1i) Project title : Using values-based digital technology to enhance and evaluate interprofessional education (IPE)

Dr Andrew Hunter Dr Dympna Casey Dr Geraldine McDarby Dr Heike Felzmann Dr Josephine Boland Dr Louise Campbell Dr Marie TierneyDr Martin Power Dr Pauline Meskell

Dr Rosemary Geoghegan Dr Tara Cusack Dr Tara Magdalinski Dr Yvonne Finn Ms Caroline Hills Ms Clare Carroll Ms Eimear BurkeProfessor Cecily Kelleher Professor David Seedhouse

ii) Partners: UCD & NUIG

Section 1: 4 minutes

iii. Overview• Inter-professional education

(IPE) is defined as occurring “when students from two or more professions learn with, from and about each other to improve collaboration and the quality of care” (Barr, 2002)

• The fundamental premise of IPE is if health professional students learn together they will be better prepared for collaboration and teamwork

• However currently health care students in Ireland typically learn in a uni-professional manner

Overall project aim

To implement and evaluate the impact of an online IPE programme designed to promote collaborative practice

within undergraduate health care disciplines

IPE programme• A six week IPE values-based decision-making programme

focused on decision making in ethically problematic health care situations

• Facilitated by a team of lecturers delivered using the online Values Exchange Network (VX)

• The education model underpinning the online system draws on several pedagogical approaches including student-centred learning, problem and group based learning and self-directed engagement including: discussions, polls, surveys.

• These strategies aim to allow students to work collaboratively to solve specific shared problems in a context specifically designed to make value judgements transparent. It is a specifically designed highly networked environment which utilises a range of interactive learning tools enabling students to work collaboratively

iv. Outcomes projected/achieved To implement an IPE programme using digital technology to improve inter professional collaborative practice

To promote students’ understanding of the perspectives, values and roles of other health care disciplines through collaborative problem solving

√

To evaluate the impact on students’ ability to collaborate with other disciplines

To capture student and staff experiences and perceptions of the entire IPE processTo identify factors that facilitate or hinder student engagement in learningTo identify changes in students’ perceptions of and attitudes toward other health care disciplines

iv. Outcomes projected/achieved contd.

To compare outcomes across participating institutions

To estimate the cost of implementing digital technology

v. Methodology (what was done/how we did it)

• A sequential exploratory mixed methods design was used to conduct the evaluation

• Phase 1:Qualitative interpretive descriptive design using focus group interviews were conducted with students (and facilitation staff

• Phase 2: A 34 item questionnaire was developed from student focus groups and distributed to students (not in initial study plan)

• Students were also asked at the start and end of the program via the online VX system to complete – the Readiness for Interprofessional Learning Scale (RIPLS)

(Luecht et al, 1990) – Interdisciplinary Education Perception Scale (IEPS) (McFadyen

et al 2007) – describe their decision making

Unforeseen challenges

• Short timeframe to develop the programme and undertake training

• Awarding credit as in semester 2 as all syllabus files already submitted

• Recruiting students to participate voluntarily

• Getting students to complete evaluations

2. Project outcomes to date: the impact on students

Section 2: 7 minutes

Qualitative Phase

• A qualitative interpretive descriptive design based on the work of Thorne et al (2004).

• Focus groups with students (n=47)

• All data recorded and transcribed verbatim

• Thematic data analysis used to analyze the data (Burnard 1991)

• NVIVO v10 used to manage and store the qualitative data

Demographics (n=47) Category Number Percentage

Age 18-22 years 39 83.0

23-26 years 4 8.5

27-30 years 2 4.3

31-34 years 1 2.1

35-39 years 1 2.1

Gender Male 5 10.6

Female 42 89.4

Previous participation in an IPE programme Yes 2 4.3

No 45 95.7

Year 1 5 10.6

2 3 6.4

3 34 72.3

4 2 4.3

5 3 6.4

Discipline Nursing 18 38.3

Medicine 13 27.7

Occupational Therapy 11 23.4

Speech and Language Therapy 5 10.6

Qualitative findings

• Four main themes identified

Meaning of IPE

Impact of IPE on learning

Barriers to IPE

Strategies to facilitate IPE

Well I suppose learning things from another professions point of view and being able to incorporate that so that you are not just thinking of your own profession when making decisions and stuff. That’s what I would have thought it is. (FG 7)

• The impact of IPE on learning– preparation for clinical practice and understanding of

other roles• …You are going to meet people out on the ward or whatever…

And I think maybe in a strange way it kind of teaches you that you need to you know, be more open to other people’s opinions, respect their opinions. If they do disagree with you well then that’s okay because that’s their opinion as well (FG1)

– reflection and critical thinking• I think it really made you reflect on your choices…there are things

that you had to go back and think about ,why you picked that, and I think that was really good. It would make you more aware of your decision making. And like make you consider more options before making the decisions I think (FG6)

– the role of values in decision making• It definitely made me think about my values a lot more. Like as in I

never really sat down and had to think well how do you actually feel about this or what will you do with this situation like ever before. And like the content of the programme, really made me think about like what I would like to do in the situation…So I feel like the content really made me think about my values like personally (FG5)

