE

LEADERSHIP MODULES FOR

UNDERGRADUATE STUDENTS

Carin Maree, Pippa Bresser, Mable Kekana,

Karien Mostert, Mariatha Yazbek, Lydia

Engelbrecht, Christa Viviers

2017

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Background information

The University of Pretoria went through organisational

restructuring, and one of the outcomes was the

merging of department to establish schools.

The School of Healthcare Sciences, Faculty of Health

Sciences consists of the following Departments:

• Human Nutrition

• Nursing Science

• Occupational Therapy

• Physiotherapy

• Radiography

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Background information (cont.)

Need was identified for collaboration for alignment

with:

• Vision of University

• National health trends (Re-engineering of Primary

Healthcare and National Department of Health’s

Strategies)

• National education trends (Higher Education

Qualification Sub-Framework)

• International trends (Interprofessional Education

and Sustainable Development Goals)

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…and one of the outcomes:

Development of ‘shared modules’ in integrated healthcare leadership in the

community setting and research for undergraduate students in the School of Healthcare Sciences, with addition of the

Department of Speech-Language Pathology and Audiology

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Professionals from different healthcare

disciplines are prepared in their own fields

with limited exposure to teamwork, with

each discipline focussing on their own

responsibilities regarding patients and

communities

Practice at that time: Traditional

Health Education

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New practice to be introduced:

Interprofessional Health Education

Professionals from different

healthcare disciplines learn with, from

and about each other while sharing

common responsibilities to the benefit

of patients and communities

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Problem statement

• The reality of healthcare includes an

overburden of diseases and lack of

healthcare professionals

• Healthcare professionals should be prepared

for the challenges and complexities for their

future careers during enrolment of

undergraduate programmes

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Potential solution

• Interprofessional teamwork is expected

to contribute to:

–Optimise use of resources

–Improve quality of healthcare

–Improve outcomes for patients and

communities(WHO 2010; Frenk et al. 2010)

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Research DesignAction research design was followed:

• Problem identification

• Action planning

• Implementation

• Evaluation

• Reflection

Based on principles:

• Learning in and through action and reflection

• Iterative process

• Collaboration

• Using multiple methods (McNiff & Whitehead 2002)

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Conceptual Framework

Knowledge-to-Action Cycle of Graham & Tetroe (2009; 2010):

• Phase 1: Planning

• Phase 2: Pre- and post implementation

• Phase 3: Evaluation

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Knowledge-to-Action Cycle (Graham & Tetroe 2009; 2010)

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Knowledge-to-Action Cycle (Graham & Tetroe 2009; 2010)

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Phase 1: Planning

Knowledge enquiry: Identify problem

• Consensus during strategic planning of

School of Healthcare Sciences was the lack

of interprofessional teamwork in health

settings at background stipulated

• Representative task team appointed to

explore problem and potential for introduction

of interprofessional modules in new curricula

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Phase 1: Planning (cont.)

Synthesis: Review knowledge

• Task team systematically unpacked common exit level

outcomes of the undergraduate degrees stipulated by

Health Professions Council of South Africa and South

African Nursing Council, as well as graduate attributes

• The common exit level outcomes and attributes were

consolidated in table format for comparison

• Through in-depth discussion and debate, potential

learning outcomes were synthesized and captured, and

were presented to the executive management and

academic staff of the School of Healthcare Sciences

• Identified modules: Integrated healthcare leadership

and research

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Phase 1: Planning (cont.)

