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BEST Practices/lessons learned: using core competencies to build a program

Alan Dow, MD, MSHA Assistant Vice President of Health Sciences for Interprofessional Education & Collaborative Care Virginia Commonwealth University Richmond, VA. BEST Practices/lessons learned: using core competencies to build a program. IPEC Institute M onday, JANUARY 13, 2014.

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BEST Practices/lessons learned: using core competencies to build a program

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  1. Alan Dow, MD, MSHA Assistant Vice President of Health Sciences for Interprofessional Education & Collaborative Care Virginia Commonwealth University Richmond, VA BEST Practices/lessons learned: using core competencies to build a program IPEC Institute Monday, JANUARY 13, 2014

  2. Objectives • To discuss how the IPEC competencies shape interprofessional education at an institutional level • To provide a framework to link behavioral objectives for teamwork with the IPEC competencies • To describe several educational programs that meet competency and behavioral objectives

  3. Virginia Commonwealth University • 53 acre Health Science campus • 5 health professional schools: allied health, dentistry, medicine, nursing, pharmacy • Tertiary academic medical center • 3200 clinical learners • Monroe Park campus • School of social work, departments of psychology and health & human performance • Distant training sites: • Inova-Fairfax (70 miles north) • UVA (70 miles west)

  4. The Center for Interprofessional Education and Collaborative Care • Official center at VCU in January of 2013 • >2,000 learners have participated in Center programs • Students and faculty from all five health science Schools, the School of Social Work, & Dept of Psychology

  5. Interprofessional Collaborative Practice Competencies Roles/ Responsibilities (n = 9) Inter- professional Communication (n = 8) Values/ Ethics (n = 10) Teams and Teamwork (n = 11) Interprofessional Education Collaborative Expert Panel. (2011).

  6. The IPEC Competencies were created to: create a coordinated effort for IPE guide curriculum provide a foundation for learning structure research promote dialogue between health professions shape accreditation, licensing, and credentialing

  7. Assesses student self-efficacy using a Likert scale Administered as an online survey with invitation email Sent to students by program leader Tool and Survey Methods 38 original IPEC competencies 1 competency omitted 5 items split into 10 items 32 competencies converted directly into items 42 items comprise the final questionnaire all items given stem and assigned to 5-point Likert scale Dow AW et al. 2014. JIC

  8. Survey Population • All students enrolled in clinical degree programs on VCU’s Health Science Campus Dentistry DDS and Dental Hygiene Allied Health Nine Departments Pharmacy Medicine MD and non-MD students Nursing BSN, MSN, PhD Dow AW et al. 2014. JIC

  9. 481 completed surveys Overall response rate: 14.9% Response rate by School: Allied Health – 4.1% Dentistry – 7.0% Medicine – 25.4% Nursing – 7.8% Pharmacy – 26.3% Results: 2012 Dow AW et al. 2014. JIC

  10. Four forced domains: accounted for 79% of the variance in responses aligned with four IPEC domains Overall scale reliability: α=.99 Reliability by domain-associated factor Values and Ethics: α =.98 Roles: α = .95 Communication: α = .95 Teamwork: α = .97 Factor Analysis and Reliability Dow AW et al. 2014. JIC

  11. Dow AW et al. 2014. JIC

  12. Center for Interprofessional Education and Collaborative Care Early Learners Advanced Learners Effective, efficient, appropriate collaborative practice Practitioners Maintain high attitudes (Value & Ethics) Build core knowledge (Roles & Responsibilities, Communication, Teams) Collaboration skills (Communication, Teams & Teamwork)

  13. Institution 1: large southern public university with a comprehensive health science campus Institution 2: large midwestern public university with a college of health professions (dentistry, nursing, PA, allied health) Institution 3: smaller health system-associated health professional school (nursing, allied health) Institution 4: large midwesternpublic university with a comprehensive health science campus Participating Institutions

  14. Results: Demographics Age Range: 19 - 65 (M=28, SD = 8)

  15. Results: Domain Scores by Institution, 2013 • Comparisons between institutions: • Values and Ethics (p=.014) • Teams and Teamwork (p=0.18) • Roles and Responsibilities (p=0.69) • Interprofessional Communication (p=0.69)

  16. Results: Domain Scores by Profession No significant differences between professions

  17. Center for Interprofessional Education and Collaborative Care Early Learners Advanced Learners Effective, efficient, appropriate collaborative practice Practitioners Maintain high attitudes (Value & Ethics) Build core knowledge (Roles & Responsibilities, Communication, Teams) Collaboration skills (Communication, Teams & Teamwork)

