Helen Orton
Directorate of Vision and Vision Science
School of Health Sciences
23rd June 2010 1Learning and Teaching Confe...
 Some misconceptions – shared teaching/
shared learning
 Learning activities involving two or more
professions where the...
 Cultural – pre-conceived ideas
 Attitudes
 Organisational level
23rd June 2010 3Learning and Teaching Conference
 Unique
 Diagnostic Radiography
 Nursing
 Occupational Therapy
 Orthoptics
 Physiotherapy
 Therapy Radiography
 A ...
 Quality Assurance Agency
 Political
 Regulatory bodies
23rd June 2010 5Learning and Teaching Conference
 Benchmark statements
 Relevant indicators of attributes and
capabilities of a new graduate
23rd June 2010 6Learning and...
 Department of Health
 1998 – Quality in the new NHS
 2000 - The NHS Plan. A Plan for Investment, a
Plan for Reform
 2...
 “Integrated care for patients will rely on models of
training and education that give staff a clear
understanding of how...
23rd June 2010Learning and Teaching Conference 9
23rd June 2010Learning and Teaching Conference 10
STANDARDS OF PROFICIENCY –
Expectations of a health care
professional
Pr...
23rd June 2010Learning and Teaching Conference 11
STANDARD CONDUCT WHAT IT MEANS
1. You must act in the best interest of
t...
23rd June 2010Learning and Teaching Conference 12
STANDARD WHAT IT MEANS
4. You must provide any important
information abo...
23rd June 2010Learning and Teaching Conference 13
FITNESS TO
PRACTISE
KNOWLEDGE AND
SKILLS
CHARACTER AND
HEALTH
23rd June 2010 14Learning and Teaching Conference
Year
1
Year
2
Year
3
 One scenario per semester;
 Representative from each professional group;
 Facilitated by staff within the School;
23rd...
Academic
Year
Semester
1
Comments and developments Semester
2
Comments and developments
2004-05 Case 1 Referred to as “Eth...
Academic
Year
Semester
1
Comments and developments Semester
2
Comments and developments
2007-08 Case 3 No change Case 4 No...
 Reflection on present situation:
 Are we completely transparent in meeting
some of the standards?
 Non-discriminatory ...
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  • Inter-professional describes a mechanism by which multi-professional working and professional relationships are developed in order to promote the collaborative delivery of integrated patient-centred and quality health care.


    Shared teaching - (multi-disciplinary and multi-professional) is considered as the teaching of common content, usually in a large group, without any intention to develop team-working and interaction, often distinguished by students of one discipline not even communicating with other student groups


    Multi-disciplinary learning activities refer to members of the same profession albeit a different branch, whilst multi-professional refers to the involvement of at least three professional groups

    Shared learning = true IPL supported by learning opportunities which encourage team-working and problem-solving activities, but with a minimum of two professional groups to improve collaboration and quality of care.
  • Cultural - medical, nursing and allied health students enter with pre-conceived and stereotyped views of their own and other professional groups and the negativity may result in a degree of professional arrogance which impacts on effective collaboration which is enhanced by uni-professional groups and by distinct codes of practice for each discipline, although very similar.

    Attitudes of tutors and clinicians towards inter-professional education out with what is learned within the classroom within programmes has done nothing to contribute to the development of inter-professional education, often referred to as a hidden curriculum

    Organisational level - few educational institutions offer or even have the facilities to offer inter-professional education but the jurisdiction of faculties and the more traditional approach to education contributes to the barriers to promote inter-professional education
  • Here at Liverpool, we are very fortunate to be able to offer IPL due to the number of programmes offered within the School of Health Sciences;

    Since their delivery commenced in 1992 (approximately),

    Major changes in professional and educational practice necessitated substantial refinement of the ongoing process

    Stakeholders identified that the current programmes needed radical review in order to meet with:

    Current NHS and social care (political agenda);

    Quality Assurance Agency for Higher Education

    Educational agendas, external agencies such as professional regulatory bodies and student expectations.