Product tools: Adapt knowledge to local context

• Discussions with executive management and

academic staff focused on content, financial and

logistical implications

• Proposed regulation changes were drafted and

submitted to Academic Planning Department

• Upon approval two representative sub-committees

were established to develop micro-curriculum and

learning material

• Department of Speech-Language Pathology and

Audiology joined the process

• Regular meetings were held to plan and reflect

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Semester 1 Semester 2

First year

NQF level 5

Uniprofessional module:

introduction to respective

professions*

Interprofessional health leadership I:

teamwork and communication in the

community health setting

(8 credits)

Second year

NQF level 6

Interprofessional health

leadership II: principles of

community health project

development and health literacy

(8 credits)


complementary content determined by

each discipline*

Third year

NQF level 7

Interprofessional health

leadership III: community

based project

(8 credits)

Uniprofessional module: complementary

content determined by each discipline*

Interprofessional Healthcare Research III:

Proposal development (30 credits)

Fourth year

NQF level 8


content determined by each

discipline*


content determined by each discipline*

Interprofessional Healthcare Research IV:

Research project (10 credits)

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Reality of planning process

• Implementation was planned regarding contact

sessions, venues, team-teaching, interprofessional

group work, individual and group assessment

• First module was rolled out in 2015 with a group of 154

students from Departments of Human Nutrition,

Occupational Therapy and Physiotherapy (other

Departments to follow in 2017/2018 when new curricula

are launched)

• Lecturers from all the Departments have been involved

in teaching and refining from the beginning, with

challenges …….

• Students were invited to comment any time and make

suggestions for improvement

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Some lessons learned thus far…

• The focus of interprofessional education should be on core competencies across professions such as ethics, professionalism, team work, communication, project management and research

• It is necessary for discipline-specific education complementary to interprofessional education to prepare healthcare students for their professional responsibilities and ‘role uptaking’

• A platform is created for future healthcare professionals to learn interactively together with the purpose of improving knowledge, skills and attitudes to work in collaboration with each other towards a common goal

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Some lessons learned (cont.)…

• Uniprofessional ‘silos’ are broken down

• Deliberate activities need to be planned to engage students in interprofessional team work

• Students’ input should be acknowledged and attended to

• Lecturers should be role models for interprofessional team work through their involvement of the modules and portray enthusiasm

• The process of development of interprofessionalmodules is intense, time-consuming, faces multiple challenges and requires commitment

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Conclusion

We are proud of what we have achieved thus far with the

introduction of interprofessionalmodules and we hope to expand it to

include more professions in the future.

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References

• McNiff J & Whitehead J. 2002. Action Research: Principles and Practice, 2nd Ed. New York: Taylor & Francis e-Library.

• Graham ID, Tetroe JM. The knowledge to action framework. In: Rycroft-Malone J, Bucknall T, eds. Models and Frameworks for implementing evidence-based practice. Linking evidence to action. West-sussex: Wiley-Blackwell, 2010: 207-221

• World Health Organization. Framework for Action on Interprofessional Education & Collaborative Practice. Geneva: World Health Organization, 2010. http://whqlibdoc.who.int/hq/2010.

• The South African Health News Service. 2014. Report: Department of Health Strategic Plan 2014/15 – 2018/19. http://health-e.org.za/2014/09/25/report-department-health-strategic-plan-201415-20189/

• Frenk, J., Lincoln, C., Bhutta, Z.A., Cohen, J., Crisp, N., Evans, T., Fineberg, H. et al., 2010, Health professionals for a new century: transforming education to strengthen health systems in an interdependent world, The Lancet, 376(9756): 1923-1958, available from http://www.thelancet.com

http://health-e.org.za/2014/09/25/report-department-health-strategic-plan-201415-20189/

http://www.thelancet.com/

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Thank you!

[email protected]

(C) +27 83 286 6696

mailto:[email protected]

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Lessons learnt from

designing and

implementing

undergraduate

interprofessional

healthcare modules

P. Bresser, C. Maree,

K. Mostert-Wentzel,

RM. Kekana

22 September 2017

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Introduction

AfriPEN 22 September 2017 – IPE Lessons learnt

Excerpt from Maree et al (ahead of print), AJPHE, Oct 2017

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Pre-implementation - Challenges

Buy in & resistance

Curriculum revision

Naming

Logistics

Learning materials

Upholding unique professional cultures


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Pre-implementation - Supports

Driving committee

Enhanced teamwork

Role players

Learning materials

Regular meetings


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Post-implementation - Lessons


Edu

cators

Logistics & Time

Group Dynamics

Role modelling

Communication

Funding

Stu

den

ts

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Post-implementation - Reflections


