Leslie W. Hall

Interprofessional Education and Practice Guide No. 1; Developing faculty to effectively facilitate interprofessional education

Abstract With the growth of interprofessional education (IPE) and practice in health professional schools, faculty members are being asked to assume new roles in leading or delivering interprofessional curriculum. Many existing faculty members feel ill-prepared to face the challenges of this curricular innovation. From 2012–2013, University of Missouri – Columbia and University of Washington partnered with six additional academic health centers to pilot a faculty development course to prepare faculty leaders for IPE. Using a variety of techniques, including didactic teaching, small group exercises, immersion participation in interprofessional education, local implementation of new IPE projects, and peer learning, the program positioned each site to successfully introduce an interprofessional innovation. Participating faculty confirmed the value of the program, and suggested that more widespread similar efforts were worthwhile. This guide briefly describes this faculty development program and identifies key lessons learned from the initiative. Peer learning arising from a faculty development community, adaptation of curricula to fit local context, experiential learning, and ongoing coaching/mentoring, especially as it related to actual participation in IPE activities, were among the key elements of this successful faculty development activity.

The Second Victim of Adverse Health Care Events

Nurses and other professionals drawn to health care by their desire to help others may be traumatized because they are involved in situations that bring harm rather than healing to patients. Health systems should develop early warning systems to alert unit or team leaders when health workers are at risk of harm from adverse events. This article focuses on health professionals who become second victims of adverse events that occur to patients.

Linking health professional learners and health care workers on action-based improvement teams.

Background and Methods Medical students, nursing students, and other health care professionals in training were integrated with health care workers on interprofessional quality improvement (QI) teams at our academic health center. Teams received training in QI, accompanied by expert QI mentoring, with dual goals of increasing expertise in improvement while improving care. Results Eighty-six learners and health system workers participated in 12 improvement teams in 2 years. Upon completion of the training, participants expressed that the program enhanced QI and teamwork skills and increased understanding of other health care professions. At the end of the program, fourth-year medical students showed greater ability to apply QI skills, as measured by the QI Knowledge Assessment Tool than did control students who did not participate in the program (P < .0001 in 2006–2007 and P < .0005 in 2007–2008). Many teams were successful in improving care processes. Conclusion The design of “learning QI by doing,” accompanied by just-in-time training and ongoing expert mentoring in QI, was identified by faculty as the most important factor contributing to success. This model successfully improved application of QI skills by learners while improving care within our academic health center. Testing of the model at other academic health centers and in other training environments is warranted.

The Second Victim

Gary Donnell MD, is a second-year resident in Medicine caring for Mr. Pauley, a 64-year-old with a history of diabetes and chronic renal insufficiency. Mr. Pauley’s nurse is Katie, a new graduate. Mr. Pauley was admitted for sudden-onset left side-weakness. A CT scan of his brain on admission showed no evidence of hemorrhage/mass. Katie paged Dr. Donnell 4 h later, when she found the patient to have a distinct change in his speech patterns from her initial admission assessment. Busy with several ER patients, Dr. Donnell did not evaluate Mr. Pauley, but ordered a STAT repeat head CT scan based on Katie’s findings. Radiology assured Dr. Donnell that Mr. Pauley’s CT would be completed within the hour. Dr. Donnell instructed Katie to perform hourly neurologic exams, and to page him with any changes.

Transfer of crew resource management training

Purpose – The IOM report “To Err is Human” recommended Crew Resource Management (CRM) training to improve patient safety and teamwork in health care. However, the effectiveness of CRM training in health care is uncertain; this study aims to identify the effect of CRM training on communication and decision making, processes that are associated with better teamwork and patient safety.Design/methodology/approach – Employees in two intensive care units at a US academic medical center, one with high training penetration (67 percent trained) and one with low penetration (27 percent), were observed and interviewed about CRM principles and teamwork.Findings – The paper found differences between the units in communication and decision making; it argues that these processes are mediating processes necessary for the effective transfer of CRM training to improvement of safety outcomes.Research limitations/implications – This study adds to the growing literature concerning health care quality interventions.Practical i...

Findings from a mixed-methods study of an interprofessional faculty development program.

ABSTRACT Forty faculty members from eight schools participated in a year-long National Faculty Development Program (NFDP) conducted in 2012–2013, aimed at developing faculty knowledge and skills for interprofessional education (IPE). The NFDP included two live conferences. Between conferences, faculty teams implemented self-selected IPE projects at their home institutions and participated in coaching and peer-support conference calls. This paper describes program outcomes. A mixed methods approach was adopted. Data were gathered through online surveys and semi-structured interviews. The study explored whether faculty were satisfied with the program, believed the program was effective in developing knowledge and skills in designing, implementing, and evaluating IPE, and planned to continue newly-implemented IPE and faculty development (FD). Peer support and networking were two of the greatest perceived benefits. Further, this multi-institutional program appears to have facilitated early organizational change by bringing greater contextual understanding to assumptions made at the local level that in turn could influence hidden curricula and networking. These findings may guide program planning for future FD to support IPE.