    More specifically, the ultimate aim of the degree programmes is to produce graduates who are “fit for purpose” and “fit for practice


  • There has been a shift of emphasis from competence to capability

    Competence:
    the minimum standard required to practice as a professional and its measurements being consistent with knowledge, skills and attitudes to

    Capability which measures the individual’s ability to adapt to change and respond by developing new behaviour and improve performance in keeping with the demands of the service users and the dynamic political climate of the NHS.

    This is also implicit with the QAA’s belief of constantly evolving and challenging clinical environment but other competency frameworks such as the NHS Knowledge and Skills Framework which aims to ensure effective working within the NHS.

  • This list is not exhaustive – key publications

    1998 - Quality in the new NHS – really introduced the idea of Lifelong learning, definition for which is on next page

    2003 – New NHS pay scheme - NHS Knowledge and Skills Framework which aims to ensure effective working within the NHS.
  • HOC – Standards of Conduct – July 2008

    NMC – 2008

    HPC – Standards of Proficiency – November 2007
  • Generic and profession specific
  • Only some highlighted

    1. Also looks at ensuring anything that we as HCP does not put anyone (service users and colleagues) in danger
  • Fit to practise
    When someone has the skills, knowledge, character and health to
    do their job safely and effectively.
  • Developed via a spiral curriculum;

    whereby these topics are revisited at increasing educational levels through the three year programme in order to foster progression and educational and professional development at each stage


    Year 3 – encourages team working


  • Difficulties with organisation due to clinical placements;

    However, ideally have at least one representative from each professional group

    Facilitators – from within School – often difficult to recruit – change in title of sessions to address this
  • The scenarios for the IPL sessions have been developed significantly since 2004. Initially, the sessions were referred to as “Ethics” and the scenarios were brief and the student tasks were too general and not focusing sufficiently on the dilemma presented. However, this was reviewed and the students were given more direction on the tasks and the concept of “Inter-professional education/learning (Ethics)” was then introduced along with guidelines on group work. Helen worked on new scenarios, some of which were based on real-life cases and where relevant, external influences (such as HPC, NHS policy) were taken into account within the tasks to encourage the students to recognise the importance of this element of their programmes. The facilitator notes were improved and incorporated into the tasks to make them more transparent and easily readable. In the last academic year, the sessions were changed again to reflect “Professional issues in clinical practice” focusing on one particular scenario. The most dramatic change occurred this semester (February 2010) where a number Fitness to Practise cases were discussed
  • The scenarios provide an excellent opportunity for the students to identify their role in the care and management of the case presented and to learn about other professional groups. Since the health care professional programmes attract a diverse range of students, some of whom are from ethnic minority backgrounds and/or are mature, this brings a wealth of experiences to the ethical discussions which may be highly contentious and it is important for students and facilitators to recognise and respect these cultural differences and views of all concerned. This learning environment proves very stimulating for all involved. This aspect of the module also reinforces the notion of recognising the professionals’ own scope and limitations of practice, their professional framework and the boundaries as specified by the professional regulatory body’s Statement of Conduct
  • Helen orton conf_10

