INTERPROFESSIONAL EDUCATION AND PRACTICE: THE BROAD HORIZON
By: Melanie Cason, PhD, RN, CNE
Advances in technology, for example, simulation and virtual platforms, increase opportunities for interprofessional education (IPE). However, both academic and practice environments continue to struggle with implementation on a large scale.
While the Institute of Medicine (IOM) promotes increased collaboration among disciplines, the practicality of implementation remains daunting. We have the TeamSTEPPS program, available at no cost from the Agency for Healthcare Quality and Research (AHRQ), which is commonly used in IPE and simulation training. However, the use of high-fidelity simulation for multiple disciplines requires appropriate identification for staff participation and agreement about desired outcomes, along with scheduling considerations. We continue to ask: Are there other ways to use simulation to promote IPE and interprofessional practice?
To my surprise, a preconference workshop at a recent summit hosted by the National Center for Interprofessional Education and Practice provided food for thought. The workshop, “By Design: Using Simulation and Design Thinking to Prototype Interprofessional Education and Practice,” involved the use of tabletop simulations on health care topics solicited from participants in a survey prior to the conference. A physician, nurse educator, pharmacist, and administrator were at my table. We were to use Design Thinking (Roberts, Fisher, Trowbridge, & Bent, 2016) to address the question: “What’s my role with my own care when I’m in the hospital?” Topics at other tables included discharge planning, medication compliance, and population health effectiveness.
Our efforts led to the creation by our interdisciplinary team of a How Might We question: “How might we create an environment where patients’ needs and preferences are heard, where patients are full participants in their own care?” To arrive at this question we followed the five components of the Design Thinking framework: problem-seeking, empathy-seeking, ideation, prototyping, and evaluation. The process involved in using the tenets of Design Thinking to address a problem is a dynamic one that challenges the use of meetings or didactic sessions to promote teamwork. At the end of the session, we used a flip board to share our end product.
The By Design session was a collaborative and totally enjoyable approach to problem-solving. There was time to think, discuss, and brainstorm. Of particular value was the opportunity to learn about the various role responsibilities of team members, learning that might not have been evident in another form of simulation.
Other sessions at the conference promoted open communication across disciplines, problem-solving as a team, and interactive techniques such as appreciative inquiry conversations to build respect and teamwork. Clearly, time needs to be provided for conversations among the various health care professions, and different forms of simulation should be considered in both education and practice.
In my experience as a facilitator in an IPE course with first-year students from medical, dental, nursing, physical therapy, occupational therapy, and physician’s assistant programs, there are differences in each discipline’s perspective, even among students who have not yet developed the posturing or attitudes that may lead to lack of mutual support. The creation of true collaboration and mutual support among disciplines may require a deeper level of experience than offered by the AHRQ TeamSTEPPS program to breach the silos of professional practice. A progressive IPE course that spans the program could be an interesting way to explore the effects of IPE. Incorporating interactive, virtual problem-solving activities with contributions from all professions prior to the simulation experience may provide a more conducive environment for the promotion of teamwork and patient safety.
The NLN has created activities and a toolbox to support faculty in developing meaningful IPE experiences, and recent updates to core interprofessional competencies are available from the Interprofessional Education Collaborative. But the use of online interactive, virtual, interprofessional sessions could solve some the logistical problems of removing health care professionals from their environments for a simulated activity. We must open our minds to innovation and change in our methods to move IPE and interprofessional practice forward.
Roberts, J.P., Fisher, T.R., Trowbridge, M. J. & Bent, C. (2016). A design thinking framework for healthcare management and innovation. Healthcare, 4, 11-14. doi: 10.1016/j.hjdsi.2015.12.002