Developing Faculty to Teach Interprofessional Team-based Care

December 4, 2012

Brenda Zierler, PhD, RN, FAANLes Hall, MD, FACP

O POur Presenters

Leslie W. Hall, MD Brenda Zierler, PhD, RN, FAAN

Objectives of Presentation

• Describe national work being done to prepare faculty to teach IP team based carefaculty to teach IP team‐based care 

• Describe the Josiah Macy Jr., Foundation pilot f IP F l D l i Tprogram for IP Faculty Development in Team‐

based Care which Drs. Hall and Zierler co‐lead 

• Highlight key learning's from the pilot program and the implications for future faculty development efforts 

Recent Timeline of IPE Initiatives

RWJ Foundation –Interdisciplinary 

RWJ Foundation –Achieving 

Competence Today (ACT)

Center for the Advancement of IPE  RWJ Foundation 

Collaborative ID Team Education (CITE)

Professional Education 

Collaborative (IPEC)

(ACT)(CAIPE) founded 

in UKIOM Report on Health Professions Education

1990     1995                          2000                        2005

Education

Hartford Foundation funds Geriatric 

ID Team Training (GITT)

IHI Health Professions Education 

Collaborative (HPEC)

Pew Health Commission 

identifies teamwork as core competency

Dartmouth Summer 

Symposium started

Josiah Macy IP Conference yielded 8 recommendations 

for IPE

Recent Timeline of IPE InitiativesCanadian 

Interprofessional Health Collaborative 

founded

Collaborating Across Borders 

(CAB) I Conference

Collaborating Across Borders 

(CAB) II Conference

Collaborating Across Borders 

(CAB) III Conference

VA Primary Care IP Centers of Excellence

Conference Conference Conference

The Lancet Report –Health Professionals for a New Century

IOM IPE Panel formed

Interprofessional collaboration 

added to Nursing Essentials for BSN

Visionary statement for pharmacy education 

embraces IPE

2005                        2010                     2012            

Essentials for BSNembraces IPE

JCAHO Conference on Transforming Health Professions 

Education

Interprofessional Education 

Collaborative (IPEC) formed

IPEC released Core Competencies for Interprofessional Collaborative 

P i

AAMC identifies IPE as one of two “horizons for 

action”

American Interprofessional Health Collaborative  

First Annual Josiah Macy Foundation 

Practice

WHO Framework 

Interprofessional Partners in Action

founded Conference on IPE

for Action on IPE

Partners in Action (IPPIA) formed

Current State of IPE Efforts 

• 2010

IOM Report The Future of Nursing: Leading– IOM Report – The Future of Nursing: Leading Change, Advancing Health

L t C i i R t H lth P f i l–Lancet Commission Report: Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an InterdependentStrengthen Health Systems in an Interdependent World (Frenk et al., 2010).

The Lancet Reportp

• “Instructional reforms should: adopt pcompetency‐driven approaches to instructional design; …promote g ; pinterprofessional and transprofessional education that breaks down professional silos pwhile enhancing collaborative and non‐hierarchical relationships in effective teams.” 1p

1 Frank J, Chen L, Bhutta Z, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet, 2010; 376:1923-1958.

Framework for Action on IP Education and Collaborative Practice

Current State of IPE Efforts 

• 2011

– Interprofessional Education Collaborative Expert Panel. Core 

t i fcompetencies for interprofessional collaborative practice: Report of an expertpractice: Report of an expert panel. 

• 20122012

– IOM Forum on Innovation in Health Professional EducationHealth Professional Education

Interprofessional Collaborative Practice Competency Domains

Interprofessional Education Collaborative Expert Panel Core competencies for interprofessional collaborativeInterprofessional Education Collaborative Expert Panel. Core competencies for interprofessional collaborative practice: Report of an expert panel. May, 2011. Washington, D.C. Interprofessional Education Collaborative.

Developing Faculty to be IPE Competent

• Why?