    1. 1. Helen Orton Directorate of Vision and Vision Science School of Health Sciences 23rd June 2010 1Learning and Teaching Conference
    2. 2.  Some misconceptions – shared teaching/ shared learning  Learning activities involving two or more professions where they learn with, from each and about each other  Overall aim – promotion collaborative delivery of integrated patient-centred and quality health care 23rd June 2010Learning and Teaching Conference 2
    3. 3.  Cultural – pre-conceived ideas  Attitudes  Organisational level 23rd June 2010 3Learning and Teaching Conference
    4. 4.  Unique  Diagnostic Radiography  Nursing  Occupational Therapy  Orthoptics  Physiotherapy  Therapy Radiography  A dynamic curriculum 23rd June 2010 4Learning and Teaching Conference
    5. 5.  Quality Assurance Agency  Political  Regulatory bodies 23rd June 2010 5Learning and Teaching Conference
    6. 6.  Benchmark statements  Relevant indicators of attributes and capabilities of a new graduate 23rd June 2010 6Learning and Teaching Conference CompetencePAST Capabilities PRESENT
    7. 7.  Department of Health  1998 – Quality in the new NHS  2000 - The NHS Plan. A Plan for Investment, a Plan for Reform  2001 – Working Together, Learning Together A Framework for Lifelong Learning in the NHS  2003 - The new NHS pay system: An overview. 23rd June 2010 7Learning and Teaching Conference
    8. 8.  “Integrated care for patients will rely on models of training and education that give staff a clear understanding of how their own roles fit with those of others within both the health and social care professions…..  …. The Government will work with the professions to reach a shared understanding of the principles that should underpin effective continued professional development and the respective roles of the state, the professions and individual practitioners in supporting this activity” 23rd June 2010 8Learning and Teaching Conference
    9. 9. 23rd June 2010Learning and Teaching Conference 9
    10. 10. 23rd June 2010Learning and Teaching Conference 10 STANDARDS OF PROFICIENCY – Expectations of a health care professional Professional autonomy •Legal/ethical boundaries •Non-discriminatory manner •Confidentiality •Consent •Obligation to maintain FITNESS TO PRACTISE Professional relationships • Work in partnership • Team- working (MDT) • Communicate effectively
    11. 11. 23rd June 2010Learning and Teaching Conference 11 STANDARD CONDUCT WHAT IT MEANS 1. You must act in the best interest of the service user Must not allow views about a service user’s sex, age, colour, race, disability, sexuality, social or economic status, lifestyle, culture, religion or beliefs to affect the way you treat them or the professional advice you give. 2. You must respect the confidentiality of service users. Treat information carefully and respect what is told/ only use information for the purpose it was given 3. You must keep high standards of personal conduct. In addition to professional 4. You must keep accurate records. Part of care and duty to undertake
    12. 12. 23rd June 2010Learning and Teaching Conference 12 STANDARD WHAT IT MEANS 4. You must provide any important information about your conduct and competence. Criminal offences/ police cautions, disciplinary matters 5. You must act within the limits of your knowledge, skills and experience and, if necessary, refer the matter to another practitioner Duty of care Scope of practice 6. You must communicate properly and effectively with service users and other practitioners. Appropriate communication; co-operate and share knowledge and expertise with others for benefit of users 6. You must get informed consent to give treatment (except in an emergency). Informed consent Recording Refusal Rights of patients
    13. 13. 23rd June 2010Learning and Teaching Conference 13 FITNESS TO PRACTISE KNOWLEDGE AND SKILLS CHARACTER AND HEALTH
    14. 14. 23rd June 2010 14Learning and Teaching Conference Year 1 Year 2 Year 3
    15. 15.  One scenario per semester;  Representative from each professional group;  Facilitated by staff within the School; 23rd June 2010 15Learning and Teaching Conference
    16. 16. Academic Year Semester 1 Comments and developments Semester 2 Comments and developments 2004-05 Case 1 Referred to as “Ethics” and not all professional groups included. Few guidelines provided for facilitators but notes detailed Case 2 No change 2005-06 Case 2 As above Case 3 Term “Inter-professional education - ethics” introduced. Ground rules, group dynamics and benefits of group work discussed with students. Student tasks much more focused. 2006-07 Case 3 Communication tasks, issues concerning scope of practice and record-keeping Case 4 Student tasks focused and facilitator notes incorporated into student tasks. 16
    17. 17. Academic Year Semester 1 Comments and developments Semester 2 Comments and developments 2007-08 Case 3 No change Case 4 No change 2008-09 Case 3 No change Case 4 No change 2009-10 Case 3 Although the scenario was the same, the term “Professional Issues in Clinical Practice” introduced. Important documents (HPC standards, Knowledge and Skills Framework, role of IPL in clinical practice (+NHS policy) highlighted plus increased emphasis on communication. Case 5 Many new cases introduced which addressed Fitness to Practise issues involving anonymised real cases reported to the HPC and Nursing and Midwifery Council. Facilitator notes adapted accordingly. 17
    18. 18.  Reflection on present situation:  Are we completely transparent in meeting some of the standards?  Non-discriminatory manner ◦ The solution - Diversity and equality scenario  Inclusion of Nursing students 23rd June 2010 18Learning and Teaching Conference
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