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IPE Nuts and Bolts: 
Development, Implementation and Evaluation 
of Sustainable Interprofessional Programming 
IPE
Introduction to IPE 
Here are my ideas about introduction to 
IPE/IPCP and Collaborative Practice – SCK 
[This slide will be deleted]
Definitions 
Interprofessional Education occurs when two or 
more professions learn about, from and with 
each other to improve collaboration and the 
quality of care. 
Collaborative Clinical Education promotes the 
active participation of students, educators, and 
workers in teaching relevant cross-disciplinary 
person-centered care. 
Center for the Advancement of Interprofessional Education (2002)
Interprofessional Practice 
Multiple health workers from different professional 
backgrounds providing comprehensive health 
services working with patients, their families, 
caregivers and communities to deliver the highest 
quality of care across settings. 
Framework for Action on Interprofessional Education & Collaborative Practice WHO, 2010.
Interprofessional Collaboration 
“… the process of developing and maintaining 
effective working relationships with learners, 
practitioners, patients/clients/families and 
communities to enable optimal health outcomes. 
Elements of collaboration include respect, trust, 
shared decision-making, and partnerships.” 
Canadian Interprofessional Health Collaborative, 2010
Why IPE? Why Now? 
Since 1999 the Institute of 
Medicine (IOM) has urged the 
practice of IP team-based care 
to prevent medical errors. 
In 2013 the Journal of Patient 
Safety reported that between 
210,000 and 440,000 patients 
each year suffer some type of 
preventable harm when 
receiving hospital care. If the 
Centers for Disease Control 
were to include preventable 
medical errors as a category, 
these conclusions would make 
it the third leading cause of 
death in America. 
James, J. T. (2013) . A new, evidence-based estimate of patient harms 
associated with hospital care. JPS, 9(3), 122-128. 
• Integration of primary, 
behavioral and oral care 
(PCMH; ACA) 
• Demographic Changes, e. g. 
aging population; chronic 
health conditions 
• Increase in dual diagnoses 
• Technological advances; 
saving lives 
• Patient Safety & Quality 
agenda 
• Workforce pressures and 
gaps 
• Healthcare and payment 
reforms
Interprofessionality is not 
• Learners hearing a lecture about or by another profession 
• Reporting out following interdisciplinary activities (e. g. service 
learning; poster sessions) 
• Co-location without intentional collaboration (e. g. events; 
simulation lab) 
• Talking about rather than with other professions/clients
Core Competencies 
http://www.aacn.nche.edu/education-resources/ipecreport.pdf
Social workers: 
• Articulate their roles and 
responsibilities as well as 
accurately and fairly represent 
the qualifications and 
obligations of colleagues from 
other disciplines 
• Demonstrate a variety of 
approaches to achieve desired 
outcomes 
• Acknowledge professional 
strengths that enhance the 
interdisciplinary team process 
and contribute to positive 
client outcomes 
• Identify and seek common 
ground with your 
interdisciplinary colleagues 
IPEC Core Competencies: 
Roles & Responsibilities: Know one’s 
own role and those of team 
members 
Ethics & Values: Recognize and 
respect the unique cultures, values, 
roles/responsibilities and expertise 
of other health professions 
Teamwork: Integrate knowledge and 
experience of other professions to 
inform effective/ethical decisions 
Communication: Listen actively, 
encourage ideas and opinions; 
express knowledge and opinions to 
team members with confidence, 
clarity, and respect, and work to 
ensure common understanding.
