Lesley Bainbridge

Active patient involvement in the education of health professionals

Context  Patients as educators (teaching intimate physical examination) first appeared in the 1960s. Since then, rationales for the active involvement of patients as educators have been well articulated. There is great potential to promote the learning of patient‐centred practice, interprofessional collaboration, community involvement, shared decision making and how to support self‐care.

Competencies for Interprofessional Collaboration

Background and Purpose. Interprofessional collaboration in health care is now considered a high priority, as concerns about patient safety, health and human resources shortages, and effective and efficient care have reached epic proportions. Although there are many models for interprofessional education for collaborative, patient‐centered care, there is little in the literature to describe competencies for an interprofessional collaborative practitioner. This article will describe an emerging Canadian competency framework for interprofessional collaboration that (1) considers previous descriptions of collaborative practice and (2) uses existing literature to support a model for describing competencies for collaborative practice. Model Description and Evaluation. In this emerging competency framework, 6 competency domains are described using a competency statement and a set of associated descriptors. The collaborative leadership, dealing with interprofessional conflict, team functioning, and role clarification domains intersect with all of the others, yet are distinct and require focused descriptions. While patient‐centered care and communication also are domains unto themselves, these competencies are integral elements of the other domains and are integrated throughout the framework. In the background supporting all of the domains are 3 key themes: context of practice, level of complexity, and quality improvement. The emerging framework was reviewed by a wide group of stakeholders, including an external review. Future use of the framework will assist in further shaping it to meet the needs of educators, researchers, practitioners, regulators, and accreditors. Discussion and Conclusion. The competency framework has been designed as a practical tool for a number of stakeholder groups. In particular, physical therapy educators can use it as a basis for interprofessional education programs and activities that prepare collaborative practitioners for the future. The framework is flexible and can be used in simple or complex situations, in a variety of practice settings, as a guide for learning outcomes and evaluation or assessment of performance, and as a tool for developing entry‐level curricula and continuing professional development. The strength of the framework will emerge as it evolves over time.

A meeting of minds: interdisciplinary research in the health sciences in Canada

Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in Canada. Based on first-hand knowledge and thoughtful reflection, the authors argue that although much progress has been made in support of IDHR in Canada, the practical experience of researchers does not always bear this out. This article examines government, industry and academia to identify the cultural and structural characteristics that demand, promote or prevent IDHR in each sector. At its heart is the question, How can universities best support and enhance IDHR, not only for the benefit of science, but also to meet the growing needs of industry and government for intellectual capital? Focusing on the predominant health sciences disciplines, the authors define IDHR as a team of researchers, solidly grounded in their respective disciplines, who come together around an important and challenging health issue, the research question for which is determined by a shared understanding in an interactive and iterative process. In addition, they suggest that IDHR is directly linked to translational research, which is the application of basic science to clinical practice and the generation of scientific questions through clinical observation. This analysis of academic, industry and government sectors is not intended to offer rigorous data on the current state of IDHR in Canada. Rather, the goal is to stimulate research-policy dialogue by suggesting a number of immediate measures that can help promote IDHR in Canada. Recommended measures to support IDHR are aimed at better resourcing and recognition (by universities and granting agencies), along with novel approaches to training, such as government-and industry-based studentships. In addition, we recommend that professional organizations reconsider their policies on publication and governance. Although intended to maintain professional scopes of practice, these policies also serve to entrench disciplinary boundaries in research. We conclude by suggesting a number of research questions for a more rigorous assessment of the climate for IDHR in Canada. We call for an inventory and comparative analysis of academic centres, institutes and consortiums in Canada that strive to facilitate IDHR; an examination of the impact of professional organizations on health research, and on IDHR in particular; and a systematic review of research training opportunities that promote IDHR, with a view to identifying and replicating proven models.

The University of British Columbia model of interprofessional education.

The College of Health Disciplines, at the University of British Columbia (UBC) has a long history of developing interprofessional learning opportunities for students and practitioners. Historically, many of the courses and programmes were developed because they intuitively made sense or because certain streams of funding were available at particular times. While each of them fit generally within our understanding of interprofessional education in the health and human service education programs, they were not systematically developed within an educational or theoretical framework. This paper discusses the model we have subsequently developed at the College for conceptualizing the various types of interprofessional experiences offered at UBC. It has been developed so that we can offer the broadest range of courses and most effective learning experiences for our students. Our model is based on the premise that there are optimal learning times for health and human services students (and practitioners) depending upon their stage of development as professionals in their respective disciplines and their readiness to learn and develop new perspectives on professional interaction.