– Socialization, culture, perspective – learned early in uni‐profession education 

– Role models for students

ildi i f– Building capacity of IPE experts

– Excellent teams in practice (but do they facilitate p ( yteam skills or clinical skills?)

Steinert’s Systematic Review on FD (2005)

• Attitudes changed positively and knowledge increased

• Teaching behavior improved (per teachers and learners)

• Key features of effective faculty development• Key features of effective faculty development:– Experiential learning – Provision of feedbacko s o o eedbac– Effective peer/colleague relationships– Well‐designed interventions following sound learning principlesprinciples

– Diversity of teaching methodsSteinert Y et al.  A systematic review of faculty dev initiatives designed to improve teaching effectiveness

di l d i G id 8 200 d h 28(6) 9 26In medical education:  BEME Guide No. 8. 2005 Med Teacher 28(6):497‐526.

Phases in Developing Faculty to Participate in and Lead Interprofessional Education

EngagementTraining to Facilitate IP 

Mentoring for IPE Leadership

LearningIPE Leadership

Possible Approaches for Engagement of Faculty

• Case‐based workshops• Team‐based rounds• Team‐building exercises• Peer coaching and gmentoring

• Web‐based learning• Longitudinal programs• Communities of practice

Silver IL and Leslie K.  Faculty development for continuing interprofessional education and collaborative practice J of Cont Educ in the Health Prof 2009; 29(3):172 7

p

and collaborative practice. J of Cont Educ in the Health Prof 2009; 29(3):172‐7.

Preparing Faculty to Lead IPE Experiences

• Faculty helping to design or lead IPE experiences need to know what works (and doesn’t work)( )

• Thistelthwaite & Nisbet (partial listing)– Clear learning outcomes– Planned involvement of professions– Linking content to clinical experienceM ki th i i t ti– Making the experience interactive

– Building in time for reflection– Planning formative or summative assessmentPlanning formative or summative assessment– Creating sustainability

Thistlethwaite J and Nisbet G. Interprofessional education: What’s the point andThistlethwaite J and Nisbet G.  Interprofessional education:  What s the point and where we’re at… The Clin Teacher 2007; 4:67‐72. 

Feedback is Key for Facilitating IPE

What are the simple rules for faculty development? (same as for students)development?  (same as for students)

• Integrate efforts into real work in which the faculty member is engaged 

• Use active learningUse active learning

• Spend time building relationships

T k d f i f l t• Track and use a few meaningful outcomes

• Align incentives

• Celebrate and spread successes; learn from failures

Examples of Faculty Development

Language and dress

Faculty Development  ‐ Active Learning  

• Readers Theatre (by Peggy Schlesinger, MD)

FD: Collaborative Leadership

Macy IPE Teaching Scholars Program

FD Training – Team Building Exercises

Josiah Macy, Jr. Foundation Grant: y,Faculty Development

GOALS

• Develop faculty to teach/facilitate IPE competencies; pilot faculty development program 

• Disseminate a validated training program to other health sciences schools by creating an exportable“Interprofessional Training Toolkit”

Josiah Macy, Jr. Foundation Grant

• One year pilot study implement and evaluate “train‐the‐trainer” model for developing facultytrainer  model for developing faculty– 3.5 day Faculty Development Training at UW (March 2012)

– 1.5 day training at Missouri U  at Columbia (Feb. 2013)

• 8 academic health centers and Puget Sound VA COE• Immerse faculty in experiential learning & teaching• ~Monthly coaching/mentoring/checking‐in• Determine exportability of training modules (includes 

teaching content faculty development strategiesteaching content, faculty development strategies, evaluation tools)

The Macy Grant –P ti i ti I tit tiParticipating Institutions

Josiah Macy, Jr. Foundation FD Grant ‐ topics

– Adult Learning Theory, applied– Appreciative Inquiry Theory Burst & Exercises– VA Primary Care Center of Excellence ExperienceVA Primary Care Center of Excellence Experience– Simulation as a vector for IPE– Front line stories (of IPE at each site)QI t f t hi / d li IPE– QI as vector for teaching/modeling IPE