Change is Hard
Implementation 
• Give specific examples of “how” each of us 
have offered our IPE courses 
• Provide details to help a participant who may 
not have developed an IPE course before 
• Convey the message - there is no cookie cutter 
approach
No “One Size Fits All” 
• Promote ideas that are 
meaningful to your faculty & 
identify common goals 
• Form an Inclusive coalition of 
faculty, students, staff & 
community partners 
• Create a common vision, clear 
message, and attainable goals 
• Walk the Talk – reach out to 
colleagues 
• Begin with small successes and 
build on them 
• Remove obstacles & sidestep 
barriers 
• Sustain momentum – establish 
a domino effect 
• Anchor change 
(Adapted from Kotter, 8-Step Change Model)
Teaching and Learning Opportunities 
Core Curriculum IPEC Event Series CLARION Competition 
IPE Student-led Clinics Global IPE Learning IPE and the Arts
More Opportunities 
Simulation Symposia IP Courses 
Student –led Research Shared Field Experience Service Learning 
ACA impact: http://youtu.be/6JAEKmNFTyA; Shared rotation: http://youtu.be/2zkQ0f3sluk
Tools & Methods 
• Handout (see slide #16) 
• Facilitation 
• TeamSTEPPS
Tools - Handout 
• Shared didactics – integrated curriculum; required & 
elective courses; designed & implemented by IP faculty 
• Shared assignments – case study presentations; 
literature reviews; posters 
• Shadowing – other professions; community workers; 
patients 
• IP Case conferences – intentionally designed with 
actual clients/patients; Clarion Root Cause analysis 
• Reflective journaling with prompts – use in field 
placements; activities; ethnographies 
• Shared field placements – IP placements 
• Service learning – deliberately designed IPSL 
• IP Scholarship & research – mini-grants; IP research
Group Exercise Idea 
• Which of the teaching and learning tools fits 
your IPE goals for the coming year 
• Break into small groups with facilitator to 
teach process and methods for activity 
• Come back into large group and share
Facilitation 
IP facilitators are: 
• Responsive to students as they interact with 
one another, surface ideas, and ask questions. 
• Encourage reflection, circumspection, and 
critical thinking 
• Guide group process and draw out the natural 
elements of group dynamics 
• Comfortable with different views and indeed, 
solicit them 
• Patient, agile, process-oriented yet able to 
manage conflict
Facilitation Goals 
• Orient learners to goals of the session 
• Prompt learners to discuss their observations 
• Encourage a non-judgmental environment 
• Make interprofessional learning explicit (e. g. let’s 
get the [discipline] view of client’s needs) 
• Inquire about what is missing and where might 
we find it? 
• Capture teachable moments 
• Prompt self-reflection 
• Encourage closure and final case/topic 
determinations
Role Modeling 
• Role model collaborative competencies in 
everyday practice 
• Share your own process – what were your 
misperceptions of other professions 
• Orient learners to interprofessional principles 
and values 
• Facilitate introductions 
• Clarify your role and have learners identify 
theirs
Facilitation Video Exercise
What is TeamSTEPPS™ 
• A teamwork system designed for 
healthcare professionals and workers. 
• Developed by Department of Defense's 
in collaboration with the Agency for 
Healthcare Research and Quality 
(AHRQ). 
• Provides attitudes, knowledge and skills 
for improving patient safety and quality 
within health and health-related 
settings. 
• Informed by evidence-based research 
aimed at improving communication and 
teamwork skills among healthcare 
professionals and workers.
"Your spoken word, your courage to challenge, your 
will to engage in teamwork, and your determination 
to ensure no harm can all be pivotal in determining 
if a patient lives or dies.“ Sue Sheridan 
http://www.ahrq.gov/professionals/education/curriculum-tools/ 
teamstepps/instructor/videos/ts_Sue_Sheridan/Sue_Sheridan-400- 
300.html
A Shared Mental Model Is... 
The perception of, understanding of, or 
knowledge about a situation or process that is 
shared among team members through 
communication. 
"Teams that perform well hold shared mental models." 
(Rouse, Cannon-Bowers, and Salas 1992)
ISBAR 
Introduce Situation Background Assessment Recommendation 
A Shared Mental Model for Communication
Patient 
• Sally Hinton is a 55 year old single women who lives on her own, receives 
MaineCare and SSI disability. She previously worked for 30 years as a school 
bus driver and continues to do volunteer work in the schools. 