Can interprofessional collaboration provide health human resources solutions? A knowledge synthesis

Many studies examine the impact of interprofessional (IP) interventions on various health practice and education outcomes. One significant gap is the lack of research on the effects of IP interventions on health human resource (HHR) outcomes. This project synthesized the literature on the impact of IP interventions at the pre- and post-licensure levels on quality workplace, staff satisfaction, recruitment, retention, turnover, choice of employment and cost effectiveness. Forty-one peer-reviewed articles and five IECPCP project reports were included in the review. We found that IP interventions at the post-licensure level improved provider satisfaction and workplace quality. Including IP learning opportunities into practice education in rural communities or in less popular healthcare specialties attracted a higher number of students and therefore may increase employment rates. This area requires more high quality studies to firmly establish the effectiveness of IP interventions in recruiting and retaining future healthcare professionals. There is strong evidence that IP interventions at the post-licensure level reduced patient care costs. The knowledge synthesis has enhanced our understanding of the relationships between IP interventions, IP collaboration and HHR outcomes. Gaps remain in the knowledge of staff retention and determination of staffing costs associated with IP interventions vis-à-vis patient care costs. None of the studies reported long-term data on graduate employment choice, which is essential to fully establish the effectiveness of IP interventions as a HHR recruitment strategy.

The road to collaboration: Developing an interprofessional competency framework

In the absence of an interprofessional competency framework in Canada, the College of Health Disciplines (CHD) at the University of British Columbia developed a universally applicable framework. This article discusses the development of the “BC Competency Framework for Interprofessional Collaboration”. Building on a Health Canada funded initiative through the Interprofessional Network of British Columbia (In-BC), the CHD compared and contrasted existing competency frameworks and consulted curriculum and IP experts throughout British Columbia. The resulting framework is designed to inform curriculum development for health and human service professionals throughout the continuum of learning, starting with pre-licensure education and extending into continuing professional development. The framework will serve as a foundation for future curriculum reform by health and human service educators, practitioners and decision-makers throughout BC and will contribute to the competency literature in Canada.

Nurturing social responsibility through community service-learning: Lessons learned from a pilot project

Background: Community service-learning (CSL) has been proposed as one way to enrich medical and dental students’ sense of social responsibility toward people who are marginalized in society. Aim: We developed and implemented a new CSL option in the integrated medical/dental curriculum and assessed its educational impact. Methods: Focus groups, individual open-ended interviews, and a survey were used to assess dental students’, faculty tutors’ and community partners’ experiences with CSL. Results: CSL enabled a deeper appreciation for the vulnerabilities that people who are marginalized experience; students gained a greater insight into the social determinants of health and the related importance of community engagement; and they developed useful skills in health promotion project planning, implementation and evaluation. Community partners and faculty tutors indicated that equal partnership, greater collaboration, and a participatory approach to course development are essential to sustainability in CSL. Conclusions: CSL can play an important role in nurturing a purposeful sense of social responsibility among future practitioners. Our study enabled the implementation of an innovative longitudinal course (professionalism and community service) in all 4 years of the dental curriculum.

The Interprofessional Rural Program of British Columbia (IRPbc)

The Interprofessional Rural Program of British Columbia IRPbc was established in 2003 as an important first step for the Province of British Columbia, Canada, in creating a collaborative interprofessional education initiative that engages numerous communities, health authorities and post-secondary institutions in working toward a common goal. Designed to foster interprofessional education and promote rural recruitment of health professionals, the program places teams of students from a number of health professional programs into rural and remote British Columbia communities. In addition to meeting their discipline specific learning objectives, the student teams are provided with the opportunity to experience the challenges of rural life and practice and advance their interprofessional competence. To date, 62 students have participated in the program from nursing, social work, medicine, physical therapy, occupational therapy, pharmaceutical sciences, speech language pathology, audiology, laboratory technology, and counseling psychology. While not without numerous struggles and challenges, IRPbc has been successful in meeting the program mandate. It has also had a number of positive outcomes not anticipated at the time the program was established.

Introducing the individual Teamwork Observation and Feedback Tool (iTOFT): Development and description of a new interprofessional teamwork measure

ABSTRACT The individual Teamwork Observation and Feedback Tool (iTOFT) was devised by a consortium of seven universities in recognition of the need for a means of observing and giving feedback to individual learners undertaking an interprofessional teamwork task. It was developed through a literature review of the existing teamwork assessment tools, a discussion of accreditation standards for the health professions, Delphi consultation and field-testing with an emphasis on its feasibility and acceptability for formative assessment. There are two versions: the Basic tool is for use with students who have little clinical teamwork experience and lists 11 observable behaviours under two headings: ‘shared decision making’ and ‘working in a team’. The Advanced version is for senior students and junior health professionals and has 10 observable behaviours under four headings: ‘shared decision making’, ‘working in a team’, ‘leadership’, and ‘patient safety’. Both versions include a comprehensive scale and item descriptors. Further testing is required to focus on its validity and educational impact.

The power of prepositions: a taxonomy for interprofessional education.

This is the second paper in a two-part series. The first paper presented a study that provided a more contextual description of the commonly applied definition of interprofessional education (IPE) offered in 2002 by the Centre for the Advancement of Interprofessional Education (CAIPE) in the UK. The studys results confirm and consolidate key characteristics of IPE by exploring the meaning of with, from and about. This second paper presents a proposed taxonomy for IPE that may serve to inform emerging applications for IPE in the context of education, service delivery and policy. This paper contributes to an emerging understanding of IPE that will support competency development and sound curriculum design, continuing professional development and evaluation of the impact of IPE and collaboration on health outcomes.