Transcript Kesinambungan belajar berbasis IPE pada tahap akademik dan

Kesinambungan belajar berbasis IPE
pada tahap akademik dan penerapannya
pada tahap profesi
Diantha Soemantri
Koordinator Kurikulum Terintegrasi
Rumpun Ilmu Kesehatan Universitas Indonesia
“ It is no longer enough for health
workers to be professional. In the
current global climate, health
workers also need to be
interprofessional “
(WHO, 2010, p.36)
PRESENTATION OUTLINE
Main concepts
of IPE
IPE in academic
stage (current
implementation)
IPE in profession
stage (future
plan)
MAIN CONCEPTS OF IPE
The need for an interprofessional
education
Educational and Health System according to WHO (2010)
Collaborative practice
Perbaikan patient
care & safety
Perbaikan outcome
pada pasien
penyakit kronik
Peningkatan
kepuasan pasien
Penurunan angka
clinical error
Compliance
terhadap terapi
yang lebih baik
WHO (2010). Framework for Action on Interprofessional Education
and Collaborative Practice
Interprofessional education
Sargeant (2008): “Contact … is not
enough to build an effective team. Teamwork is a
sophisticated social activity requiring cognitive
(knowledge), technical (skills), and affective (attitude)
competencies and education for developing these”
How to organize an
interprofessional education
Components of Interprofessional Education Program (WHO, 2010)
“International environmental scan”
 Only 38% reported that IPE is MANDATORY
 Only 66% reported that the students know the
LEARNING OBJECTIVES of IPE program
 Only 37% reported that the learning objectives are
ASSESSED
 Only 31% reported that there is a TRAINING for
staff involved in IPE program
 30% reported that IPE program is not EVALUATED
Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education &
Collaborative Practice (2010). Where in the world is interprofessional education? A global
environmental scan. Journal of Interprofessional Care 24(5): 479-91
Current implementation
IPE IN ACADEMIC STAGE
in Universitas Indonesia…
• A learning module in which students sit
together listening to the same lecture or
reading the same book is not adequate
Multiprofessional education
• Informally, students can interact with each
other in this module, most probably
superficially
in Universitas Indonesia…
• Therefore, multiprofessional education must
be accompanied with interprofessional
education
• Interprofessional education  specifically
aims to equip students with the ability to
collaborate and work in a healthcare team
effectively
in Universitas Indonesia…
Medicine
Public
health
Nursing
Health
sciences
Dentistry
Pharmacy
• Resource sharing
• Efficiency of
resource use
• Closer relationship
and more effective
communication
between professions
• Added competency:
the ability to
collaborate and
work in a team in
providing health
care services
Structure of Health Sciences Faculties
curriculum
Study program (profession
specific) modules
Faculty compulsory
modules
University compulsory
modules
Multiprofessional &
interprofessional
learning modules
Shared learning modules
COMPETENCY
MODULE
CREDIT (in SKS)
Ethics and Law
Ethics and law in health profession
2
Basic biomedical sciences
Basic biomedical sciences
3 (theory) + 1
(practical)
Communication
Effective communication in
healthcare services
2
Disaster management
Disaster Management
2
Research
Research
IPE
Teamwork and collaboration of Teamwork and collaboration of
healthcare team
healthcare team
(preclinical and clinical)
MPE
3
2 (preclinical) + 1
(clinical)
Interprofessional competency domains in the “Teamwork & Collaboration of
Healthcare” Module
Universitas Indonesia
(2013)
Canada (2010)
IPEC (2011)
Group dynamics
Interprofessional
communication
Interprofessional
communication practices
Concept of collaboration
and healthcare service
system
Patient/client/family/comm Roles and responsibilities
unity-centred care
Conflict management
Role clarification
Values and ethics
Interprofessional
communication &
leadership
Team functioning
Interprofessional teamwork
& team based practice
Roles of each profession
Collaborative leadership
Obstacles & strategies for
interprofessional
collaboration
Interprofessional conflict
resolution
Module: Teamwork and collaboration of
healthcare team
Teaching methods
–
–
–
–
–
Introductory lecture
Collaborative learning
Question based learning
Case based discussion
Plenary presentation
Assessment system
•
•
•
•
Self reflection
Tutor & peer assessment
Written exam (in group)
Group project
80
70
60
50
40
30
20
10
0
Input from students:
“Continuity of program from academic to professional stage”
“Real world application of interprofessional collaboration principles” 
hospital? community?
5.75
5.88
30.47
30.48
37.68
38.27
Pre-module
Post-module
Roles and
responsibilities
Professional
identity
Teamwork and
collaboration
Mean score comparison of RIPLS (Readiness for Interprofessional
Learning Scale) in year 1 Health Sciences students
Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road.