• Sally was discharged a week ago after 2 days in the hospital being worked 
up for angina. Her diagnoses include insulin dependent diabetes, obesity, 
depression, and hydradenitis suppurativa (i.e., the development of cysts in 
the breasts, arm pits, neck and groin which require occasional draining). She 
takes nine different medications. 
• During a routine office visit today Sally seems uncharacteristically 
disoriented. She denies using alcohol or other intoxicating substances. You 
ask if she’s taking her medication appropriately to which she replies that 
she thinks so. When you ask to see her medications she tells you that they 
are stored in their vials in a kitchen drawer. She cannot however tell you 
which medications she takes, when she takes them or their dosages. 
• Sally also describes two falling incidents that occurred last week during the 
night. Although nothing was apparently broken, she shows you large bruises 
on her hip and forearm. She also has an open injury on her shin that she 
says is painful and not healing properly. 
• What are your thoughts about Sally’s health and well-being? 
• Describe how you would use ISBAR when transferring or referring Sally’s 
care.
28 
Briefs, Huddles & Debriefs 
Brief 
Who is on the team? 
Agree on Goals 
Roles & Responsibilities 
Understood 
Plan of Care 
Availability 
Access 
Resources 
Huddle 
Problem-solving 
Review situation 
Discuss new & 
emerging events 
Anticipate outcomes & 
possibilities 
Assign resources 
Express Concerns 
Debrief 
Communicate clearly 
about event 
Go over details 
Were roles & 
responsibilities 
understood? 
What went well 
What should change 
Can we improve?
Check-Back Is when Practitioners…
Racial & Ethnic Disparities 
• IOM’s Unequal Treatment 
highlighted evidence of 
racial and ethnic disparities 
in health care 
• Language barriers are less 
well documented 
• The root causes of patient 
safety events for non- 
English speaking patients in 
are: (1) poor 
communication and (2) 
insufficient use of qualified 
medical interpreters and 
cultural navigators 
http://www.youtube.com/watch?v= 
ABn0sE1aiGo
Case Study 
Mr. Morales is a 45-year-old car mechanic with type 2 diabetes. 
He was born in Mexico, speaks English as a second language, 
and has an eighth grade education. He just learned that he must 
transition to insulin therapy to manage his illness. His attempts 
at weight loss were challenged by desire to show appreciation 
for his wife and mother’s cooking. His PCP sent him to a 
dietician, who in turn provided him with an 1800 calorie-count 
diet plan. 
Written materials given to Mr. Morales were not helpful because 
he does not read English. He has also heard that insulin causes 
blindness and is thus fearful of starting this new medication 
delivery method. For now Mr. Morales chooses to use Mexican 
remedies such as prickly pear, offered by his mother.
Risks in Translation 
• Not using a professional interpreter or 
community health worker 
– Using family members or hospital/clinic staff 
as interpreters 
– “Getting by” with provider’s or patient’s poor 
language skills 
– Interpreter only present for part of the 
encounter
Community Health Outreach Workers 
Community health outreach 
• Culturally relevant health 
workers (CHOWs): trusted 
education 
• Mediate between community 
members of their communities 
who provide vital links between 
health systems and 
communities and play critical 
roles on the health team. 
members and services providers 
• Case management, systems 
navigation & insurance 
enrollment 
• Medical interpretation 
• Health promotion 
• Conduct surveys, collect 
community and health related 
data. 
• Contribute information on 
community needs and needed 
resources. 
• Educate health professions 
Whitley et al (2006). Measuring return on investment of outreach by 
community health workers. J of Health Care for the Poor and 
Underserved, 17, 6-15.
Teach-Back Is… 
• Confirmation of understanding 
• Opportunity to correct miscommunication 
• Comprehensive 
– “Tell me in your own words how you will take 
this medicine when you get home…”
Equipping Patients & Families 
• Quality care is a team effort 
• Patients and families can 
improve their care by taking 
active roles in the process 
• Invite patients to ask questions, 
and evaluate their option 
• Be culturally responsive to 
patients 
• Encourage shared decision-making 
in their health care 
• The AHRQ Web site 
―www.ahrq.gov/questionsareth 
eanswer/ 
Questions Your Patients Should 
Ask 
What is the test for? 
