Richard GrayRichard Gray

Principal Lecturer in Primary Principal Lecturer in Primary CareCare

Brighton and Sussex Medical Brighton and Sussex Medical School.School.

Workshop TitleWorkshop Title

• An exploration of the preparation An exploration of the preparation and support required by teachers and support required by teachers involved in inter-professional involved in inter-professional educationeducation

What is Inter-What is Inter-professional professional Education?Education?

DefinitionDefinition

• ““Inter-professional education occurs Inter-professional education occurs on occasions when two or more on occasions when two or more professions learn professions learn fromfrom and and aboutabout each other to improve collaboration each other to improve collaboration and the quality of care” CAIPE and the quality of care” CAIPE (1997).(1997).

Why should we do Why should we do it?it?

Why?Why?

• Estimation of 98,000 people die each year Estimation of 98,000 people die each year because of medical errors, mostly attributed because of medical errors, mostly attributed to poor systems design of teams, lack of to poor systems design of teams, lack of teamwork, distrust amongst healthcare teamwork, distrust amongst healthcare professionals leading to poor communication professionals leading to poor communication between professionals and between between professionals and between professionals and patients.professionals and patients.

• Johnson A, Pothoff S, Carranza L, Swenson H, Johnson A, Pothoff S, Carranza L, Swenson H, Platt C and Rathbun J (2006) “ Clarion: A Platt C and Rathbun J (2006) “ Clarion: A novel Approach to Heathcare Education”. novel Approach to Heathcare Education”. Academic Medicine 81 (3): 252-256.Academic Medicine 81 (3): 252-256.

Why?Why?

• Cultivate team workingCultivate team working• Ability to deal with complexityAbility to deal with complexity• Flexibility of rolesFlexibility of roles• Proliferation of new rolesProliferation of new roles• Overcoming resistance to changeOvercoming resistance to change• Effective improvementEffective improvement• Mutual supportMutual support

But, it is difficult……….But, it is difficult……….

• ProfessionalProfessional• EducationalEducational• OrganisationalOrganisational• FinancialFinancial• LogisticalLogistical

Is any of this of Is any of this of relevance to your relevance to your

experience?experience?

Thesis TitleThesis Title

• An exploration of the preparation An exploration of the preparation and support required by teachers and support required by teachers involved in inter-professional involved in inter-professional educationeducation

Rationale - historyRationale - history

• WHO (1988) “Learning to Work Together”. WHO (1988) “Learning to Work Together”. World Health Organisation. Geneva.World Health Organisation. Geneva.

• Butler Sloss E (1988) “Report into Child Butler Sloss E (1988) “Report into Child Abuse in Cleveland 1987”. HMSO. London.Abuse in Cleveland 1987”. HMSO. London.

• General Medical Council (2003) General Medical Council (2003) “Tomorrow’s Doctors. Recommendations on “Tomorrow’s Doctors. Recommendations on undergraduate medical education”. GMC undergraduate medical education”. GMC Publications. London.Publications. London.

Rationale 2Rationale 2

• Horder (2004) described importance Horder (2004) described importance of training and accreditation of IP of training and accreditation of IP teachersteachers

• Barr (2002) described importance of Barr (2002) described importance of research involving inter-professional research involving inter-professional medical undergraduate education and medical undergraduate education and preparation of teachers.preparation of teachers.

• Mhaolrunaigh et al (1995) concluded Mhaolrunaigh et al (1995) concluded that little research had been done on that little research had been done on teachers involved in IPEteachers involved in IPE

ContextContext

• Clinical Practice 1 introduces concept Clinical Practice 1 introduces concept of multi-professional team workingof multi-professional team working

• Ideal opportunities for IPT: nursing, Ideal opportunities for IPT: nursing, midwifery, pharmacy, medical and midwifery, pharmacy, medical and social work studentssocial work students

• Mixed response from studentsMixed response from students

Research questionsResearch questions

• Is inter-professional education Is inter-professional education occurring in UK medical schools?occurring in UK medical schools?

