integrated interprofessional education in veterinary medicine · professions learn “about, from...
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Integrated Interprofessional Education in Veterinary Medicine
Laura Molgaard Associate Dean for Academic and Student Affairs
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Agenda
• Framework and Background • IPE at Minnesota, Western U, and Oregon
State • Interprofessional Interactions of
Veterinarians
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Definitions
• Interprofessional Education: IPE • Occurs when students from two or more
professions learn “about, from and with each other” to enable effective collaboration and improve health outcomes (WHO)
• The WHO “framework for action on interprofessional education and collaborative practice” states need to prepare "collaborative practice-ready" health workforce that is better prepared to respond to local health needs
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Interprofessional Education Collaborative: IPEC
• Goal: “to prepare all health professions students for deliberatively working together with the common goal of building a safer and better patient-centered and community/population oriented U.S. health care system” Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional
collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative
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IPEC Competencies
Structured to yield “collaboration ready” trainees • Domain 1: Values/Ethics for Interprofessional
Practice • Domain 2: Roles/Responsibilities • Domain 3: Interprofessional Communication • Domain 4: Teams and Teamwork
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Interprofessional Professionalism Collaborative: IPC
Interprofessional professionalism, when practiced by all health professions:
• enhances quality healthcare outcomes for patients
• promotes a culture that values and fosters individual competence
• improves practice and academic environments
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Background
• The case for IPE is not new in human health professions
• Institute for Healthcare Improvement “Triple Aim” – Improving the patient experience of care (including quality and
satisfaction); – Improving the health of populations; and – Reducing the per capita cost of health care.
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Background
• Canada and UK are leaders in IPE • ACPE now requires IPE and other human
health professions are moving in that direction
• One Health initiative supports IPE for veterinary students
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IPE in Veterinary Medicine
• “Talking Walls” – RVC resource to introduce Interprofessional
Skills in context of veterinary team – Communication – Understanding and respecting roles (including
misconceptions) – Teamwork
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IPE in Three Academic Health Centers with CVMs
• University of Minnesota (2008 / 2010) • Western University of Health Sciences
(2009) • Oregon State collaboration with Western U
(2011)
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Minnesota • Academic Health Center with Colleges/Schools of:
– Dentistry – Medicine – Nursing – Pharmacy – Public Health – Veterinary Medicine and Center for Allied Health Programs
• Long-standing interest in team approach student desire for
interprofessional interaction and learning
• 2010 commitment to 1Health and three “phase” model – Phase I: Orientation – Phase II: Necessary/Essential Skills – Phase III: Expertise in Practice
•
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• Phase I (2010) = Foundations of Interprofessional Communication and Collaboration (FIPCC) with 6 modules on – Training, roles, responsibilities, stereotypes – Ethics – Teamwork – Inteprofessional decision making
• Phase II (2012) = Electives to “build the toolkit” • Phase III (2013) = and is intended to happen in the
healthcare setting as a capstone experience – “Exemplary Interprofessional Learning Environments” (EILE) – National Center for Interprofessional Practice and Education
Minnesota
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Western U
• Phase I: inter-institutional IPE program – all first year students from 9 health professions at Western U, 8
health professions at Oregon State and Linn-Benton CC in an. – facilitated small groups in a PBL format – clinical cases emphasize interprofessional communication,
collaboration, teams & teamwork in healthcare, scope of practice, and one health.
• Phase II: second year students – small groups, throughout the academic year
• Phase III: pilot stage of development – brings students from various professions working in clinical
environments and with standardized patients and standardized clinicians
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Western U
• One Health emphasized as a core competency throughout all 3 phases of the IPE curriculum, weighs heavily in written assessments of students from 13 health professions.
• Based on student outcomes and feedback, the perception of veterinary medicine as a healthcare profession is changing.
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Oregon State • Part of the inter-institutional IPE program with Western U • Together with the Pomona campus, students are enrolled in
an inter-institutional IPE course with a total of 13 health professions represented, including veterinary medicine on all campuses
• 2011-2012 pilot to replace veterinary integrative course (basic/clinical integration) with IPE
• One Health concept strong motivator • Challenges that led to 2012-2013 hiatus
– Distance and time required – Cases – role of vet med perceived as contrived although the
cases used in the curriculum were factual, real cases where veterinarians had roles.
• Planning to re-join in 2013
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Lessons Learned
• Political and logistical challenges are significant
• Good facilitators are critical • Cases need to be realistic • Opportunities to educate others about
veterinary medicine are never-ending
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Research: Interprofessional Interactions of Veterinarians
• Margaret Root Kustritz, Laura Molgaard (MN) and John Tegzes (Western U)
• Survey of 4000 AVMA members using AVMA employment functions (self-reported)
• 18.6% response rate – 15% <10 years – 39% 10-25 years – 41% 26-45 – 5% >45 years
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Frequency of interactions with professions by employment type (1 = never, 2 = rarely, 3 = regularly, 4 = frequently)
1
1.5
2
2.5
3
3.5
Practice
Teaching
Industry
Other
Root Kustritz M, Molgaard L, Tegzes J, unpublished data
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“Veterinarians should promote interaction to enhance patient care and growth”
• Physicians, PhDs, biomedical engineers, researchers - promote animal models of disease and collaborate on research
• Social workers or psychologists - how to work with clients and in how to manage own personal stress
• Physical therapists, chiropractors, and acupuncturists - provide non-traditional care and rehabilitation (balanced with concerns)
• Law enforcement officers – role in identifying abuse situations, work with animal rights groups, adherence to regulations
• Physicians, public health officials, etc. - disaster preparedness • Attorneys - medical record documentation, legal issues • Accountants or business professionals - practice management
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“Professions veterinarians could most positively affect “
• Physicians and nurses - zoonotic diseases • Physicians and nurses - in parasitology • Pharmacists - in physiology of domestic animals,
pharmacokinetics, administration (routes and challenges), contraindications
• Physicians - in prudent use of antimicrobial agents. • Physicians and public health officials - in food animal
production (animal welfare, food safety, and antimicrobial resistance)
• Physicians, PhDs, and other researchers - animal models of disease for research
• Teachers and other educators - promote veterinary medicine and interest in science in young people
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Conclusions
• While DVMs do not frequently interface with human health care professionals in practice, greater interaction may benefit veterinary medicine as well as human health
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Questions and Comments
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