Edu

cators

Authentic

Teamwork

Community engagement

Ownership & Empowerment

Interprofessional Learning

Stu

den

ts

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Interventions introduced

Enhanced communication channels

Streamlining processes

Administrative support

Multiple source feedback

Brainstorming & revision sessions

Facilitation skills development

Flexible but controlled group allocation

Increased hybrid teaching


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The way forward

3rd phase of monitoring and evaluation

Clear sponsorship guidelines

Maintain enhanced communication pathways

Review of projects through educator meetings

Establish database to avoid community saturation

Facilitation training and mentoring for staff

Focus on evaluation of impact

Source project funding


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Conclusion

Upholding standards and unique cultures of different

professions while simultaneously promoting

interprofessional health team concepts is a

challenging but achievable goal

Process of change that requires continued reflection

from all involved


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Thank You


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Experiences of facilitators of interprofessional education

Hanlie Pitout

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Facilitators and students

Facilitators and students from:

Occupational therapy

Physiotherapy

Human nutrition /dietetics

Speech language pathology and audiology

Skills centre: included Standardised Patients

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TeamSTEPPS

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Literature

IPE is an expectation of WHO, HPCSA andprofessional organisation.

Facilitators need to be role models: interprofessional and collaborative practice.

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METHOD

Pilot study

Qualitative

Purpose: preparation for next year’s IPE

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Data collection

• Offered choice: open ended questionnaire; individual interview or focus group.

• The least experienced facilitators preferred to complete the questionnaire.

• The five SPs were seen in a focus group.

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Results

Participants

• Eleven of the fifteen facilitators from four professions responded.

• SP coordinator / facilitator

• Five SP’s

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Themes

• Value and uniqueness of IPE

• Knowledge, attitude and skills

• Planning and logistics

• Course content

• Students reactions

• SP’s

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Value and uniqueness of IPEUnique challenges compared to departmental teaching. Takes facilitators out of their comfort zones. Bottom up and top down

“Like to share experiences of teamwork with students”

“Correct way to treat patients”

“Need to improve students confidence to work with other professions before qualification.”

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Knowledge, attitude and skillsNot necessary to know everything of all professions – focus should be on team work and not so much on profession’s content.

“Need to feel equipped and prepared – it is impossible to present if you were not part of the preparation, the process and do not understand your own role.” “Need to be open minded”

“Facilitators learn from each other more on ways to facilitate but also about the roles of other professions.”

“Other staff in own department may not view IPE as important as you do.”

“IPE need time for preparation, participation, marking reflections and feedback / debriefing.”

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Planning and logistics

Vital for success and strive to ensure a positive experience

“facilitators need to have good time management to maintain students cooperation and interest”

“Constant group of students and facilitators -> students relax more but if there is change -> students learn to adapt to new expectations and learn to work with others / different professionals.”

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Course content

“Very challenging to develop scenarios that are complex enoughbut not too challenging.” “Scenarios that are more dimensionalcreates a stronger learning experience.”

“Developing the scenario is an important part of the process ofdeveloping cohesion and comprehension of facilitators”.

“The reflection is one of the most valuable IPE learning opportunities. Initially students reflections were very narrow but then it expanded”

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Students reactions

“Students got the opportunity to present themselves as their profession – students confidence grew because they can assert themselves.”

“Need to be open to the process and remind yourself that you do not need to know everything – that you will learn as you go. Remember IPE is about the students and you are there to benefit them and they are relying on your commitment”

An unprepared or unsure facilitator -> students feel unsafe -> react with aggression or become apathetic -> limited participation -> affect the whole small group.

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SP’sImportant for the success of IPE role play / simulation. Valued by both facilitators and students.

Preparation of SPs is vital. All the facilitators need to be part of the preparation.

“Facilitators also need to be prepared to work with SPsunderstanding their role in the session, their background /training and what they need to provide to enable the SPs to playthe role.”

“With good training SP’s can steer the students in the rightdirection i.e. if SP give an authentic portrayal of the patient thestudents will pick up on the emotional issues.”

