Co-authors: Rebecca Wolfgang, Dr Leanne Brown, Luke Wakely, Julia Greaves,

1. Innovative interprofessional learning for allied health students on rural placementsElesa Crowley Co-authors: Rebecca Wolfgang,Dr Leanne Brown, Luke Wakely, Julia Greaves, Dr Tony Smith, Hazel Harries-Jones University Department of Rural Heath, Northern NSW

2. Interprofessional Education ‘The process by which a group of students from health-related occupations with different educational backgrounds learn together during certain periods of their education, with the interaction as an important goal1,’ World Health Organisation 1988 Why Interprofessional Learning2? Changing models of health care Ageing population (with complex co-morbidities) Heightened consumer awareness Higher costs Risk of sub-optimal care Poor collaboration Outcome focused eg NSW balanced scorecards, KPI’s, multidisciplinary ward teams 1. World Health Organisation (1988) Learning Together to Work Together for Health. Technical Report Series 769, Geneva, Switzerland. 2. Smith T, Williams L, Lyons M, Lewis S. Pilot testing a Multiprofessional Learning Module: lessons learned. Focus on Health Professional Education, 2005; 6: 21-23. Background 2

3. Why Interprofessional Learning3? • Participation in clinical decision making across disciplines • Respect for the contributions of all disciplines • Continuous communication amongst care-givers 3. Health Canada (2003) Interdisciplinary Education for collaborative patient centred practice. Research and Finding Report, Feb 20

4. The Setting University Department of Rural Health Northern NSW • Pilot development2 • Interprofessional Learning Modules (IPL’s) are part of placement attachments The following disciplines are involved: • Medicine • Nursing • Physio • OT • Pharmacy • N&D • Speech • MRS 2. Smith T, Williams L, Lyons M, Lewis S. Pilot testing a Multiprofessional Learning Module: lessons learned. Focus on Health Professional Education, 2005; 6: 21-23.

5. Rationale • Interprofessional collaboration is a key factor to ensure high quality patient care. Aim • To improve student awareness and attitudes to other professional roles in the clinical management of patients.

6. Methods • Clinical topics have included: • Stroke • Ethical Health Care and Professional Practice • Self Care and Child Protection • Hip fracture • Trauma • Diabetes • The modules have used a variety of teaching and learning techniques including • Role plays • Debates • Hypothetical's and practical sessions.

7. Methods (continued) An Example In Brief:Hip Fracture A 76 year old woman arrives at Tamworth Rural Referral Hospital in the back of an ambulance. Marjorie had been found lying on the kitchen floor of her Tamworth home at 9 am that morning. She had apparently tripped over her cat at about 3 am on her way back from the toilet.

8. Methods of Evaluation • Parsell G, Bligh J (1999) The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS). Medical Education, 33:95-100. • Pre- and post-module evaluations • Categorical – 5 point Likert scale • Continuous – 10 centimetre Visual Analogue Scale • ‘Role Knowledge’ scoring • Open comments 8

9. Results Table 1: Evaluation of Interprofessional Learning Modules conducted March 2010 - May 2011 Total N&D students = 32

10. Results (continued) Evaluation of content - March 2010 to May 2011

11. Results (continued) Evaluation of Delivery - March 2010 to May 2011

12. Results (continued) Describe the way in which this session contributed to your understanding of working with other professions in the health care setting. “This case showed potential life threatening effects of which I personally and my profession lack knowledge, such as refeeding consequences” Medical student “I learnt about issues such as suicide and eating disorders which are outside my scope of knowledge, yet will greatly influence every aspect of treatment and the patients willingness to participate in their own care” Physiotherapy student “Professions depend upon the expert opinion of their colleagues to successfully diagnose, manage and treat a patient. Support of other health professionals is essential.” Occupational therapy student “Every patient requires help from multidisciplinary teams” Dietetics student

13. Results (continued) Ethical Health Care & Professional Practice • Did the Module improve the understanding of other professions? • Identify 2 types of service of 4 different professions • Both before and after the Module • Simple ‘Role Knowledge’ score • Pre-module mean = 8.2 out of a possible 16 points • Post-module mean = 11.3 points

14. 100 90 80 70 60 % Pre 50 Post 40 30 20 10 0 Strongly Agree Neutral Disagree Strongly Agree Disagree Category of Response Results (continued) Self-Care and Child Protection • A multiprofessional approach is important in child protection Scores shifted to the left in post-module evaluations

15. Discussion • Students believed in the value of the IPL • Adult learning principles were well received • Interaction with other disciplines enhanced learning • Skills learned during the modules are used during placement. • Placement supervisors report that students are applying knowledge and skills. • Breaking down boundaries between disciplines has improved.

16. Conclusion • Interprofessional Learning Modules are a useful tool to improve awareness, understanding of the roles and partnerships between health professionals required for patient care. • After participating in IPL’s students believe a multidisciplinary approach improves patient care The question remains whether these learning modules: • should be mandatory for all health profession students? • will have any long-term effect in breaking down interprofessional barriers?

17. Acknowledgments Academic allied health staff at the UDRH, Northern NSW UDRH staff are funded through the University of Newcastle by the Commonwealth Department of Health and Ageing Our partners The University Department of Rural Health (UDRH) and Rural Clinical School (RCS), is a collaborative project between the University of Newcastle and the Commonwealth Department of Health and Ageing. Additionally, the UDRH has strong strategic alliances with the University of New England and Hunter New England Area Health.