Dr Saee Deshpande Dr Tapasya Karemore

1. Inter-
Professional
Education
A Guide to
Implementation

2. Digdoh Hill, Hingana Road, Nagpur
Ph. No. 07104-306100 email: info@vspmdentalcollege.in
www.vspmdentalcollege.in

3. Learning Objectives
• What does this increasing focus on inter-
professional education and collaborative care
mean for dental education?
• Why should dental schools be concerned with
collaborative care?
• What are the key challenges to and strategies
for implementing a successful IPE program?

4. Background
IPE in Dentistry

5. Dinner is one time during the day
we set aside to be together and talk.
There’s more to being a family than
just living in the same house…we
need to INTERACT once in a while!!

6. Workplace : Our extended family

7. Collaborate
Improve
healthcare
Learn
From
Each other
Learn
About
Each other Learn
With
Each other
In simple words……….

8. Early initiatives began in the 1940s in the USA,
Canada in the 1960s, Sweden & Australia in the
1970s and the UK in the 1980s.
The move toward inter-professionalism was influenced by reports
from the Institute of Medicine (IOM) in 2003 and the World Health
Organization (WHO) in 2010.

9. Dentistry & IPE
• The American Dental Education Association
(ADEA- CCI) Commission on Dental Accreditation
(CODA) standard to promote collaboration 2006
USA: By 2014, 90% of dental schools offered IPE
experiences for their students and 69% of those
activities were mandatory
UK: 2001 Dept of Health framework : learning
together- working together, one of GDC’s nine
principles

10. Core Concepts
IPE in Dentistry

11. Interprofessional
Collaborative Practice
IPCP
• when two or more professions
learn about, from and with
each other to enable effective
collaboration and improve
health outcomes.
• Professional - knowledge
and/or skills for the physical,
mental and social well-being of
a community.
• Collaborative practice -multiple
health workers from different
professional backgrounds
provide comprehensive services
by working with patients, their
families, care givers and
communities to deliver the
highest quality of care across
settings.
• Practice includes both clinical
and non-clinical health-related
work
Inter-professional
Education
IPE

14. Its NOT IPE

16. To develop knowledge, skills and
attitudes that result in inter-
professional team behaviors and
competence.
To learn how to function in an
inter-professional team and carry
this knowledge, skill, and value
into their future practice
To provide patient-centered care
in a collaborative manner to
improve quality of care

18. Comprehensive
Patient Care
Empowers
Team
Members
Closes
Communica
tion Gaps
Minimizes
Readmission
Rates-Cost
Promotes
a Team
attitude

19. Reduced
cost
Improved
quality of
care
Improved
public
health
Institute for Healthcare Improvement ( IHI ) : Triple Aim

20. In same discipline
Dental
nurses
Dental
assistants
Dental
hygienists
Dental
technicians

21. Across other disciplines
Medical
Engineering
Speech
therapist
NursingBiotechnology
Physiotherapy
Community
health worker

22. Role of Dental Schools in IPE
Dental
School
Involve
other
professions
Develop
students for
IPE
University
involvement

23. IPE in Dentistry
Examples of areas of collaboration

24. medical
emergencies in
dental practice
common medical
conditions with
dental implications
relationship
of general
and oral
health

26. Owens et al 2011, University of North Carolina at Chapel Hill School of Dentistry USA

27. Interprofessional faculty development: integration of oral
health into the geriatric diabetes curriculum, from theory
to practice
Dounis et al, Department of Clinical Sciences, Department of Biomedical
Sciences, Department of Physiological Nursing, Department of Physical Therapy,
University of Nevada Las Vegas School of Dental Medicine USA
• A statewide comprehensive type 2 diabetes
training program was developed and offered
to multidisciplinary health care faculty using
innovative educational methods on type 2
diabetes and comorbidities.

28. As a result…
• Attitude, knowledge, and perceptions of health care
faculty regarding Interprofessional team building
and the team approach to management of the oral–
systemic manifestations of chronic disease in older
adults was improved.
• Uniform language to promote communication
across health professionals, care settings, and
caregivers/patients, was noted.

