Dr Barbara Parker

1. Educational strategies for enhancing IPL: Learning together, changing together Dr Barbara Parker Trenna Albrecht, Jane Coffee, Sue Gilbert-Hunt, Dr Sara Jones, Dr Geoff March, Dr Carmel Nottle, Denise Ogilvie, Josephine To, Dr Julie Walters

2. Teamwork • improves • patient outcomes • & work environments • of • health care providers • (Way et al. 2003, Learning and Teaching for Interprofessional Practice Australia, 2009, Mann et al. 2010, Schroder et al. 2010)

3. Team training 50%in adverse outcomes Mann (2006) IPL communication tool LOS in ICU 50% Pronovost (2003) Teamwork aligned attitudes Post-op sepsis rates Sexton (2006) Teamwork system clinical error rate (30.9% to 4.4%) 27% in nurse turnover Morey (2002), DiMeglio (2005)

4. What does this mean for UG Health students? • Health disciplines: practical experience is critical • Often discipline specific practice • Rethink models of best practice: shortage of clinical training places, complexity of contemporary practice and workforce constraints, accreditation reqs • Simply merging healthcare professions from different backgrounds into a team does not guarantee that they will have the knowledge, skills or attitude necessary to work collaboratively to enhance patient care • (Miller et al. 1999) • Given the multifaceted nature of IPL, need to further understand the processes of learning and change which occur • (Mann et al. 2010; Schroder et al. 2012)

5. Division of Health Sciences • Profile • Over 7,000 students • Occupational therapy, physiotherapy, medical radiation, podiatry, pharmacy, nursing, midwifery, dietetics, exercise physiology, • 3,500 nursing & midwifery students • State of the art on campus facilities • PBL simulated environment: • Health service spans 3 levels • Units: ED, critical care/surgical, medical, palliative care, paediatric, antenatal/birthing unit/post natal, home/nurse practice clinic • Briefing/practice rooms, clean and dirty areas • Staffed by senior practicing nurses & midwives

6. Method

7. Session structure

8. Session structure • Standardised patient • During the data collection sessions, the simulated patient: • acted out the scenario, • simulated attachments (i.e. oxygen mask, IV tubes, and wound moulage)

9. Data Analysis • Focus group data: • analysed and then triangulated (combined) • transcribed verbatim and analysed thematically • The researcher: • Viewed each session tape to develop a thematic framework • Quotes were lifted from their original context and re-arranged under the newly-developed appropriate thematic content. • The final stage involved determining the relationship between quotes, and links between the data as a whole.

10. Findings • Preparation • Understanding roles • Support • Valuable additional time in clinical practice prior to formal clinical placements in health settings • More information on the scenario before the workshop • 3 weeks provided opportunity to review and improve practice

11. “At first I think the first week when we came to here together and we get the case note then we just confused who is going to do this, and who is going to do this. We wonder and then we just all totally confused ……………” Preparation

12. “..think its really helpful as we have placement next year and not sure if put in hospital or aged care but there will be lots of other students from health professions or division and we’ve never really worked with students from other health professions before so it will be really useful ….” Preparation

13. Findings • Understanding roles • An opportunity to understand the role of other health professionals • An opportunity to practice how to work in a team with other health professionals

14. Understanding roles “Sort of makes me, um, think that if I don’t do my role then you know at the same time you see what everyone else is doing and they have to do…….…..then I’m thinking if I don’t jump in there and talk about …….it’s probably not going to get done or you know maybe will be overlooked or something like that.”

15. “I think that before I didn’t realise or know that as a team we were working together to get the information. One person doesn’t have to ask them everything; they can talk to other professionals as well.” Understanding roles

16. Understanding roles “As we got to know each other we got more comfortable with what each other is doing and helped us to know what we have to do and each needs to do. More comfortable about what we need to know working with someone another health professional”

17. Findings • Support • A lecturer or clinician from their discipline to discuss care and assist in planning and implementation of care to the ‘patient’ • Another student from their own profession to collaborate with and to discuss care and assist in planning and implementation of care to the ‘patient’ • ‘Time out’ from the scenario to liaise with a clinician or another student from own discipline to discuss care and assist in planning and implementation of care to the ‘patient’

18. Support “Although I think it might be just as interesting to do it in a group of other, with other professionals like yourself, ………Maybe another opinion as well to go with that.”

19. Incidental findings • Flow on effect for staff with greater understanding of roles • Job satisfaction and camaraderie • What happens when I'm not here? • Commitment to develop further IPL opportunities • Expensive and requires considerable resources: staffing, space and consumables

20. Summary The Division of Health Sciences InterProfessional Learning Group was convened for the purpose of determining practical IPL opportunities within the School of Nursing and Midwifery PBLs for students across the division. Since the group’s inception, active debate has ensued and opportunities identified for continued improvement and integration of IPL within the health science curriculum. This pilot study was one such opportunity. Small study & cannot generalise but students who had not been on placement identified deficits and learnings in understanding of their role and others within the healthcare team and in patient care.