When will I get the results? 
Why do I need this treatment? 
Are there any alternatives? 
What are the possible 
complications? 
Which hospital is best for my 
needs? 
How do you spell the name of 
that drug? 
Are there any side effects?
3 Things 
Write down 3 things that you take away from 
today’s teaching and learning time together. 
Share one with the rest of the group.

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Interprofessional Education and Practice: Nuts and Bolts for Teaching IPE

  • 1. IPE Nuts and Bolts: Development, Implementation and Evaluation of Sustainable Interprofessional Programming IPE
  • 2. Introduction to IPE Here are my ideas about introduction to IPE/IPCP and Collaborative Practice – SCK [This slide will be deleted]
  • 3. Definitions Interprofessional Education occurs when two or more professions learn about, from and with each other to improve collaboration and the quality of care. Collaborative Clinical Education promotes the active participation of students, educators, and workers in teaching relevant cross-disciplinary person-centered care. Center for the Advancement of Interprofessional Education (2002)
  • 4. Interprofessional Practice Multiple health workers from different professional backgrounds providing comprehensive health services working with patients, their families, caregivers and communities to deliver the highest quality of care across settings. Framework for Action on Interprofessional Education & Collaborative Practice WHO, 2010.
  • 5. Interprofessional Collaboration “… the process of developing and maintaining effective working relationships with learners, practitioners, patients/clients/families and communities to enable optimal health outcomes. Elements of collaboration include respect, trust, shared decision-making, and partnerships.” Canadian Interprofessional Health Collaborative, 2010
  • 6. Why IPE? Why Now? Since 1999 the Institute of Medicine (IOM) has urged the practice of IP team-based care to prevent medical errors. In 2013 the Journal of Patient Safety reported that between 210,000 and 440,000 patients each year suffer some type of preventable harm when receiving hospital care. If the Centers for Disease Control were to include preventable medical errors as a category, these conclusions would make it the third leading cause of death in America. James, J. T. (2013) . A new, evidence-based estimate of patient harms associated with hospital care. JPS, 9(3), 122-128. • Integration of primary, behavioral and oral care (PCMH; ACA) • Demographic Changes, e. g. aging population; chronic health conditions • Increase in dual diagnoses • Technological advances; saving lives • Patient Safety & Quality agenda • Workforce pressures and gaps • Healthcare and payment reforms
  • 7. Interprofessionality is not • Learners hearing a lecture about or by another profession • Reporting out following interdisciplinary activities (e. g. service learning; poster sessions) • Co-location without intentional collaboration (e. g. events; simulation lab) • Talking about rather than with other professions/clients
  • 9. Social workers: • Articulate their roles and responsibilities as well as accurately and fairly represent the qualifications and obligations of colleagues from other disciplines • Demonstrate a variety of approaches to achieve desired outcomes • Acknowledge professional strengths that enhance the interdisciplinary team process and contribute to positive client outcomes • Identify and seek common ground with your interdisciplinary colleagues IPEC Core Competencies: Roles & Responsibilities: Know one’s own role and those of team members Ethics & Values: Recognize and respect the unique cultures, values, roles/responsibilities and expertise of other health professions Teamwork: Integrate knowledge and experience of other professions to inform effective/ethical decisions Communication: Listen actively, encourage ideas and opinions; express knowledge and opinions to team members with confidence, clarity, and respect, and work to ensure common understanding.