– Changing Systems of Care with IPE:  Understanding the Impact of Context and CultureJ i i F l D l E Di l– Just in time ‐ Faculty Development – Error Disclosure

– Error disclosure training of ~450 students (immersion)– FD literature review– Curriculum mapping across HP Schools– Assessment and Evaluation Tools

IPE Competency Domains‐Teaching Example

‐ Role Clarity and Responsibility (what to teach)

‐ IPE Pictionary  (example of how to teach)y ( p )

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel Washington D C : Interprofessional Education Collaborativeexpert panel. Washington, D.C.: Interprofessional Education Collaborative. (AACN one of the IPEC Members)

Interprofessional Pictionary R l Cl itRole Clarity

• Faculty need to understand roles and responsibilities in order to teach students

• Interactive Exercise: As a team decide whoInteractive Exercise: As a team, decide who the health care professional is based on information provided by that disciplineinformation provided by that discipline

• Draw a representation of the health care f i l i h i l bprofessional without using letters or numbers 

(MD, RN, Rx, etc – not allowed) 

Training Requirements:Doctoral Degree

Usual Practice settings:Hospitals (inpatient and outpatient care), Community Settings, Clinics) y g

Scope of Practice includes: Health and medication education, treatment consultation, prescribe under protocol, administer medications, provide immunizations

Unusual Practice setting:NASA

Training Requirements: Doctoral DegreeUsual Practice Settings: Private Practice, schools, hospitals,

nursing homes, professional athleticsnursing homes, professional athleticsScope of Practice includes: Practice without a MD prescriptionUnusual Practice Setting: Consulting, Film Studios

IP Pictionary: Reflection

• What assumptions am I making?

• Where did I learn these values?• Where did I learn these values?

• What values/beliefs orient me?

• How might someone whose role is different than mine look at this?

• What are the biases and stereotypes about the profession? Do I perpetuate them with students?

Faculty Development ‐ Immersion

Faculty Development – Train‐the‐Trainer Model

Faculty Development – Mentorship

Train‐the‐Trainer (Visiting Faculty in Green)

collaborate.uw.edubl f i l i i lki ( b i )• Exportable Interprofessional Training Toolkit (Website)

Evaluation Strategy for Macy Grant

• Quantitative evaluationQuantitative evaluation– Faculty satisfaction with training

Curriculum implemented; students taught– Curriculum implemented; students taught

• Qualitative evaluation– Structured interviews to identify most helpful elements of faculty development program

F db k d t bilit f IPE t i i d l– Feedback on adaptability of IPE training modules

Project Timelinej

S ttl C f C l bi C fO i IPE C i lSeattle Conference

Grant approved

Columbia ConferenceOngoing IPE CurricularWork at AHCs

Jan Mar May July Sept Nov Jan Feb* * * * *

Jan Mar May July Sept Nov Jan Feb2012 2013

= Periodic conference calls* EVALUATION

Faculty Development ‐ Challenges 

• Release time for IPE trainingR l i f IPE hi• Release time for IPE teaching 

• Assumptions about being IPE competent• Teaching in new ways:  active learning vsPowerPoint

• Receiving credit for group projects (APT)• Intellectual property – IPE Modules (have clear plan for acknowledging contributions from team and individual(s)

Faculty Development – Unanswered Questions

• What is the relative importance of:• High quality training material?g q y g• Online support?• On site coaching/mentoring?Off i hi / i ?• Off site coaching/mentoring?

• How much development is needed for IPE experiences?experiences?– Example:  Just in time training for error disclosure

• How do we scale up to reach all health professions faculty?– How do we train faculty in IPE who teach at single profession campuses?profession campuses?

S h D !Save the Date!

F b 20 2012

The Education Practice NexusFebruary 20, 201211:00 – 12:00 CST

M k E t MD PhDMark Earnest, MD, PhDDirector, REACH|LEADS ProgramsProfessor of MedicineUniversity of Colorado

Questions?