Interprofessional Education for Geriatric Care (IEGC) IECPCP Cycle 1

1. Project phases • The IEGC Program has five overlapping stages with project status • in phases two (recruitment) and three (implementation and data • collection). • The IEGC Program is built around an iterative design that • implements feedback from multiple sources (students, clinicians, • team members, and Steering Committee) to continually refine the • experiential block content. • Research and evaluation • The IEGC project uses a mixed methods design based on the JET • modification of Kirkpatrick’s model of educational outcomes¹ for • interprofessional education and the Program Logic Model. Specific • activities include • designing and implementing an IEGC learning module centered around seven core competencies in the day hospital setting during a four week experiential block. • providing senior health discipline students approximately 15 hours of training and testing and providing opportunities to practice the IEGC skills as an interprofessional team with clients. • conducting educational activities around interprofessional teaming for faculty champions and clinical team members. • communicating and informing the Steering Committee of project progress, obtain feedback, and address sustainability issues. • Instruments • The IEGC Project has 17 research and evaluation instruments. The • instruments are a combination of questionnaires, interviews, and • observational strategies. Pre- and post-testing measures are given • to participants prior to and after the experiential blocks. • The instruments used in the IEGC research were adapted with • permission from the GITT program². Project partners University of Manitoba Faculties of Medicine, Nursing, Pharmacy, School of Medical Rehabilitation (Departments of Occupational Therapy and Physical Therapy). Day Hospitals: Deer Lodge Centre, Riverview Health Centre, and St. Boniface General Hospital Government of Manitoba, Manitoba Health, and Winnipeg Regional Health Authority IEGC Project team members: (Top row, left to right) Cornelia van Ineveld, Michelle Nelson, Ruby Grymonpre, Theresa Sullivan,Rachel Ines (Front row, left to right) Jenneth Swinamer, Ann Booth, Fiona Jensen, Amy De Jaeger, Monika Madera-Trzeciak, Leah Weinberg Missing: Elizabeth Boustcha Interprofessional Education for Geriatric Care (IEGC) IECPCP Cycle 1 • Scope of project • The IEGC program is a two-year, nine-month project running from • July 1, 2005 to March 31, 2008. This initiative is undertaken in • three geriatric community based day hospitals located in Winnipeg, • Manitoba: Deer Lodge Centre, Riverview Health Centre, St. • Boniface General Hospital, in collaboration with the University of • Manitoba. • Estimated participants over the two-year period include students • (60) and Faculty Champions (9) from five disciplines: Medicine, • Nursing, Pharmacy, Departments of Occupational and Physical • Therapy, Clinical Team Members (60), Steering Committee (12), • Clients/Patients (12), and clients/informal care providers (9), • student reps (10). • IEGC Project goals and objectives • The overarching goal of this project is to develop a sustainable • interprofessional education opportunity in the context of • community-based geriatric care. • The specific objectives of this project are • To develop and implement an interprofessional education experience in geriatric care. • To promote IEGC within the University of Manitoba. • To identify ‘champions’ within each faculty with expertise/interest in interprofessional education, geriatrics and/or collaborative patient centred care who are willing to participate in the development, implementation and evaluation of IEGC and advocate for its sustainability. • To increase the knowledge, skills and attitudes of students, faculty and clinical team members in the areas of geriatric care, interprofessional collaboration and effective teaming. • To conduct an extensive evaluation of the IEGC experience. • To share our experiences with and disseminate our project findings to government, health organizations, universities, and communities. • Intervention • To achieve the goal of implementing and sustaining an • interprofessional experience, the IEGC learning modules are • embedded into existing clinical placements which are designed to • run for four weeks, providing advanced trained learners from • three or more disciplines with real world training in an • interprofessional team setting. • IEGC learning module goals for the educational experience are • Learners will be able to demonstrate understanding and management of the complex needs of older adults, recognizing the need for an interprofessional team; • Learners will have the opportunity to observe and practice interprofessional teaming in the clinical context