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Dedicated Education Units: Strengthening a Learning Culture
1. Innovation in Care Delivery: Advancing a Professional Practice Environment
Dedicated Education Units:
Strengthening a Learning Culture
2. Overview
History of the Dedicated Education Process
Initial Implementation at MGH
The Interprofessional Dedicated Education
Unit Experience at MGH
3. Why Clinical Education Must
Obstacles to achieving quality clinical education experiences have
Change
been reported.
Recommendations to optimize clinical learning have been articulated:
Align learning and engagement in clinical practice realities
Focus on achievement of students’ clinical learning goals
Address quality and safety improvement
Develop clinical reasoning and a spirit of inquiry
(Ard & Valiga, 2009; Benner, Sutphen, Leonard, & Day, 2010, IOM-Future of Nursing Report, 2011; Ironside &
McNelis 2010; NLN Think Tank of Transforming Clinical Education, 2008; NLN National Survey, 2009)
4. Visit by Kay Edgecombe, Flinders University
So. Adelaide, Australia September 2010
5. The History
blog.questia.com
Edgecombe’s DEU model for
nursing clinical education
represents a dramatic shift in
focus on staff nurses
assuming the clinical
instructor responsibilities for
individual students per
semester, as well as the
entire clinical unit and all
staff focused on student
learning and immersion into the
clinical setting.
6. Clinical Education
Shared Vision and Goals
Partnerships
Quality Education and Innovative Practice
Nursing Faculty and RN Shortages
Diverse Workforce
Patient Care Unit Development
Professional Nurse Formation
Quality & Safety Competencies
Continuous Improvement
Coordination and Relationship-building
Processes
7. A Partnership: University of
Massachusetts Boston, Massachusetts
General Hospital, and Brigham and
Women’s Hospital
A model where nursing practice informs nursing
education and nursing education influences
nursing practice
8. Dedicated Education Unit
is….
An innovative model of clinical nursing education.
An entire patient care unit is transformed into an
optimal teaching/learning environment.
The DEU model strives to address the mechanisms
that help alleviate the faculty shortage while
providing enhanced nursing education and
improving practice.
9. Defining the Roles of the DEU
Model
CI = Clinical Instructor. A BS prepared staff nurse
with five years of clinical experience is granted an
adjunct faculty appointment at UMASS Boston. The
staff provides direct clinical instruction, supervision, and
evaluation of two nursing students.
CFC = Clinical Faculty Coordinator. A course
professor at UMass Boston who collaborates with
nursing management to support the CIs in their
education and evaluation of the students.
10. Features of the DEU
Exclusive use of the DEU by University of
Massachusetts Boston students.
Staff nurses would serve as clinical Instructors for two
nursing students over the course of the semester.
Orientation and faculty enrichment days provided to the
CIs by the College of Nursing.
University faculty expertise to support the CIs.
Commitment by all parties to build an optimal learning
environment.
11. DEU IMPLEMENTATION
TIMELINE
Jan 2008 Began Two DEUs
Jan 2008 Began Two DEUs
Pilot Study focused on
Pilot Study focused on
Quality/Safety competency
Quality/Safety competency
development, Staff Nurse
development, Staff Nurse
Satisfaction RWJF Grant
Satisfaction RWJF Grant
QSEN Phase Two, Project
QSEN Phase Two, Project
School
School
2006
UMass Boston with
UMass Boston with
MGH and BWH of
MGH and BWH of
Partners HealthCare
Partners HealthCare
Partnership formed
Partnership formed
2007
Additional DEU
Additional DEU
Study site began
Study site began
Good Samaritan
Good Samaritan
Medical Center,
Medical Center,
Brockton, MA
Brockton, MA
Steward Health
Steward Health
Systems
Systems
2010
2011
RWJF Grant (Jan 2010)
RWJF Grant (Jan 2010)
Evaluating Innovations in
Evaluating Innovations in
Nursing Education Program
Nursing Education Program
Project PDQ
Project PDQ
First randomized control DEU
First randomized control DEU
study, Expanded number of
study, Expanded number of
2012
Two
Two
-year
-year
EIN
EIN
Study
Study
complete
complete
d
d
12. Overarching Research
Question
“How does the DEU intervention develop new instructors
(thus building capacity), enhance faculty work-life (thus
sustaining recruitment, retention, and productivity), and
promote educational quality, functioning within a shared
DEU partnership structure and within local contexts,
amidst nursing unit similarities and differences?”
