Transcript UK CENTRE FOR THE ADVANCEMENT OF …

UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
BACK TO THE FUTURE
Three CAIPE / CIPW Publications:
- History of pre-2000 Interprofessional Education
(Hugh Barr)
- Ethnographic Study of Contemporary State of
IPE post-2000 (Geoff Meads)
- Management Framework for future IPE strategy
and development (Lisa Hughes)
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
WHAT IS THE QUESTION?
From: ‘How has CIPW contributed to effective IP
practice and development?’
To:
‘Which modern NHS policies have been
effective and why?’
To:
‘What are the factors which may promote
sustainable cultural change in relation to
interprofessional practice and
development?’
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
3-D APPROACH
Ethnographic Study
• Three participation-observation sites
• 16 semi-structured interviews with IPE Directors
and Medical Deans
• Documentary and Literature Reviews 2003-2006
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
FALSE STARTS AND FALSE DAWNS
From New Era of ‘Working Together’ (2000)
“looking at the workforce in a different way, as teams of
people rather than as different professional tribes. For
too long we have planned and trained staff in a uniprofessional/uni-disciplinary way”
To New Agenda of
“new providers, extended practice and patient choice …
in which new skills mix, substitution and semiprofessional roles are the way forward”
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
FALSE STARTS AND FALSE DAWNS
Evidence cited:
• Rise and fall of NHSU, Care Trusts, WFC,
Intermediate Care and Collaboratives
• Absence of Tsars, Action Plans, NILSI and 2006
Policy references
• Pre-eminence of 2003 Skills and Knowledge
Framework
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
THE TORTOISE AND THE HARE
(Many) HEIs are lagging behind NHS modernisation
– Managed Markets with competitive imagery: USPs,
‘Added Value’, ‘Collaborative Advantage’
– S-T ‘task training’, workplace and on-line
– IPE equals limited resources for low grade HEIs in
universities’ own market:
“Irrelevant to the development of tomorrow’s future
super-specialists beyond the Internet”.
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
MUCH ADO ABOUT NOTHING
Much increased activity levels, from FE Access courses to
Foundation Years: IPE integral to career advancement
BUT:
• At ‘Explore/Engage’ or ‘Fight/Flight’ stages; not yet
‘Outcomes driven Education’
• ‘Second Job Syndrome’
• “Illusions” of “re-badged” programmes while IPE
Masters courses fail
• Withdrawal of WFC ‘shared learning’ pilots and funding
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
MEDICAL OPPOSTION OR WHAT?
Individual IPE legacy of:
‘territorial warfare’, ‘stigma and stereotypes’, ‘rural teamwork’
BUT
Corporate IPE future driven by:
• New GMC regulatory requirements from ‘Tomorrow’s
Doctors’/CAIPE
• Multidisciplinary Research Council requirements
• Financial Performance Management of SIFT to MPET workforce
• Redesign resulting from NICE
• CIPW and Personal Leadership of 2nd and 3rd tier
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
1.
2.
3.
4.
5.
THE IDEAL TYPE
Supportive 1st tier SHA leadership
Tone and terms setting Vice-Chancellor
Practice team based learning contracts with HE
Schools of Health AND Social Studies
Shared IPLD databases
NHS change seen as dynamic educational
resource
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
THE IDEAL TYPE
6. FE / HE use of local case study sites / care
pathways and protocols
7. Multidisciplinary IPE / CPD curricula
development mechanisms and management
8. IPE skills and knowledge standards inclusion in
formal student assessments
9. Transferable learning locally and internationally
for HE / Service partners
10. IPE inclusion in PFI terms and contract tenders
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
CRISIS, WHAT CRISIS?
Moving beyond child abuse / clinical negligence
cases via:
• new ‘teams’ and ‘networks’
BUT issues arise from:
• reduced ‘children’ focus in IPE commissioning
• resource restraints
• corporate NHS performance targets for individual
practitioners
• inter-agency not interprofessional agenda
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
AN ACUTE DILEMMA
• Absence of hospital based IPE practice and
publication
• Growth in Palliative and Primary Care for
long-term conditions
• Signs of Hope: CIPW / NSFs / IJIC etc
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
WILL IT LAST?
Future ‘Communities of Practice’ depend on:
1. Pre-disposing influences: including policy,
organisation and structures
2. Precipitating influences: including crises, media
issues and interest groups
3. Enabling influences: cultures, local government
processes, public relations, community
development
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
SUSTAINABLE CHANGE
The 4 ‘Enabling’ factors for IPE:
1. Infrastructure of LA sponsored collaborative
developments with ‘Third Sector’ as integral partner
2. Positive, proactive media with thematic of ‘Regional’
good news/identity/development
3. Creative, charismatic individuals selling the ‘sacrificial
shared vision’ and planning ‘succession’
4. Scale of ‘Socialising mechanisms’ for
‘Interprofessionality’ versus a ‘Common Enemy’
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
TRANSFERABLE LEARNING
Important principle
- local AND international partners
- adapt not adopt
- developing countries are richest resource
where curricula and community
development align
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
CREATING AN INTERPROFESSIONAL
WORKFORCE – INDIRECTLY
Lessons of initial programme and international experience
-
complex project management skills and strategy
required
Key others include Third Sector and regulatory bodies
Training and preparation for Context / Decentralisation
is vital
A tough and enduring challenge
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
POLICY: FRIEND OR FOE
Alternative Mental Models
- Vertical, “Done to”, “Forced Change” equals
“Defensiveness”
- Loss of negotiating rights, “Incrementalism”, no resources
- Lack of SHA/Intermediate level leadership
OR
- Lateral, Reciprocal, Workplace Focussed, Policy as resource
- Scope for pedagogic innovation: E-learning and PBL
- “We need to all learn together for policy as much as from
policy – in bite sized chunks”
UK CENTRE FOR THE ADVANCEMENT OF INTERPROFESSIONAL EDUCATION
CAIPE
WALK THE TALK
“Turn words into action”
- an excess of ‘Interprofessionality’ rhetoric
- an excess of ‘Contextual Dissonance’
“The Ultimate Message” is:
IPE as a “daily way of life”
- culturally compliant
- policy driven but not dependant