29. Temporo-Mandibular Disorders
Prosthodontist
Oral surgeon
Pain
specialist
Neurologist
Orthodontist
Radiologist

30. Klasser et al, 2012, School of Dentistry, Louisiana State University, USA

31. Branch-Mays , 2017,
University of Minnesota School of Dentistry USA

32. • The theory is that oral bacteria re
lease toxins, which reach the pla
centa through the mother's blood
stream and interfere with the gro
wth and development of the fetus
• At the same time, the oral infecti
on causes the mother to produce
labor-triggering substances too q
uickly, potentially triggering pre
mature labor and birth.
Periodontitis as precursor for
low birth weight & preeclampsia:

33. Geriatric dental care
Coping with tooth loss, age related changes in oral cavity specially
changes in taste, xerostomia, chronic systemic diseases like
hypertension, diabetes, heart diseases, neuromuscular disorders

34. Engineering

35. Biotechnology

36. Dentistry Physiotherapy

37. Approaches to IP clinical experiences
CARES
• Social
workers at
dental clinic
• Buffalo Uni
• To improve
retention
rates by
reducing
barriers to
care
Seamless care
Model
• Dalhousie
Uni
• Medicine &
dentistry
• Hospital-
community
OHNEP
• New York Uni
• Co-location
of clinics in
close
proximity
• Nursing- oral
health
CHOMP
• Case western
reserve
university
• Collaborative
home for oral
health
medical
review and
health
promotion

38. IPE examples from VSPM Dental
College, Nagpur, India

40. So what was done..

41. How it was tested..?

42. What was the outcome..
• There were improved attitudes toward
perception of each other’s role in maxillofacial
rehabilitation after participation in the
module and positive effect of better
teamwork on patient care perceived by
greater number of participants evident in pre
& posttest scores as well as responses to semi-
structured interview.

43. Now we are included ..

44. Dissemination at Association of Medical
Educators in Europe (AMEE) Annual Conference
at Helsinki, 2017

46. Tobacco cessation
school teachers

47. Tobacco cessation
community health workers
• Development of oral hygiene module to be
implemented with ASHA (Accredited Social
Health Activist) workers

48. • To anticipate future needs for IPE and
practice, one must understand the current
state of IPE and IPCP training.

49. Group Activity 1

50. • Is there any clear problem in your dental school,
local healthcare system or community which can
be addressed by inter-professional approach?

51. IPE in Dentistry
Important Competencies

52. Responsibilities/Teamwork
Communication,
accountability and task
management
Conflict management and
negotiation
Leadership and
membership

53. Who is on my team?
Responsibilities/teamwork
understanding role of different discipline
Everyone’s
professional
role/
responsibility
Process of
scope and
practice
Role of patient,
relatives or
community
representative as
integral partners
Influence of
different
clinical settings

54. How will our work get done?
Communication, accountability and task manager
Discuss communication
methods
Demonstrate tools and
strategies
Task distributions and follow up
of those tasks

55. Can we deal with challenges?
Conflict management and negotiation
Source of
conflict ?
Conflict
management
styles
Identify
methods to
resolve
Use communication
strategies to manage
conflicts

56. How can we work together?
Leadership
Analyze one's
own strengths,
areas for
development,
and leadership
style.
strategies and
tools for
effective
healthcare team
leadership and
membership

57. If we practice…what else it should contain....?
• Evidence-based practice

58. IPE in Dentistry
Teaching-Learning

59. IPE in Dental Curriculum
Pre-
qualification
Post-
qualification

60. Learning Theory
Reflective
learning
Experiential
learning
Social
learning

61. T-L Types
Formal Informal
Face to face Online
Synchronous Asynchronous

62. Didactic /
classroom based
Community
based
Simulation
based
Clinical /service
based

63. Conventional Techniques
– Interactive Large and small group teaching
– Pre-session assignment like quiz
– Expert interviews
– Videos
– Role play
– Mentoring

64. Special Techniques
Portfolios
Group debrief
Reflections

65. Electronic Health Records
ease of access and communication

66. • sophisticated high definition real-time video
equipment with live stream, multiformat,
multistandard editing and live production to meet the
highest broadcast specifications.
• Video recording enables instant replay, discussion,
and feedback to the faculty trainees, program
instructors and provides an opportunity for reflection.

67. High-Fidelity Clinical Simulation
animated
manikins
Controlled
environme
nt by
softwares
Tailored
to
learner’s
needs
digital
AV
recordin
g media

68. Blended learning
Contextual learning

69. How to Choose..?
• Type of learners
• Learning objectives- competencies to be
developed

70. Check the following..
• Calendar and schedule agreement among the
participating colleges and programs.
• Evening and weekend activity opportunities.
• Expertise to develop simulation experiences
with inter-professional objectives in mind.
• Personnel to debrief experiences.