Barriers to IPE • Revolved around the following subcategories:

The online system

ECTS and workload

Insufficient instruction and training

Unequal involvement of disciplines

The online system

…as the weeks got on it got harder to use the different tabs and just finding the stuff…It was hard to navigate like…It was a bit like mixed up the way you were clicking into different things and then you weren’t sure if you clicked into this already... (FG 6)

the interface was pretty difficult but other than that I think content wise it was pretty stimulating …it’s only in its infancy stage, so I mean these are teething problems. Once it is solved I think it should be a really useful source of learning. (FG5)

ECTS and workload

…so it’s social science, we also have law and psychology and then we have got philosophy and then we’ve got like VX and an assignment in philosophy…So that’s like four, four things for at the end of the day social science is worth…ten credits. (FG 1)

And it’s not just going on Monday for the two hours and doing your, your surveys, or whatever…But then it’s taking up a lot more of the week…Your drowning in it and then that’s only a third of one module. (FG 3)

Insufficient training and instruction

…like the first week like literally no one was commenting… there was only two people who like responded in the group discussions so it wasn’t really helpful like. Its only like two professions that responded. (FG6)

…Last week… that was very difficult, that dashboard challenge …We had to figure that out ourselves…Trawl through this pages and pages of information (FG1)

Unequal involvement of disciplines

IPE course has potential!

• it is a fantastic concept. I do think that it is a brilliant idea. But it just wasn’t gone about in the right way to start off with.(FG1)

• …If you were to fix those things I think it would be brilliant! (FG2)

• Yea, I think that if it was done the way we were kind of saying, the little bits that need to be done. I think it could be really good; it could work really, really well (FG3)

• I think it’s a really, really positive thing. Like I as I said if it was me I really enjoyed it in that sense and I think it has so much potential for the future, this is the first step that’s being done really (FG7)

Describing decision making on week 6 versus week 1

79.2% (n=61) reported that they were a little more or much more aware of the role of their values in the decisions which they make

Strategies to facilitate IPE

Simplify the VX online system

Review workload and distribution of ECTS

Make compulsory for all students

Improve the instruction and training

Have smaller IPE groups

Evaluation Questionnaire Demographic Characteristic Number of students

Age 18-22 years 8923-26 years 1527-30 years 731-34 years 435-39 years 540-49 years 2

Gender Male 18

Female 104Discipline Nursing 71

Medicine 22Occupational Therapy 21Speech and Language Therapy

7

Social Care 1Previous participation in IPE

Yes 3No 119

Evaluation Questionnaire

Evaluation Questionnaire

Evaluation Questionnaire

Why they would not recommend the programme • 95 students (78%) responded to this open question

• Most recognised the potential of the programme, however the reasons given for not recommending the programme echoed those voiced in the focus group data and included heavy workload, lack of training and difficulties navigating the online VX system

• I would highly recommend the content of the online Values Based IPE programme but I think the delivery format could be improved as at times it was difficult to find each week's information (Medical student).

• The layout of the website was quite difficult to use, though the content

was quite good (Occupational Therapy student)

• I feel it would benefit from a review of some aspects of how its run taking into consideration that workload of other modules and the fact that we also have to submit a philosophy assignment as well as taking part in the programme (Nursing student)

• i) How the project outcomes impact nationally

• Evaluates the use of the online system as a medium to deliver IPE in the higher education sector.

• Provides a list of factors that facilitate / hinder student engagement with digital technology

• Future design of IPE digital technology programmes shaped by this project

• Potential to change the way we deliver and teach IPE

3. National Impact of outcomes Section 3: 4 minutes

• i) strategies to ensure national dissemination?

• The following publication outputs have been undertaken:– Poster presented at: EdTech 2015. 16th Educational Technology

Conference of the Irish Learning Technology Association; 2015 May 28th and 29th; Limerick. (http://programme.exordo.com/edtech2015/)

– Paper presented at: EuroSoTL 2015. Proceedings of the 1st European Conference on the Scholarship of Teaching and Learning; 2015 June 8th and 9th; Cork. (http://www.nairtl.ie/documents/EuroSoTL%20Programme_2015.pdf)

– Paper presented at: CELT The Annual Galway Symposium on Higher Education; 2015 June 19th; NUI Galway. (http://www.nuigalway.ie/celt/)

• Two Abstracts have also been submitted to :– 16th Healthcare Interdisciplinary Research Conference, Dublin. (

http://www.trinityhirc.com/)

3. National Impact of outomes contd.

3ii) . 3 Benefits to the higher education sector of having completed this work.

1. Introduces a new and innovative teaching and learning method for IPE at undergraduate level and highlights the potential of IPE to better prepare students for the transition into the workforce

2. Provides insight into the effective use of digital technologies in teaching and learning and provides a a list of recommendations to improve the process and allow other higher education sectors nationally to learn from and build further on this work.

3. Provides programme content and clinical case scenarios which can be made available to other institutions interested in introducing an online IPE project.

This project reveal that an IPE programme is acceptable to students, they value the concept and appreciate its potential to enhance learning,

collaborative practice and the quality of patient care.