• If so, is there any preparation or If so, is there any preparation or support for teachers involved?support for teachers involved?

• If so, what is it and what happens?If so, what is it and what happens?

MethodMethod

Stage 1- background information obtained by Stage 1- background information obtained by literature review and UK survey of medical literature review and UK survey of medical schools by means of initial questionnaire schools by means of initial questionnaire (n=31).(n=31).

Stage 2- in-depth questionnaire sent to medical Stage 2- in-depth questionnaire sent to medical schools where preparation and support for schools where preparation and support for teachers of IPE is occurring (n=13).teachers of IPE is occurring (n=13).

Stage 3- telephone interviews with organisers of Stage 3- telephone interviews with organisers of such sessions (n=6) and participants (n=8).such sessions (n=6) and participants (n=8).

Stage 4- observational study of sessions (n=4).Stage 4- observational study of sessions (n=4).

Results 1Results 1

• Stage 1.Stage 1.

25 (31) respondents to initial 25 (31) respondents to initial questionnaire (81% response rate).questionnaire (81% response rate).

17 medical schools reported IPE 17 medical schools reported IPE occurringoccurring

13 of these reported preparation 13 of these reported preparation sessions for new teacherssessions for new teachers

11 of these reported support sessions 11 of these reported support sessions for established teachersfor established teachers

Results 2Results 2

• Stage 2 - 11 (13) respondents to in-depth Stage 2 - 11 (13) respondents to in-depth questionnaire.questionnaire.

• Stage 3 – 6 (7) organisers were interviewedStage 3 – 6 (7) organisers were interviewed

8 (21) respondents were interviewed8 (21) respondents were interviewed

Quantitative data from questionnaires Quantitative data from questionnaires analysed by SPSSanalysed by SPSS

Qualitative data from questionnaires and Qualitative data from questionnaires and interviews analysed by modified content interviews analysed by modified content analysis analysis

Themes from interview with Themes from interview with preparation/ support preparation/ support

organiserorganiser

• Influence of participantsInfluence of participants• Type of preparation courseType of preparation course• Importance of team workingImportance of team working• Incentives for teachersIncentives for teachers• Support for established teachersSupport for established teachers

Influence of participantsInfluence of participants

• ““Although the different back Although the different back grounds introduces a creative grounds introduces a creative mixture of different professional and mixture of different professional and educational perspectives, it also educational perspectives, it also brings participants requiring brings participants requiring different needs from preparation different needs from preparation courses”. courses”.

Importance of team Importance of team workingworking

• “ “ The sessions help develop team The sessions help develop team spirit and a feeling of having spirit and a feeling of having travelled together over the last 3-4 travelled together over the last 3-4 years. They are important for years. They are important for developing common thinking for developing common thinking for understanding”. understanding”.

Provisional ConclusionsProvisional Conclusions• 1. IPE is challenging and requires skills over 1. IPE is challenging and requires skills over

and above mono-professional teaching.and above mono-professional teaching.• 2. Preparation and ongoing support for 2. Preparation and ongoing support for

teachers of IPE, although practically difficult teachers of IPE, although practically difficult to arrange, is possible and is essential.to arrange, is possible and is essential.

• 3. Preparation should include theory, practice 3. Preparation should include theory, practice (especially facilitation skills) and developing (especially facilitation skills) and developing and understanding a common inter-and understanding a common inter-professional philosophy.professional philosophy.

• 4. Ongoing support should include evaluation 4. Ongoing support should include evaluation of student sessions to aid continual of student sessions to aid continual development of the programme and teachers. development of the programme and teachers.

Is there relevance Is there relevance to your to your

professional professional practice ?practice ?

ReferencesReferences

• Barr H (2002) Barr H (2002) “Inter-professional education-Today, Yesterday, and Tomorrow”.“Inter-professional education-Today, Yesterday, and Tomorrow”. CAIPE, CAIPE, London. London.

