Innovative interprofessional learning

for allied health students on rural placements

Elesa CrowleyCo-authors:

Rebecca Wolfgang, Dr Leanne Brown, Luke Wakely, Julia Greaves,

Dr Tony Smith, Hazel Harries-Jones

University Department of Rural Heath, Northern NSW11

Interprofessional Education

‘The process by which a group of students from health-related occupations with different educational backgrounds learn together during certain periods of their education, with the interaction as an important goal1,’

World Health Organisation 1988

Why Interprofessional Learning2?

Changing models of health care

Ageing population (with complex co-morbidities)

Heightened consumer awareness

Higher costs

Risk of sub-optimal care

Poor collaboration

Outcome focused

eg NSW balanced scorecards, KPI’s,

multidisciplinary ward teams

1. World Health Organisation (1988) Learning Together to Work Together for Health. Technical Report Series 769, Geneva, Switzerland.

2. Smith T, Williams L, Lyons M, Lewis S. Pilot testing a Multiprofessional Learning Module: lessons learned. Focus on Health Professional Education, 2005; 6: 21-23.

Background

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Why Interprofessional Learning3?

Participation in clinical decision making across disciplines

Respect for the contributions of all disciplines

Continuous communication amongst care-givers

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3. Health Canada (2003) Interdisciplinary Education for collaborative patient centred practice. Research and Finding Report, Feb 20

The Setting University Department of Rural Health Northern NSW

Pilot development2

Interprofessional Learning Modules (IPL’s) are part of placement attachments

The following disciplines are involved:

Medicine Nursing Physio OT Pharmacy N&D Speech MRS

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2. Smith T, Williams L, Lyons M, Lewis S. Pilot testing a Multiprofessional Learning Module: lessons learned. Focus on Health Professional Education, 2005; 6: 21-23.

Rationale

Interprofessional collaboration is a key factor to ensure high quality patient care.

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Aim

To improve student awareness and attitudes to other professional roles in the clinical management of patients.

Methods Clinical topics have included:

Stroke Ethical Health Care and Professional Practice Self Care and Child Protection Hip fracture Trauma Diabetes

The modules have used a variety of teaching and learning techniques including Role plays Debates Hypothetical's and practical sessions.

Methods (continued)

An Example In Brief:Hip FractureA 76 year old woman arrives at Tamworth Rural Referral Hospital in the back of an ambulance. Marjorie had been found lying on the kitchen floor of her Tamworth home at 9 am that morning. She had apparently tripped over her cat at about 3 am on her way back from the toilet.

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Methods of Evaluation

Pre- and post-module evaluations Categorical – 5

point Likert scale Continuous – 10

centimetre Visual Analogue Scale

‘Role Knowledge’ scoring

Open comments

881. Parsell G, Bligh J (1999) The development of a questionnaire to assess the

readiness of health care students for interprofessional learning (RIPLS). Medical Education, 33:95-100.

Results

InterprofessionalLearning Modules

Date Attendees Evaluation Responses

Adult Trauma May-11 19 16

COPD Apr-10 19 19

Overdose Mar-10 42 39

Chronic pain April-11 41 20

Paed Spinal Cord Injury May-10 21 19

Hip Fracture Oct-10 23 23

Chronic pain Feb-11 18 18

Stroke Mar-11 38 38

Total 221 192

Table 1: Evaluation of Interprofessional Learning Modules conducted March 2010 - May 2011

Response rate 86.9%99

Total N&D students = 32

Results (continued)Evaluation of content - March 2010 to May 2011

1010

Results (continued)Evaluation of Delivery - March 2010 to May 2011

1111

Results (continued)Describe the way in which this session contributed to your understanding of working with other professions in the health care setting.“This case showed potential life threatening effects of which I personally and my profession lack knowledge, such as refeeding consequences”

Medical student“I learnt about issues such as suicide and eating disorders which are outside my scope of knowledge, yet will greatly influence every aspect of treatment and the patients willingness to participate in their own care”

Physiotherapy student“Professions depend upon the expert opinion of their colleagues to successfully diagnose, manage and treat a patient. Support of other health professionals is essential.”

Occupational therapy student“Every patient requires help from multidisciplinary teams”

Dietetics student

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Results (continued)

Ethical Health Care & Professional Practice

Did the Module improve the understanding of other professions?

Identify 2 types of service of 4 different professions

Both before and after the Module Simple ‘Role Knowledge’ score Pre-module mean = 8.2 out of a possible 16

points Post-module mean = 11.3 points

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Results (continued)

Self-Care and Child Protection A multiprofessional approach is

important in child protection

1414

0102030405060708090

100

StronglyAgree

Agree Neutral Disagree StronglyDisagree

Category of Response

Pre

Post

%

Scores shifted to the left in post-module evaluations

Discussion

Students believed in the value of the IPL Adult learning principles were well received Interaction with other disciplines enhanced

learning Skills learned during the modules are used

during placement. Placement supervisors report that students

are applying knowledge and skills. Breaking down boundaries between

disciplines has improved.1515

Conclusion

Interprofessional Learning Modules are a useful tool

to improve awareness, understanding of the roles and

partnerships between health professionals required

for patient care.

After participating in IPL’s students believe a

multidisciplinary approach improves patient care

The question remains whether these learning

modules: should be mandatory for all health profession students?

will have any long-term effect in breaking down

interprofessional barriers? 1616

Acknowledgments

Academic allied health staff at the UDRH, Northern NSWUDRH staff are funded through the University of Newcastle by the Commonwealth Department of Health and Ageing

Our partnersThe University Department of Rural Health (UDRH) and Rural Clinical School (RCS), is a collaborative project between the University of Newcastle and the Commonwealth Department of Health and Ageing. Additionally, the UDRH has strong strategic alliances with the University of New England and Hunter New England Area Health.

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