AMEE Conference 2013, Prague
Future Plan
IPE IN PROFESSION STAGE
1
ROLE MODEL
• Interprofessional team in hospitals/clinics
• Examples of interprofessional collaborative practice in
hospitals/clinics
• Healthcare practitioners  understand the roles of
each profession, and aware of the importance of
interprofessional, collaborative healthcare services
• Minimizing negative stereotyping and hierarchy of
profession
2
INSTITUTIONAL SUPPORT
• Adjustment of the curriculum
• Time allocated for interprofessional education
• Allocation of human and physical resources, including
a number of main/affiliated hospitals, satellite/family
clinic, community health centers, etc.
• Training for teaching staff
3
ORGANIZATION
• Module management
• Organization of a high number and diverse students
and teachers
• Individual preparedness: students, teachers
• Student-centered active learning
Some examples of IPE in profession stage
(pre-qualification stage)
• Guest et al (2002)
– Interprofessional placement
– Pediatric ward in a large teaching hospital
– 90 senior nursing students, 90 junior medical
students  ‘buddied’
– Discuss and reflect students’ ward-based
interprofessional learning experiences
Some examples of IPE in profession stage
(pre-qualification stage)
• Van der Horst et al (1995)
– Interprofessional community placement
– Medicine, nursing, occupational therapy,
physiotherapy, social work
– Activities: observation of community
interprofessional health teams, interviews with
local community experts, interviews with the
users of community health services
Some examples of IPE in profession stage
(pre-qualification stage)
• Ker et al (2003)
– Simulated ward environment in a clinical skills
centre
– Medical and nursing students  interprofessional
teams
– Responsibility for the ward for a shift  prepare a
joint report  discuss and receive feedback from
tutors
the way forward…
• Designing an instructional design for IPE program in
professional (pre-qualification) stage by an
interprofessional teaching team
–
–
–
–
Explicit learning objectives
Relevant activities
Valid assessment methods
Feasible timing
• Formation of interprofessional team of students
– Medicine, nursing, dentistry, pharmacy and public health
– 1 group  10 students max?
the way forward…
• Choices of placements:
– Community placement
• Students are given a patient/family who needs an
interprofessional healthcare approach, that they have to
monitor and intervene during a particular period
– Clinical ward placement
• Students team-up to observe and experience an
interprofessional approach in treating patients in the ward
– Simulated ward environment
• Similar to the clinical ward placement, but in a simulated
environment  simulated patients. More opportunities for
hands-on experience
the way forward…
• In each placement:
– Tutors’ guidance and supervision
– Discussion and reflection upon the experiences
– Tutor assessment and feedback
– Peer assessment and feedback
• Evaluation (program)
– Level 1: students, teachers satisfaction
– Level 2: students’ learning achievement
to sum up….
• IPE is a must, preferably both at academic and profession
stage (continuum of the early and advanced stage of
education)
• Classroom-based teaching  main activities at the
academic stage
• Community/hospital ward placement  main activities
at the profession stage
• Specifically at the profession stage: IMPORTANT  not
only the instructional design of the IPE program, but also
the ROLE MODELING from healthcare practitioners
References
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Canadian Interprofessional Health Collaborative. A National Interprofessional Competency Framework.
February 2010.
Guest C, Smith L, Bradshaw M & Hardcastle W (2002). Facilitating interprofessional learning for
medical and nursing students in clinical practice. Learning in Health and Social Care 1: 132-138
Interprofesional Education Collaborative (IPEC) Expert Panel (2011). Core competencies for
interprofessional collaborative practice: report of an expert panel. Washington, DC. Interprofessional
Education Collaborative.
Ker J, Mole L & Bradley P (2003). Early introduction of interprofessional learning: a simulated ward
environment. Medical Teacher 37: 248-255
Modul Kolaborasi dan Kerjasama Tim Kesehatan. Rumpun Ilmu Kesehatan, Universitas Indonesia, 2012
Rodger S, Hoffman S on behalf of the WHO Study Group on Interprofessional Education &
Collaborative Practice (2010). Where in the world is interprofessional education? A global
environmental scan. Journal of Interprofessional Care 24(5): 479-91
Sargeant J, Loney E & Murphy G (2008). Effective interprofessional teams: “contact is not enough” to
build a team. Journal of Continuing Education in Health Professions 28(4):228-234
World Health Organization (2010). Framework for action on interprofessional education and
collaborative practice. Geneva: WHO Press
Van der Horst M, Turpie I, Nelson W et al (1995). St Joseph’s Community Health Centre model of
community-based interdisciplinary health care team. Health and Social Care in the Community 3: 3342
Yolanda S & Soemantri D (2013). Developing IPE in UI: the long and winding road. AMEE Conference
2013, Prague