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DISCUSSION

‘Expert teacher’ needs to be replaced by ‘facilitator’ or ‘coach’.

Instead of teaching ‘work with learners’. Oandasan and Reeves, 2005.

Facilitators must be ready to encounter interprofessional friction –understand issues of power and hierarchy.

Prepared by facilitating small groups.

Facilitators who know each other are more effective.

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Discussion (cont)

• Weekly meetings of all facilitators: feedback and debriefing

- >improved facilitation of future sessions.

• Departmental commitment may need top down approach.

• Staff who have never participated before underestimate the complexity of IPE facilitation.

• Assessment of facilitation skills are available and may contribute to facilitator preparation. Sargeant, Hill, Breau (2006); Davis et al. (2015)

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TAKE HOME MESSAGE

• Facilitators can promote, cultivate and direct IPE initiatives.

• Need enough time and appropriate activities to prepare facilitators.

• Be prepared to move out of comfort zone.

• Open minded.

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REFERENCES

• Available on request

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QUESTIONS

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The research process followed to assess theIPEP*-value of activities students participatein at a community-based rehabilitation centre

Kloppers, M., Bester, J., Bardien, F., Koornhof, H.E.K. & Statham, S.

•Community based out-patient physical rehabilitation centre in Western Cape, RSA•Established 1993 in partnership with Department of Health, Stellenbosch University and the Bishop Lavis Community•Inter-professional service-delivery @BLRC based on WHO ICF Model1 to ensure holistic patient centred treatment•Training of four health professions at the centre with students participating in a variety of activities with fellow students- Physiotherapy(3rd&4th years),- Occupational Therapy(3rd&4th years),- Speech,Language and Hearing Therapy(4th years) - Human Nutrition(4th years)

2 Reason for research:

3 Variety of IPEP-activities students participate in:

•A descriptive study with a before-after design

•All undergraduate students trained at BLRC invited to participate in study while completing their clinical placement

•Mixed data gathering methods to triangulate data

•Informed consent obtained

•Cohort of 42 students participated over an one year period

•Valuable and insightfull doing research in an IP-team (about IPEP)

•Important to differentiate between 3rd&4th years due to maturity that takes place i.t.o. their own professional identity

Corresponding author: [email protected]

6 Lessons learned:

Results from student feedback, given upon completion of their clinical placement, indicated that inter-professional learning occurred spontaneously between various professions as a result of how the centre and activities are managed2. This led to the research questions:- What IPEP happens during students clinical placement at BLRC? - From students’ perspective: what activities facilitates this IPEP?

1 Background:Bishop Lavis Rehabilitation Centre (BLRC)

Patient DiscussionWeekly inter-professional team meeting todiscuss patients, mutual goals setting andreferrals needed

4 Focus of poster:

Research process followed to ascertain IPEP at BLRC and well as the students’ perception of the activities that contributed to it

5 Methodology used:

GroupsStudents get the opportunity to present

and shadow a variety of groups

Home VisitsStudents do assessment and treatment in patients’ homes with fellow professions

WorkshopsStudents get the opportunity to present

and shadow a variety of workshops

Team SocialsMonthly team dress-up lunches are held

for staff and students

1. World Health Organization. Towards a common language for functioning, disability and health ICF. Geneva: World Health Organization, 2002. http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf (accessed 27 September 2012)

2. Kloppers, M., Koornhof, H.E.K., Bester, J. & Bardien, F. 2015. Students’ experiences of inter-professional education through International classification of functioning-based activities at a community-based rehabilitation centre. African Journal of Health Professions Education. 2015:7(1):22-25, doi:10.7196/AJHPE.289.