13. STUDY
DESIGN
UMB CNHS Juniors, Good
Academic Standing
XOXOX
OXOXO
XOXOX
OXOXO
14 Week
Semesters
4 Cohorts
(Students)
Surveys,
Junior Year: NU310
Control
8:1
Senior Year: NU455
Control
1:1
4 Clinical
Rotations
Random
Assignment
DEU
2:1
DEU
1-2:1
Clinical Instructors: Provide clinical instruction to students
CFCs: Coach CIs and provide clinical
instruction guidance
CNHS Faculty: Provide classroom-based instruction;
Colleagues with CFCs in academic service partnership
16. RESULTS
Comparison of Educational Quality:
DEU vs Traditional Students (Mean Scores)
P < .001 SECEE; P < .01 GCL; QSEN
P < .001 SECEE; P < .01 GCL; QSEN
17. RESULTS
Comparison of QSEN Competency Development:
DEU vs Traditional Students (Mean Scores)
P<.001 QI, Informatics, Teamwork
P<.001 QI, Informatics, Teamwork
18. DEU Students Spend More Time on
Time spent on instruction (2x) compared to other activities, by group
Instruction
remainder: same time spent on patient care/management of care activities
19. CONCLUSION
S
DEU clinical education model is as effective as traditional model.
Exceeds students’ perception of clinical learning in almost all
items. Clinical learning is optimized.
DEU model provides more clinical learning opportunities and
focus on QSEN competency development.
DEUs provided similar total direct patient care time; however,
DEU students reported more instructional time, especially during
patient care
Opportunity for teamwork experiences exceeded those available
in the traditional model.
21. WORK LIFE
DEU CIs Exhibit Enhanced
Spirit of Inquiry and Motivation
“So I think it has helped me realize that there is so much
still to learn. It keeps you fresh. You keep going back to
your basics, you know. Because you kind of get lost in
the fact that you’ve been doing this for so long that it
becomes old hat to you…”
“It keeps me up to date with my knowledge. I feel like,
you know, you’re kind of molding the brains of new
nurses. It makes you learn about yourself, how you
learn, positives and negatives.”
27. Professional
Development
ASN – BSN Enrollment
4 Staff Nurses have enrolled in BSN completion
program within the last two years.
BSN – Masters
4 Staff Nurses have enrolled in Masters program within
the last two years.
Masters-level Enrollment
8 -12 vouchers per year utilized by DEU staff
28. Recommendations for Further
Study
Deeper dive into:
Unit sustainability
(mix of staff, rotation patterns, CI retention, max./min. student numbers.)
Student performance
CI development and CFC coaching
Transition to practice
29. Interprofessional Dedicated
Education Unit Experience at MGH
Carmen Vega-Barachowitz, MS, CCC-SLP
Director MGH Speech, Language & Swallowing Disorders
IPDEU Member Steering Committee & IPDEU Faculty
30. Overview
The purpose of this part of the presentation is to:
Discuss current evidence indicating that interprofessional
collaborative practice are essential to safe, high quality,
patient-centered care
Discuss the rationale for interprofessional education as
precursor to interprofessional collaborative practice
Discuss the Interprofessional Dedicated Education Unit
(IPDEU) including the evolution, structure and outcomes
evaluation
31. Introduction
Healthcare Reform:
A great moment to re-examine interprofessional
approaches with the goal of addressing:
Quality
Safety
Efficiency
Effectiveness
Patient Centeredness
32. Evidence to Support
Interprofessional Education
System is fragmented, silo-filled and more discipline-centric than
patient-centered
Incidence of medical errors; 66% attributed to interprofessional
communication breakdown
Coordination across complex systems, especially with multiple comorbidities, requires expert collaboration across all members of
the team.
