Interprofessional Education in Allied Health

1. Interprofessional Education in Allied Health Caroline Robinson, Annette McLeod-Boyle, Kristy Robson, Narelle Patton, Lauren Blatchford.

2. Outline Background Interprofessional working in the Allied Health Clinic Themes for consideration Future directions

3. Charles Sturt University (CSU) was established in 1989 as a multi-campus institution. It is a progressive University well-known for its innovative approach to education and applied research. “Through our network of campuses, and in close association with industry, professions and government, we are committed to maintaining a course and research profile to meet the needs and supports the aspirations of our communities, and contribute to the enrichment of inland Australia”.

4. The Faculty of Science has more than 7500 students and over 350 staff. The School of Community Health hosts courses in: • Health and Rehabilitation Science • Occupational Therapy • Physiotherapy • Podiatry • Speech Pathology

5. The Allied Health Clinic The Allied Health Clinic on the Albury campus was established in 2001, initially to provide clinical placement experience for podiatry students. It currently operates 48weeks of the year. Managing up to 240 clients per week. Up to 85 students and 12 clinical educators engage in workplace learning each week.

6. Community Engagement and Wellness (CEW) Centre This new centre is scheduled for development on the Thurgoona campus, situated close to the Dental and Oral Health Clinic. It will provide purpose designed spaces for health and social care provision to the community, by undergraduate students working in an authentic interprofessional setting. Due for completion end of 2012.

7. Interprofessional opportunities within the Allied Heath Clinic 2006-7: Podiatry and Pharmacy students 2007-present: Podiatry and Physiotherapy students This collaboration was further developed in 2009 to form the Musculoskeletal Clinic 2009-present: Podiatry and Occupational Therapy students

8. Interprofessional education Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care (Curran, Sharpe, & Forristall, 2007).

9. Interprofessional practice Aims • Improve knowledge and skills through collaboration, mutual respect and effective communication (Conway, 2009) • Improve professional relationships, increase efficiency and coordination, and enhance patient health outcomes (Curran et al, 2007) • Improve service delivery and patient care (Hammick et al, 2007)

10. Focus group discussions with occupational therapy, physiotherapy and podiatry students have highlighted relevant issues for interprofessional working. liv.ac.uk

11. Client focused care Enabling student participation Facilitating IP learning Inter-professional working Extending practice knowledge Professional communication Becoming a practitioner Preparation for the workplace The balance of power

12. Scope of practice Different perspectives Interprofessional working Reinforcing stereotypes Teamwork “To see how the different allied health professions work together and to show us that we’re not all separate, but we do actually work together a lot within our professions” (2nd year OT). Understanding how another AHP practices Addressing prejudices Challenging the taken for granted Referral to another practitioner

13. Holistic care Enhancing client outcomes Client focused care Enhancing compliance Complex case management “It enables you to take two different approaches to the problem, so you’re more likely to have a better outcome for the client. So I’ve had physios look at lower back and knee issues and I’ve looked at what I can do for the foot, orthoses or something, and we’ve combined the two things” (3rd year Pod). Continuity of care Family and carers Client communication Client overload

14. Learning from other practitioners Enhancing understanding Extending practice knowledge “I learnt how to feel your core stabilisers so when to feel you’re actually contracting your pelvic floor and how to get a client to feel that. I never learnt that through our Podiatry stuff, but then I did it myself a couple of weeks after I learnt it with the physio class, just as myself as a Podiatrist” (3rd year Pod). Broadening perspective Sharing knowledge Student as educator

15. Record keeping Professional terminology Professional communication “I don’t have a blue clue what they’re on about when they’re explaining something to you, they just start talking in Podiatry talk and you’re like no I don’t have any idea what you’re saying” (2nd year OT). “It’s really hard if your last patient was seen by a physio and you’re the next person to see the notes, then to decipher what they’ve written, cause they don’t do SOAP notes like we do” (4th year Pod).

16. Professionalism Accepting responsibility Becoming a practitioner Appreciating your own limitations Feeling valued “But I think at the same time they do see us not as a full professional but they have a quality of respect for what we’re saying. They’re not just going to be like, ‘oh they’re just a student they don’t really know’. It was good to see that they had taken on board what we’re saying and how we’re treating them. It’s working as well, that’s exciting (3rd year PT). Gaining confidence Mutual respect

17. Supervisor behaviour Continuity of supervision Facilitating interprofessional learning Structuring the IP learning experience Role modelling “The way they check your notes they just read over them but gave you a tip for next time, not actually criticise so you weren’t scared to write it the next time” (2nd year OT). “They won’t stand there and watch you do the treatment or watch you give them the exercises or watch you do the assessment, you actually do it yourself. And I think it shows their confidence in you (3rd year PT).

18. Expectations of students Pre-placement preparation Enabling student participation Environmental factors “But when you come into a new situation on the first day, you’re not going to be able to get in there and do it. I mean it would take a fairly special person to be able to come in to a whole group of people you don’t know and just perform. So coming in more than once would be beneficial” (Year 3 Pod). Social networking Time management

19. Differing levels of experience Too many opinions The balance of power Poor practice “They know exactly what they’re doing and they look so suave and they’ve got it all sorted and then we come in and we’re like, what the hell are we doing in here?” (2nd year OT). Segregation Dealing with conflict Inclusiveness

20. Different to other placements Preparation for the workplace “I think being able to just spend more time working [in the interprofessional clinics]. Especially if you go into a hospital setting or something like that you will be working with a multidisciplinary team, so it’s really important to have developed those skills (3rd year PT). Need for additional clinical experience Preparation for external placements

21. Shared learning works well when there is a common goal, mutual respect, mutual benefit and a balance of power between the different groups involved. Between different groups of allied health professionals shared learning promotes respect for, and a deeper understanding of, the role of each health professional within the multidisciplinary team.

22. Future Directions The development of the Community Engagement and Wellness (CEW) centre will provide many diverse opportunities for interprofessional learning and teaching. • Podiatry • Physiotherapy • Occupational Therapy • Speech Therapy • Health &Rehabilitation • Pharmacy • Psychology • Nursing • Dietetics • Exercise Physiology

23. Thank you to: The other members of the project team: Kristy Robson (Podiatry) and Narelle Patton (Physiotherapy) The research assistant: Lauren Blatchford The undergraduate allied health students for participating in these clinics and for attending the focus groups. The clinical educators, Allied Health support staff and fieldwork coordinators, for their support of the UG students.

24. References Conway, J. (2009). Implementing interprofessional learning in clinical education: Findings from a utility-led evaluation. Contemporary Nursing, 32(1-2), 187-200. Curran, V.R., Sharpe,D., & Forristall, J. (2007). Attitudes of health sciences faculty members towards interprofessional teamwork and education. Medical Education, 41, 892-896. Hammick, M., Freeth, D., Koppel, I., Reeves, S. & Barr, H. (2007). A best evidence systematic review of interprofessional education: BEME guide no. 9. Medical Teacher, 29, 735-751.

25. Select one of the issues highlighted in this presentation which is of interest to you and discuss how you would address this issue to enable successful interprofessional collaboration. ah-ha-moments.net