3. RIPLS McFadyen, A. K., Webster, V., Strachan, K., Figgins, E., Brown, H. and McKechnie, J. (2005). The Readiness for Interprofessional Learning Scale: A possible more stable sub-scale model for the original version of RIPLS. Journal of Interprofessional Care, 19(6), 595-603

4. IEPS McFadyen, A. K., Maclaren, W. M., and Webster, V. S. (2007). The Interdisciplinary Education Perception Scale (IEPS): An alternative remodeled sub‐scale structure and its reliability. Journal of Interprofessional Care, 21(4), 433-‐443

Data gathering method(Completed individualy)

Purpose

Before(Completed within first

week of placement)

After(Completed within last

week of placement)

RIPLS3

Readiness for Interprofessional Learning Scale

The RIPLS was used to assess the students’ perception of readiness for inter-professional learning

IEPS4

Interdisciplinary Education PerceptionScale

The IEPS was used to determine students’ professionally orientated perceptions and related affective domains

CASE STUDYCase of female with neurological condition. Medical and social history as well as outline of her resultant disability and function provided

Students were required to identify all the relevant professionals who they deemed necessary for the comprehensive management of the patient and to motivate the reason for their inclusion. This assisted in measuring the change in students’ perceptions and understandings of inter-professional collaboration

REFLECTIONReflect on an academic, social and personal level about their Inter-professional teamwork experience

To gain insight into the meaning that students derived as a result of their participation in IPEP-activities. Students reflected on what they learned, in what situation they learned it and how it will change their practice in future

ACTIVITY RATINGStudents rated the activities they participated in as part of their clinical placement

Activities were rated in terms of the contribution it made to students’ understanding of other professions and their ability to work together with other professionals

Data gathering method (Completed in group)

Purpose After

FOCUS GROUPData collected using an interview guide

To gather information regarding IPEP learning experiences of students within one month after completion of their clinical placement

7 References:

*Inter-Professional Education and Practice (IPEP)

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Faculty development: A need for successful implementation of Interprofessional Education

1Rhoda, A, Frantz J, G. Fielies, Waggie F.

University of the Western Cape, Faculty of Community and Health Sciences, South Africa

INTRODUCTION

The belief that health professions educators, trained in the previous

century, are adequately equipped to lead a process of education

innovation to transform the current model of Health Professions

Education training may be misguided. Preparing academics to drive the

Interprofessional Education (IPE) agenda both nationally and

internationally is therefore key. The Faculty of Community and Health

Sciences (FCHS) at the University of the Western Cape embarked on a

process of Faculty development to ensure that academics are sufficiently

skilled to facilitate the implementation of Interprofessional Education

and Collaborative practice (IPECP) initiatives for students

PURPOSE

The purpose of this presentation is to share the implementation and

outcomes of IPE faculty development initiatives implemented in the

Faculty of Community and Health Sciences at the University of the

Western Cape.

CONCLUSION AND TAKE HOME MESSAGESupporting and implementing IPE faculty development initiatives

facilitates outputs in IPE.

IMPLEMENTATION AND OUTPUTS

IPE

FACULTY GOALS IPE CHAMPIONS ACADEMICS NEEDS

Buy In Research Project Publications

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Title:

• Faculty development: A need for successful

implementation of Interprofessional

Education

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INTRODUCTION

• The belief that health professions educators, trained in the previous

century, are adequately equipped to lead a process of education

innovation to transform the current model of Health Professions

Education training may be misguided. Preparing academics to drive

the Interprofessional Education (IPE) agenda both nationally and

internationally is therefore key. The Faculty of Community and

Health Sciences (FCHS) at the University of the Western Cape

embarked on a process of Faculty development to ensure that

academics are sufficiently skilled to facilitate the implementation of

Interprofessional Education and Collaborative practice (IPECP)

initiatives for students

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PURPOSE

• The purpose of this presentation is to share

the implementation and outcomes of IPE

faculty development initiatives implemented

in the Faculty of Community and Health

Sciences at the University of the Western

Cape.

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CONCLUSION AND TAKE HOME MESSAGE

• Supporting and implementing IPE faculty

development initiatives facilitates outputs in

IPE.