• Cooper H, Spencer-Dawe and Mclean E (2005) “Beginning the process of teamwork: Cooper H, Spencer-Dawe and Mclean E (2005) “Beginning the process of teamwork: Design, implementation and evaluation of an inter-professional education for first year Design, implementation and evaluation of an inter-professional education for first year undergraduate students”. undergraduate students”. Journal of Inter-professional Care.19Journal of Inter-professional Care.19 (5): 492-508 (5): 492-508

• General Medical Council (2003) General Medical Council (2003) Tomorrow’s Doctors. Tomorrow’s Doctors. GMC Publications.GMC Publications.

• Horder J (2004) “Inter-professional collaboration and inter-professional education”. Horder J (2004) “Inter-professional collaboration and inter-professional education”. BJGPBJGP, vol 54, no.501, 242-244., vol 54, no.501, 242-244.

• Mhaolrunaigh S, Clifford C, and Hicks C (1995) “Mhaolrunaigh S, Clifford C, and Hicks C (1995) “An evaluation of shared earning in An evaluation of shared earning in educational programmes of preparations for nurse, midwife and health visitor teacherseducational programmes of preparations for nurse, midwife and health visitor teachers”. ”. English National board for Nursing, Midwifery and Health Visiting. London.English National board for Nursing, Midwifery and Health Visiting. London.

• Leathard A (1999) Leathard A (1999) “Going inter-professional- working together for health and welfare ”.“Going inter-professional- working together for health and welfare ”. Routledge, LondonRoutledge, London

• Leaviss L (2000) “Exploring the perceived effects of an undergraduate multi-professional Leaviss L (2000) “Exploring the perceived effects of an undergraduate multi-professional educational intervention”. educational intervention”. Medical EducationMedical Education. Vol. 34, 483-486.. Vol. 34, 483-486.

ReferencesReferences

• Miller C, Ross N and Freeman M (1999Miller C, Ross N and Freeman M (1999)”An evaluation of shared learning in )”An evaluation of shared learning in educational programmes of preparation for nurse, midwifery and health visitor educational programmes of preparation for nurse, midwifery and health visitor teachersteachers”. English National Board for nursing, Midwifery and Health ”. English National Board for nursing, Midwifery and Health Visiting. .London.Visiting. .London.

• Parsell G, Spalding r and Bligh J (1998) “Shared goals, shared learning: Parsell G, Spalding r and Bligh J (1998) “Shared goals, shared learning: evaluation of a multi-professional course for undergraduate students”. evaluation of a multi-professional course for undergraduate students”. Medical Medical EducationEducation. Vol. 33, 304-311.. Vol. 33, 304-311.

• Pietroni P (1991) “Stereotypes or archetypes? A study of perceptions amongst Pietroni P (1991) “Stereotypes or archetypes? A study of perceptions amongst health-care students”. Journal of Social Work Practice. Vol.15, no.2, 61-69.health-care students”. Journal of Social Work Practice. Vol.15, no.2, 61-69.

• Stew G (2000) Stew G (2000) “An evaluation on inter-professional shared learning”“An evaluation on inter-professional shared learning” in in Bourner T, Katz T and Watson D (eds) “New Directions in Professional Higher Bourner T, Katz T and Watson D (eds) “New Directions in Professional Higher education”. The Society for Research into Higher Education and Open education”. The Society for Research into Higher Education and Open University Press. Buckingham.University Press. Buckingham.

• Zwarenstein M and Bryant W (2002) “Interventions to promote collaboration Zwarenstein M and Bryant W (2002) “Interventions to promote collaboration between nurses and doctors”. Cochrane Review. In between nurses and doctors”. Cochrane Review. In the Cochrane Librarythe Cochrane Library, issue , issue 4, 2002.oxford: Update software.4, 2002.oxford: Update software.