InterProfessional Teaching Jonathan Corne East Midlands North School

Inter-Professional Teaching Jonathan Corne East Midlands (North) School of Medicine

Today's Session • • • What Why Who Where Challenges How

Inter-Professional Learning ……. . is where people from different disciplines and/or professions learn from and about each other to improve collaboration and the quality of care Multi-professional education is where people learn alongside one another

Why? • • • Understanding each others viewpoint/roles Understanding our own role Developing common approaches Appreciate diversity of ways of working Cross-fertilisation of ideas Improving trust and communication Growing up together Understanding the patient experience Need to manage MDTs Increase emphasis on long term conditions

GMC and Inter-Professional Learning ‘. . inter-professionalism is an important area in medical education, but it is more likely to be embedded into medical practice through experience. . ’ ‘. . there is concern that poorly designed interprofessional learning could harm collaborative interactions and polarise attitudes. . ’

Where? • • • On the ward/consulting room General practice Simulation centres Community Lecture room Workshop

Who GPs Physicians Patholgists Radiologists Rehabilitation physicians Occupational Therapists Physiotherapists Neurologists Stroke physicians GPs Secondary care Commissioners Patients Oncologists Surgeons Cancer nurses Palliative care Physicians Radiologists

Challenges • • • Relevant to all groups Relevant to practice Understood by all Encourage interaction and discussion Making it feel natural

Set Objectives • Understand topic • Understand contribution/role of each professional • Understand real world interactions • Establish team working • Establish informal networks

How to do • Interactive • Fun • Dovetailing

How not to do it • Formal lectures • Piggy backing

How to Do It Problem based learning Case studies Joint professional shadowing Visits to a patient Role-play Task orientated activities Exchange placements

Three Examples The bad, the good and the better

Example 1 – Stroke Teaching • • GP trainees and Core Medical Trainees Afternoon session Lectures by primary and secondary care physicians Topics covered – – – – Prevention in the community Acute presentation When/how to refer Hospital care including thrombolysis Rehabilitation When to discharge Infomration needed at discharge Community follow up

Stroke Feedback • No interaction between GPs and secondary care trainees • No mixing • No added benefit of joint teaching

Feedback - Stroke Joint Session Teaching style more suitable for hospital doctors Most information based round secondary care Not relevant to primary care Session had great potential but failed to fulfil it

I think that medics and GPs have different slants on same topic… I would rather have gone through how to respond to stroke in community- evidenced based initial management…. how to refer to TIA clinic – via choose and book? Plus community rehabilitation …. ie what to do if called out to see somebody post-stroke and new neurology/ increased tone and query contractures…. ? Can we re-refer to stroke specialist OT/Physio/ for botox…. what about referral for stroke rehab in somebody who has had an old stroke…eg in nursing home but not picked up before…. eg if they need SALT…what about managing cognitive decline and behavioural aspects post-stroke…what services are there? I am not sure that this type of session was that helpfulsorry- although I think the level of information given was excellent.

Example 2 - CPCs • Half day sessions • Core Trainees • Organised into specialist groups e. g. Cardiology /ITU • Trainee led • Involve pathology and radiology trainees • Consultant facilitated

CPC’s Feedback Quotes on the feedback forms included: “Excellent – Please can we have one every four months. ” “Really interesting cases for discussion” “I learnt a lot – good cases. ” “Brilliant cases, thank you. It was good to have consultants there to interject but the trainee led the day very effectively”

CPC Feedback

Example 3 - Management Objectives • Understand the process of commissioning • Integrate primary and secondary care trainees • Encourage teamwork

Plan of Day 09. 00 09. 05 09. 30 10. 50 11. 20 12. 20 13. 20 15. 30 15. 45 Introduction Quiz on pre-course reading Group work – to develop service re-design Coffee Develop outline business place Lunch Dragons den Assessment of providers performance Prize-giving Summary

Feedback - Management Helped to give a good insight into NHS management Good to mix with core medical doctors – different perspectives and ideas Good team working – well organised Helped me understand how primary and secondary care can be intergrated

Feedback – Management (A Warning) Secondary care physicians seemed to blame problems on inappropriate GP referrals…. Felt that the day was spent sorting out inadequacies in primary care…. . quite demoralising spending time working out ideas for them to be completely ripped apart

Acknowledgements • Prit Chahal – Associate Postgraduate Dean • Jane Little – Core Training Program Organiser

Discussion • Questions • Experiences of interprofessional education – Successes – Failures • Potential for nonphysicians Beyond the Classroom • Where? • Inter-professional involvement in organisation of medical education • Integrating interprofessional involvement in routine clinical experience • Inter-professional education at undergraduate level

Further Information www. caipe. org. uk www. eipen. org www. interedhealth. org