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INTRODUCTIONIt is the imperative of universities and faculties to develop and offer cohesive curricula that are systematically aligned with program objectives as well as national and international imperatives. Introducing concepts into a curriclum needs to be evalauted and assessed in order to ensure that it is relevant. Curriculum mapping introduces two main objectives: (i) to make the curriculum more transparent to all stakeholders; and (ii) to demonstrate the links and relationships between the various components of the curriculum. Thus curriculum mapping was used to indicate to faculty and students how the core competencies of interprofessional education in the curriculum are implemented and how it is linked to the identified university graduate attributes.

RESULTS

PURPOSEThis study aimed to offer insight into how discipline-specific curricula incorporate the competencies of interprofessional education as part of

promoting their graduate attributes.

Aligning graduate attributes with the interprofessional core competencies in an interdisciplinary health science faculty

1Frantz J, N.Mlenzana, N.Roman. C. Erasmus, H. Julie, G.Fielies, W. Cassiem, A.Rhoda1University of the Western Cape, Department of Physiotherapy,

Faculty of Community and Health Sciences, South Africa

METHODOLOGYA qualitative methodology using a case study approach was used for this study.

The curriculum map process was used and module descriptors for specific programmes were reviewed. Departments who volunteered to participate in

the study included Occupational therapy, Physiotherapy, Natural medicine,

Social Work, Child and Family Studies, Sport Science and Nursing. The unit

of analysis is the interprofessional core competencies as it is reflected within health professional discipline curricula.

CONCLUSIONSAlthough integrating inter-

professional core competencies

was an accepted imperative

amongst these departments,

the interpretation of the core

competencies varied. Implications

for the faculty were to unpack the

core competencies and develop a

common understanding that was

relevant to our context.

REFERENCESKelly et al. (2008).

PLANNING:Decide what

questions should be answered about the curriculum

CREATE THE CODE:

Decide what data will be gathered to answer the questions in Step 1 and carefully define the

metrics for measurement and the ‘‘code’’ for the map. This code must clearly communicate meaning to faculty.

FACULTY INPUT AND DATA

GATHERING:Plan the process

for gathering data from faculty

ANALYSIS OF MAP:Decide how to use the

map to answer pertinent curriculum questions

generated in Step 1.

IMPLEMENT CHANGES:

Create a plan to

address the changes

needed based on

the analysis in

Step 4.

INTERPROFESSIONAL CORE COMPETENCIESInterprofessional communication

Patient/client/family/

community-centred care

Role clarification

Team functioning

Interprofessional conflict resolution

Collaborative leadership

Values/Ethics for Interprofessional

Practice

GRADUATE ATTRIBUTES

Skilled communicators

Inquiry-focused and

knowledgeable

Critically and relevantly

literate

Interpersonal flexibility and confidence to engage across difference

Autonomous and collaborative

Ethically, environmentally and

socially aware and active

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Exposing students to IPE experiences – thinking out of the box

Gerda M Reitsma; Belinda Scrooby; Grieta HanekomCHPE, Faculty of Health Sciences, North-West University

IntroductionInterprofessional Education is still a somewhat new and unexplored concept at

the Faculty of Health Sciences at the NWU. In 2015 an IPE pilot project was

implemented in the Faculty, focussing on third year students and following a

theoretical based group discussion model. The results of the project indicated

many gaps to address for sustainable and successful IPE integration in thecurriculum. After collaboration with different stakeholders in the faculty

(lecturers, teaching-learning advisors and management), a different approach to

IPE implementation was put on the table. This approach aims to expose

students to different experiences of IPE from their first year to their final

year of undergraduate studies, in various contexts and including different

professions at different stages of the model. These include IPE collaboration

in first year anatomy classes, producing primary health care video’s in the

second year, participating in an IPE race in the third year, and presenting

research projects in a final year seminar.

PurposeTo present an alternative approach to IPE integration in the curriculum, and

to research the planning, implementation and evaluation of this model in

the faculty of Health Sciences.

MethodsPhase 1: Presentation and motivation of the alternative IPE model.

Phase 2: Mixed Methods research on the planning, implementation and

evaluation of the IPRace.

Students as well as lecturers will form part of the target population. Programme

leaders responsible for curriculum quality will be included in the final reflection

and debriefing stages.