  18. Activities Inputs Outputs Medium-term Goal Long-term Goal Engage in Shared Problem Solving Students Sequenceof Learning Activities Increased Inter-professional Competency Improved patient outcomes and community health Communicate in Context Faculty Resolve Conflict Enhance Team Performance Resources Be a Change Agent

  19. Context-Specific Experiences Profession-Specific Experiences Foundational Health Professions Experiences Pre-Curricular Experiences

  20. Pre-Curricular Experiences

  21. Inter Health Professional Alliance (IHPA) • Student-initiated and student-run group • 4 years old • Over 200 members • A number of peer-reviewed publications and national presentations • School of Allied Health Professions • School of Dentistry • School of Medicine • School of Nursing • School of Pharmacy • School of Social Work • School of Engineering • VCU Dietetics Internship program

  22. Foundational HealthProfessions Experiences • Interprofessional Case Series • >600 students • Pericurricular sessions  full 1-credit course • Student feedback: more! • Foundations of Quality and Safety • ~500 students • Full 1-credit course

  23. 2012-2013 • Extracurricular • Interprofessional Case Series • Meet your peers • Learn something (roles) • Encouraged but not required • Pizza • Positive evaluations with suggestions

  24. 2013-2014 2012-2013 • Pericurricular • Interprofessional Case Series • Meet your peers • Learn something (roles, teams) • Required* • Positive evaluations with suggestions • Extracurricular • Interprofessional Case Series • Meet your peers • Learn something (roles) • Encouraged but not required • Pizza • Positive evaluations with suggestions

  25. Sample item: I am able to respect the unique cultures, values, roles/responsibilities, and expertise of other health professions.

  26. 2013-2015 2015-2016 2012-2013 • Pericurricular • Interprofessional Case Series • Meet your peers • Learn something (roles, teams) • Required* • Positive evaluations with suggestions • Curricular • Foundations Course • Meet your peers • Learn something (roles, teams, systems) • Required 1-credit course • Extracurricular • Interprofessional Case Series • Meet your peers • Learn something (roles) • Encouraged but not required • Pizza • Positive evaluations with suggestions

  27. Profession-Specific Experiences • Interprofessional Critical Care Simulations • All N4s and M4s (320 students) • Three two-hour sessions around simulators: how do you manage a patient with an acute clinical deterioration? • Student feedback: more!

  28. Profession-Specific Experiences • Interprofessional Virtual Case • Homegrown case system for asynchronous collaboration • ~600 participants annually (SOM, SON, SOP, SOSW) • Now being used at several other institutions

  29. High-value learning

  30. Case Activity Measures

  31. Correlations between Case Activity Measures and Scores

  32. Context-Specific Experiences • Richmond Health and Wellness Program • Nursing, Pharmacy, Social Work, Medicine, Psychology • HRSA-funded • Community-focused care coordination in an indigent setting • Patient and student impact • “Hotspotting”

  33. Context-Specific Experiences Profession-Specific Experiences Foundational Health Professions Experiences Pre-Curricular Experiences

  34. Scholarship and Dissemination National Presentations or Manuscripts (*=student/trainee) • Emswiller Symposium • Regional interprofessional symposium • >150 attendees past two years • Interprofessional Virtual Case • Patent pending • Licensing to UNT, UNM, KU • RHWP • Dissemination to other institutions • Grant funding • HRSA • Macy Foundation • Reynolds Foundation • Melissa Abell • Nital Appelbaum* • Nathaniel Arnold* • Peter Boling • Antoinette Coe • Ann-Marie Conlon • Steve Crossman • Jeff Delafuente • Deborah DiazGranados • Alan Dow • Alex Enurah* • Jessica Evans* • Moshe Feldman • Cheryl Garland • Sarah Hobgood • Susan Johnson • Tanya Huff • Sharon Lanning • Kelly Lockeman • Paul Mazmanian • Natalie Nguyen* • Kelechi Ogbonna • Shelley Orr • Darshan Pandya* • Pamela Parsons • Sheldon Retchin • Andrew Rock* • Lana Sargent • LyubovSlashcheva* • Stephanie Umphlette* • Lynn VanderWeilen* • Jean Ellen Zavertnik

  35. Questions and Discussion Alan Dow awdow@vcu.edu

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