  • 11. Implementation • Give specific examples of “how” each of us have offered our IPE courses • Provide details to help a participant who may not have developed an IPE course before • Convey the message - there is no cookie cutter approach
  • 12. No “One Size Fits All” • Promote ideas that are meaningful to your faculty & identify common goals • Form an Inclusive coalition of faculty, students, staff & community partners • Create a common vision, clear message, and attainable goals • Walk the Talk – reach out to colleagues • Begin with small successes and build on them • Remove obstacles & sidestep barriers • Sustain momentum – establish a domino effect • Anchor change (Adapted from Kotter, 8-Step Change Model)
  • 13. Teaching and Learning Opportunities Core Curriculum IPEC Event Series CLARION Competition IPE Student-led Clinics Global IPE Learning IPE and the Arts
  • 14. More Opportunities Simulation Symposia IP Courses Student –led Research Shared Field Experience Service Learning ACA impact: http://youtu.be/6JAEKmNFTyA; Shared rotation: http://youtu.be/2zkQ0f3sluk
  • 15. Tools & Methods • Handout (see slide #16) • Facilitation • TeamSTEPPS
  • 16. Tools - Handout • Shared didactics – integrated curriculum; required & elective courses; designed & implemented by IP faculty • Shared assignments – case study presentations; literature reviews; posters • Shadowing – other professions; community workers; patients • IP Case conferences – intentionally designed with actual clients/patients; Clarion Root Cause analysis • Reflective journaling with prompts – use in field placements; activities; ethnographies • Shared field placements – IP placements • Service learning – deliberately designed IPSL • IP Scholarship & research – mini-grants; IP research
  • 17.
  • 18. Group Exercise Idea • Which of the teaching and learning tools fits your IPE goals for the coming year • Break into small groups with facilitator to teach process and methods for activity • Come back into large group and share
  • 19. Facilitation IP facilitators are: • Responsive to students as they interact with one another, surface ideas, and ask questions. • Encourage reflection, circumspection, and critical thinking • Guide group process and draw out the natural elements of group dynamics • Comfortable with different views and indeed, solicit them • Patient, agile, process-oriented yet able to manage conflict
  • 20. Facilitation Goals • Orient learners to goals of the session • Prompt learners to discuss their observations • Encourage a non-judgmental environment • Make interprofessional learning explicit (e. g. let’s get the [discipline] view of client’s needs) • Inquire about what is missing and where might we find it? • Capture teachable moments • Prompt self-reflection • Encourage closure and final case/topic determinations
  • 21. Role Modeling • Role model collaborative competencies in everyday practice • Share your own process – what were your misperceptions of other professions • Orient learners to interprofessional principles and values • Facilitate introductions • Clarify your role and have learners identify theirs
  • 23. What is TeamSTEPPS™ • A teamwork system designed for healthcare professionals and workers. • Developed by Department of Defense's in collaboration with the Agency for Healthcare Research and Quality (AHRQ). • Provides attitudes, knowledge and skills for improving patient safety and quality within health and health-related settings. • Informed by evidence-based research aimed at improving communication and teamwork skills among healthcare professionals and workers.
  • 24. "Your spoken word, your courage to challenge, your will to engage in teamwork, and your determination to ensure no harm can all be pivotal in determining if a patient lives or dies.“ Sue Sheridan http://www.ahrq.gov/professionals/education/curriculum-tools/ teamstepps/instructor/videos/ts_Sue_Sheridan/Sue_Sheridan-400- 300.html
  • 25. A Shared Mental Model Is... The perception of, understanding of, or knowledge about a situation or process that is shared among team members through communication. "Teams that perform well hold shared mental models." (Rouse, Cannon-Bowers, and Salas 1992)
  • 26. ISBAR Introduce Situation Background Assessment Recommendation A Shared Mental Model for Communication
  • 27. Patient • Sally Hinton is a 55 year old single women who lives on her own, receives MaineCare and SSI disability. She previously worked for 30 years as a school bus driver and continues to do volunteer work in the schools. • Sally was discharged a week ago after 2 days in the hospital being worked up for angina. Her diagnoses include insulin dependent diabetes, obesity, depression, and hydradenitis suppurativa (i.e., the development of cysts in the breasts, arm pits, neck and groin which require occasional draining). She takes nine different medications. • During a routine office visit today Sally seems uncharacteristically disoriented. She denies using alcohol or other intoxicating substances. You ask if she’s taking her medication appropriately to which she replies that she thinks so. When you ask to see her medications she tells you that they are stored in their vials in a kitchen drawer. She cannot however tell you which medications she takes, when she takes them or their dosages. • Sally also describes two falling incidents that occurred last week during the night. Although nothing was apparently broken, she shows you large bruises on her hip and forearm. She also has an open injury on her shin that she says is painful and not healing properly. • What are your thoughts about Sally’s health and well-being? • Describe how you would use ISBAR when transferring or referring Sally’s care.