Qualitative data (focus group interviews, written narratives and student

portfolios) and quantitative data (structured questionnaires) will be gatheredthroughout the implementation of the new IPE model. Observation and field

notes will from an integral part of the process

ResultsPhase 1:

Figure 1: Mono-, Trans- and Interdisciplinary exposure in HealthProfessions Training.

The alternative model is based on the research conducted by Viviers et.al.,

(2016) where the principles of team functioning of students in a

competitive but safe environment were implemented to develop

pervasive skills. The pervasive skills listed by Viviers et al (2016) are

similar to the CANMED competencies (Frank, 2005) listed for Health

professions.

The model will be implemented in 2018 at which time data will be collected

(Phase 2).

DiscussionIPE need to be implemented at a stage when the students’ have

established their own professional identity but are open towards

interprofessional experiences (Coster et al, 2008; Cooper et al, 2001).

Results from a pilot study (Reitsma et al, 2017) indicated that 3rd year

students in most of the health professions were ready to participate in

IP experiences, except the psychology students.

The IPRace is designed according to a model developed by Viviers et al

(2016).

Advantages:

• A large number of students can be accommodated.

• Students can be involved in different aspects of the IPRace (Steps 1-6

Figure 2) in IP teams.

• Students play a role in planning, implementing and evaluating, providing

ample opportunity for IP competency development.

• The IPRace takes place in a safe controlled environment (on-campus, in

Sim labs, using SP’s), without the logistical and resource constraints of

sending students to other training platforms.

• All professions can be accommodated as the students take responsibility

for designing the case studies.

• Debriefing can help students reflect on and understand the dynamics of IP

better.

Disadvantages:

• Planning and designing can be time consuming.

• Additional role players (including campus staff) will have to be included.

The advantages of the educational game on which the IPRace is modelled

have been proven in previous research (Viviers et al, 2016). The IP Race may

be an alternative to exposing students to IP scenarios where logistical barriers

such as timetables, finances and lack of appropriate supervised clinical

platforms exist. Students from all health professions, and the lecturers, can be

involved in different steps of the IPRace, providing adequate opportunities for

IP experiences for large student numbers. The necessity for IPE in health

professions education is undebatable, but the approach should be tailor-made

to the contexts and needs of the training institution to promote

sustainable integration in the curriculum. The results of this study may

form the blue-print for IPE implementation in the Faculty of Health Sciences,

NWU.

ReferencesCooper, H., Carlisle, C., Gibbs, T., & Watkins, C. 2001. Developing an evidence base for interdisciplinary

learning: A systematic review. Journal of advanced nursing, 35(2), 228-237.

Coster,S., Norman, I., Murrells,T., Kitchen, S., Meerabeau,E., Sooboodoo, E. & d’Avray,L. 2008.

Interprofessional attitudes amongst undergraduate students in the health professions: A longitudinal

questionnaire survey. International Journal of Nursing Studies 45: 1667–1681

Frank, J.R. (Ed). 2005. The CanMEDS 2005 physician competency framework. Better standards. Better

physicians. Better care. Ottawa: The Royal College of Physicians and Surgeons of Canada.

Reitsma, G.M., Scrooby, B., Rabie, T., Du Preez, A., Pretorius, R., Van Oordt, A., Swanepoel, ., Naudé,

A., Viljoen, M., Dolman, R., Smit, K. 2017. Inplementing interprofessional education in health sciences at

a South African university without a medical school: a pilot study. (unpublished).

Viviers, H.A., Fouché, J.P., & Reitsma, G.M. 2016. Developing soft skills (also known as pervasive skills),

Meditari Accountancy Research, 24(3): 368 - 389

Proposed IPE implementation

Conclusions

Figure 2: Proposed model for the IPRace

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How to use community primary care clinical placements as a medium for Inter-professional Education in BotswanaMmoloki Molwantwa1 Detlef Prozesky Mpho Mogodi

BackgroundMedical and nursing students at the University of Botswana (UB) have clinical placements in similar primary care clinics. These students also have clinical skills classes in their own skills laboratories and sometimes the topics learnt are similar. Opportunities for students to learn together in skills training and clinical placements are not being utilized in spite of the common learning outcomes and events that exist.