71. IPE in Dentistry
Assessment

72. if learning
has taken
place
to promote the
value or
importance of IPE
to the learner
Successful
Assessment

73. Process based
reflections are
important Outcome based
Qualitative
Quantitative

75. Curriculum
Goals
Objectives
of
assessment
Setting
Assessment
Tool

76. Modified Kirkpatrick’s Model of Educational Outcomes
for Inter-professional Education

77. Assessment tools used for assessing
competencies for inter-professional education
ITOSCE
Portfolios
Reflections
Questionnaires
Direct
observation in
simulated patients
Logbooks

78. Questionnaires

82. Competency T-L Method Assessment
IPE core concepts Online Knowledge based
Roles &
responsibilities
Online & Face to face
interactive teaching
Problem/ team based
learning
IT OSCE
Questionnaires
Communication
Conflict Mt
Negotiations
Face to face
Videos
Role play
IT OSCE
Direct observations in
simulated patients
Teamwork and
leadership
Face to face
Simulated patients
IT OSCE
Direct observations in
simulated patients

83. Disseminating findings from an evaluation
Websites
National or
international
conferences
Scholarly
papers in peer-
reviewed
journals
Newsletters at
the institutions or
professional
regulatory bodies
Local
meetings

84. IPE in Dentistry
Challenges, Strategies to overcome

85. Administration
Faculty members
lack of
perceived
value to IPE
Attitudinal
differences in
health
professionals,
scheduling,
rigid
curriculum
Students-
Matching
levels of
learners

86. Administration
Whether it is worthwhile …
• To direct resources to a new change ?
• To develop infrastructure for IPE?

87. Strategies …
• Involvement of key
administrators and senior
faculty at this initial
developmental stage
• Align center goals with
national and local health
systems priorities and make
a business case
• Apply for external grant
funding- Govt. agencies
and philanthropic
organizations

88. Strategies …
• Integrate required IPE
into the core curricula,
provide evidence that it is
effective, and create a
curriculum framework for
developing new IPE
activities
• Disseminate findings
widely at scholarly
meetings, consultations,
media and website

89. Faculty members
• Preconceived Notions
• Academic elitism
• ‘Silo’ approach

90. Strategies…
Faculty development is
a planned program
designed to prepare
institutions and
faculty members for
their various roles
National
Regional
Institutional
Individual
Short courses
Fellowships

91. What can be addressed??
(a) Interprofessional education and collaborative
patient-centred practice.
(b) Teaching and learning.
(c) Leadership and organizational change -
stakeholders.

92. Interprofessional education & collaborative
patient-centered practice
• What is IPE?
• Why IPE?
• What is the evidence?
• Barriers to IPE
• Models of IPE
• Models of collaborative practice
• Strategies for promoting IPE and collaborative
patient-centred practice
• Team functioning and team building

93. Teaching and learning
• Curriculum design and development.
• Interactive lecturing.
• Small group teaching.
• Case-based teaching.
• Feedback and evaluation.

94. Leadership and organizational change
• Leadership – practice and educational
settings.
• Organizational behavior, structure and
dynamics
• Organizational change and development
• Conflict management and negotiation

95. Rigid curriculum / curriculum gridlock
• Scheduling
• Complex timetables
• Limited resources

96. Strategies …
• Technology
enhanced learning
• Web based learning
• Asynchronous
learning
• Peer coaching
• Self directed learning
• Careful planning

97. Students- Matching levels of learners
• Students’ ages
• Learning styles
• Motivations

98. Strategies ...
• Showcase ‘‘best
practices’’
• Use examples from
other professions.
• Role modeling and
‘‘reality’’ – show it to
students

99. Attitudinal differences in health professionals
strategies to overcome…
• Shared goals
• Communication of a sense
of purpose and meaning
• The fostering of
collaboration and
cooperation
• Empowerment and trust
building

100. Individual projects :
Less obstacles but may not
sustain in longer run
Institutional projects :
More obstacles but
will sustain in longer run
No action .. NOT an
option..!!

102. WE NEED TO….
- Inclusion in curriculum
- Faculty development
- Changing working environment
- Propagate…campaign....

103. We Are Working Together!!

106. Group Activity 2

107. Design your IPE module
• Topic & stakeholders
• Content
• Learners
• Schedule : T/L & A
• Barriers & Facilitators
• Ways to overcome including ways for faculty
development

109. Organizing committee of 30th
Annual Meeting SEAADE, 2019
Dr Pravin Patil, IMU, Malaysia
Dr Usha Radke (Dean, VSPM
Dental College, Nagpur)