  • 28. 28 Briefs, Huddles & Debriefs Brief Who is on the team? Agree on Goals Roles & Responsibilities Understood Plan of Care Availability Access Resources Huddle Problem-solving Review situation Discuss new & emerging events Anticipate outcomes & possibilities Assign resources Express Concerns Debrief Communicate clearly about event Go over details Were roles & responsibilities understood? What went well What should change Can we improve?
  • 29. Check-Back Is when Practitioners…
  • 30. Racial & Ethnic Disparities • IOM’s Unequal Treatment highlighted evidence of racial and ethnic disparities in health care • Language barriers are less well documented • The root causes of patient safety events for non- English speaking patients in are: (1) poor communication and (2) insufficient use of qualified medical interpreters and cultural navigators http://www.youtube.com/watch?v= ABn0sE1aiGo
  • 31. Case Study Mr. Morales is a 45-year-old car mechanic with type 2 diabetes. He was born in Mexico, speaks English as a second language, and has an eighth grade education. He just learned that he must transition to insulin therapy to manage his illness. His attempts at weight loss were challenged by desire to show appreciation for his wife and mother’s cooking. His PCP sent him to a dietician, who in turn provided him with an 1800 calorie-count diet plan. Written materials given to Mr. Morales were not helpful because he does not read English. He has also heard that insulin causes blindness and is thus fearful of starting this new medication delivery method. For now Mr. Morales chooses to use Mexican remedies such as prickly pear, offered by his mother.
  • 32. Risks in Translation • Not using a professional interpreter or community health worker – Using family members or hospital/clinic staff as interpreters – “Getting by” with provider’s or patient’s poor language skills – Interpreter only present for part of the encounter
  • 33. Community Health Outreach Workers Community health outreach • Culturally relevant health workers (CHOWs): trusted education • Mediate between community members of their communities who provide vital links between health systems and communities and play critical roles on the health team. members and services providers • Case management, systems navigation & insurance enrollment • Medical interpretation • Health promotion • Conduct surveys, collect community and health related data. • Contribute information on community needs and needed resources. • Educate health professions Whitley et al (2006). Measuring return on investment of outreach by community health workers. J of Health Care for the Poor and Underserved, 17, 6-15.
  • 34. Teach-Back Is… • Confirmation of understanding • Opportunity to correct miscommunication • Comprehensive – “Tell me in your own words how you will take this medicine when you get home…”
  • 35. Equipping Patients & Families • Quality care is a team effort • Patients and families can improve their care by taking active roles in the process • Invite patients to ask questions, and evaluate their option • Be culturally responsive to patients • Encourage shared decision-making in their health care • The AHRQ Web site ―www.ahrq.gov/questionsareth eanswer/ Questions Your Patients Should Ask What is the test for? When will I get the results? Why do I need this treatment? Are there any alternatives? What are the possible complications? Which hospital is best for my needs? How do you spell the name of that drug? Are there any side effects?
  • 36. 3 Things Write down 3 things that you take away from today’s teaching and learning time together. Share one with the rest of the group.

Editor's Notes

  1. The status quo is not acceptable and cannot be tolerated any longer. Despite cost pressures, liability constraints, resistance to change and seemingly insurmountable barriers, it is simply not acceptable for patients to be harmed by the same health care system that is supposed to offer healing and comfort
  2. This slide offers an example of technology usage.
  3. Facilitation Materials will be put on a handout