AimsTo maximise the opportunity for medical and nursing students to learn together in their clinical skills and placement programmes through; Merging similar clinical skills sessions of medical and nursing students into a joint IPE skills

curriculum. Planning learning activities in clinical placements that can foster IPE amongst the students.

Current situation

Medical students Nursing students

Examples of students working in parallel

programmes

Plans Engage relevant leadership from Faculty of Health Sciences and Faculty of Medicine to consider IPE in

their curricular Develop IPE curriculum for clinical skills teaching for medical and nursing students Include IPE activities as one of the outcomes in clinical placements

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The Collaborative Care Project

Jana Muller

Undergraduates collaborate interprofessionally to improve health

care in a vulnerable, rural community in South Africa

2012-2017

The project takes place in a health resource-constrained and socially vulnerable community. Students from five to seven professions are involved for one afternoon a week.

Aim

Using an interprofessional approach to patient assessment and

management during home visits to: improve health care delivery 1 ;

foster ‘agents of change’ 2 ; develop young professionals who are

Holistic, patient-centered clinicians who take ownership of change

Responsive to contextual factors that impact their patients

Cognisant of the power within their health care team

Aware of the resources available to them to best meet the needs of

their patients and community.

Context:

Medical student: ‘Being able to go to

the patient’s house and see this is

where they live and this what they

have to deal with and what they have

available to them. I think that rounds

you more as a clinician’

Identity:

Allied health

student: ‘You’re not

just someone, you’re

actually a therapist,

you’re a team

member’

Deeper understanding:

Medical student: ‘You need to ask (the

patients) about their life, how they cope at

home. I understand 100% that’s why we do

home visits. You’re shocked to see, oh hectic,

wow, this is bad. This is why my patient didn’t

arrive (for follow up) or this is why they don’t

have money, or why they want a (social)

grant, they really just can’t get by’

Partnerships:

Allied health student:

‘Definite highlights for me

were working with the

community health care

workers. Just getting to

know them.… They know

the patients on a more

intimate level’

Transformation:

Medical student: ‘The

home visit project

shapes better clinicians,

and it teaches us how to

work in interdisciplinary

teams, which is very

important….as a patient

would get better

treatment’

Role clarification:

Medical student: ‘We would see

what the Allied Health Sciences are

actually doing, as opposed to just

sending the patient to them and not

knowing what’s happening’

Outcomes

1. Reciprocal teaching, learning and a sense of social

accountability within the group

2. Change in self perception, team identity and role clarification

3. Development of student projects to meet identified need i.e. student

run rehab, therapy garden, sports project and support groups

4. Expansion of the project to other communities in 2017

Conclusion

The Collaborative Care project is contextually relevant,

allowing students to develop a better understanding of the

precipitating factors to health and wellness not necessarily

addressed in routine health care education or delivery.

The diverse team of students and community is inclusive,

despite differing professions and cultural backgrounds

providing space for reflection and transformative learning.

Jana Muller (MSc. Physio)

Ukwanda Centre for Rural Health

Faculty of Medicine and Health Sciences

Stellenbosch University

1 Durban Street, Worcester, Western Cape, South Africa, 6850

Tel: (023) 346 7812 / Fax: (023) 346 7859 / Cell: 083 504 1046

Email: [email protected] / Website: www.sun.ac.za/ukwanda-rcs

Bibliography

1. World Health Organisation, 2010: Framework for action in interprofessional and collab-

orative practice: Geneva: Wold Health Organisation

2. Frenk, J., et al., 2010: Health professionals for a new century: transforming education

to strengthen health systems in an interdependent world: The Lancet; 376:1923-1958

Acknowledgments: Ukwanda Centre for Rural Health, Prof H. Conradie and

Dr S. Snyman, Sharon Montgomery, FAIMER and Karin Schermbrucker (photographs)

Data from 2012-2015

155 days

200 homes visited

280 people identified

365 referrals made

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