during their experiential placements; • Learners will develop the necessary competencies (goal directedness, disciplinary articulation, flexibility, conflict management, communication, team dynamics, leadership), key behaviours, and attitudes that contribute to effective interprofessional teaming. • Data analysis procedures • Data analysis involves • conducting both quantitative and qualitative data analysis and compare and contrast the data obtained • analyzing pre and post test quantitative data, assuming a before/after and test/control comparison involving a 1:1 matched sample (ideally controlled by discipline, age, gender, and level of training) • using a mixed modeling procedure to allow for matching and comparisons across cohorts (test/control) and time (before/after) • documenting and controlling for covariates that might influence the study subjects’ choice to participate • using content and key theme analysis to analyze qualitative information from participants Evaluation The IEGC project is collecting information from all participant groups that will be used to evaluate the experiential block process, impact at the clinical site and overall success of the project. Data sources include post experiential block evaluation surveys, focus groups to elicit information regarding implementation, and feedback from Steering Committee about project progress and sustainability. • Benefits and challenges encountered • Benefits and challenges to date are experienced at the micro, • meso, and macro level. • Core competencies are recognized by clinical teams and students to be relevant to interprofessional teaming. • Clinical team members want to be active participants in the development and implementation of educational activities. • Experiential learning is an ideal way to synthesize information with opportunities for practice. • Challenges to date since developing the IEGC project include • Planning for sustainability • Communication in the academic and clinical environments • Buy in from faculty, institutions, clinicians • Coordinating clinicians and student placements • Ensuring patient centred care and patient involvement in project Project dissemination In an attempt to impact change at the micro, meso, and macro levels, the dissemination plan uses a mutli-pronged approach. Dissemination strategies target all levels of government, education and health care institutions, accrediting and licensing bodies, as well as collaborative education initiatives. To date IEGC dissemination includes • Project progress presentedlocally, nationally, internationally • IEGC Project representationon CIHC Steering Committee and five Sub Committees, IHI-HPEC, and NaHSSA • IEGC project Web site and quarterly newsletter • Co-hosted and organized Manitoba Science Café meetings Definitions and key terms Client: The individual receiving care in the day hospital environment and/or their proxy/informal care givers. Clinical team: All health care practitioners working as part of an interprofessional team in the participating day hospitals, regardless of discipline. IEGC experiential block: A period of education, interprofessional teaming embedded during a traditional clinical practicum experience. IEGC learning modules: The educational activities (learning objectives, core competencies, schedule of activities) developed by the IEGC Program and implemented during the experiential block. Learner: Any IEGC participant that engages in educational activities presented by the IEGC program; specifically targeting Advanced trained student learners, Clinical Team Learners, and Faculty Learners. Acknowledgements The IEGC Project acknowledges the support in kind provided by Riverview Health Centre, the clinical teams at the participating day hospitals, and Monika Madera-Trzeciak. Production of this material has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. Citations ¹A Critical Review of Evaluations of Interprofessional Education. Freeth, D., Hammick, M., Koppel, I., Reeves, S. and Barr, H. (London: Learning and Teaching Support Network for Health Sciences and Practice, 2002). ²Reproduced from Geriatric Interdisciplinary Team Training: the GITT Kit, 2nd Edition, edited by K. Hyer, E. Flaherty, S. Fairchild, M. Bottrell, M. Mezey, T. Fulmer, M. M. Bolton-Blatt, K. Lenio (New York: John A. Hartford Foundation, Inc., 2003). Ruby Grymonpre BSc(Pharm), PharmD, Cornelia van Ineveld MD, MSc, FRCP(C), Elizabeth Boustcha BA, MD, CM, MScA, Michelle Nelson BA, BRS, MAIn alphabetical order: Ann Booth BSc(OT), MBA, Amy De Jaeger BA, BA (Hon.), Rachel Ines BA, Dipl. (Tech Comm, Hon.), Fiona Jensen RN, MSN, Theresa Sullivan BSc(OT), MA, Jenneth Swinamer BPT, MSA (Health), & Leah Weinberg BPT, MSc, PhD Correspondence: PE 446, 1 Morley Avenue, Winnipeg MB, R3L 2P4 Email: iegc@umanitoba.ca