Traditional HP education still occurs in silos; exposure to other
disciplines is random and not purposeful
33. Quality & Safety
Implications
Decreased medical errors and near misses:
attributed to IP communication
by increasing comfort with direct communication through
standardized language
by improving understanding of roles, responsibilities and
the abilities of team members
34. JC Sentinel Events
Context Patient Safety Concerns
Root Causes of Sentinel Events (all categories, 1995 –
2005)
We need to foster better
communication between
healthcare professionals as an
approach to improving patient
safety
Percent of 3548 events
35. Strong Collaboration Leading to Better
Outcomes
Association Between
Nurse-Physician
Collaboration
and Negative Patient
Outcomes in ICU
The higher the level of
The higher the level of
nurse-physician
nurse-physician
collaboration, the lower
collaboration, the lower
the risk of a negative
the risk of a negative
patient outcome
patient outcome
Med-Surg
Surgical ICU
Medical ICU
Source: Definitions.net, STANDS4 LLC, 2012.
http://www.definitions.net/definition/communication,
accessed January 17, 2012; Fagin CM,
Collaboration Between Nurses and Physicians: No
Longer a Choice, Academic Medicine, 1992;
67(5):295-303; Baggs, et al., “Association Between
Nurse-Physician Collaboration and Patient
Outcomes in Three Intensive Care Units,” Critical
Care Medicine, 1999, 27(9):1991-1998.
36. Interprofessional
Collaboration
Interprofessional Education
Interprofessional Collaboration is a patient-centered
approach to health care delivery that synergistically maximizes
the strengths and skills of each contributing health worker to
optimize the quality of patient care.
Interprofessional Education occurs when learners from
two or more professions learn with, from and about each other
to enable effective collaboration and improve health outcomes.
37. Background:
IPE as precursor of IPC
Create a coordinated effort across health professions
Guide professionals and institutional curricular
development of learning approaches & strategies
Provide a dialogue to evaluate the fit between
education and practice demands
Provide a foundation for a learning continuum in IPC
for lifelong learning
38. A process which includes but is not limited to
communication and decision-making
Collaborative practice includes:
Responsibility
Accountability
Coordination
Communication
Cooperation
Assertiveness
Autonomy
Mutual trust and respect
Interprofessional
Collaboration
Interprofessional
Education
40. Goal:
Interprofessional Collaborative Practice
as the key to safe, high-quality,
accessible patient-centered care
Sponsors
American Association of Colleges of
Pharmacy
American Association of Colleges of
Nursing
American Association of Colleges of
Osteopathic Medicine
American Dental Education Association
Association of Schools of Public Health
Association of American Medical Colleges
41. Goal:
Interprofessional Collaborative Practice
as the key to safe, high-quality,
accessible patient-centered care
IP Competency Domains
A generally identified cluster of more specific
interprofessional competencies that are conceptually
linked, and serve as theoretical constructs.
Values/ethics for IP Practice
Roles/Responsibilities
IP Communication
Teams and Teamwork
43. Model & disciplines involved
Model of DEU for nursing
4. DEU students
are hired as RNs
on DEU units,
Supporting the
DEU model: RNs
return for advanced
degrees.
1. Staff nurses
become CIs
SED TWICE
e version on slide 23)
3. Students, nurses,
the nursing unit
and educational
unit benefit.
2. CIs become
more skilled in
clinical instruction
with CFC
coaching.
44. MGH staff in clinical educator
(PT) role or senior staff (SLP)
is a mentor and coach to
less experienced
clinical supervisors
Physical
Therapy
& SLP Model
MGH Experienced
Clinician
becomes
clinical supervisor
1:1 discipline
specific clinical education
at the bedside or
ambulatory setting
46. IPDEU Goals &
Objectives that has
Deliver effective interprofessional clinical education
potential to lead to effective interprofessional collaborative
practice and improved patient outcomes
Integrate both professional and interprofessional activities and
competencies in the clinical experience
Generate interest in practicing in the acute care environment
Offer professional development opportunities for clinical
instructors
Increase the understanding of discipline specific contributions
leading to appropriate consults and referrals
49. The Students
Twenty-four students from CSD, Nursing, PT are
placed into mixed discipline pairs (dyads) per
semester
Nursing students are in the Accelerated BSN program or
Direct Entry Nursing (DEN) program
Physical therapy students are in the Doctor of Physical
Therapy program
Communication Science and Disorders students are in the
Masters of Science in Speech and Language Pathology
program.
50. The Faculty
Clinical Faculty Coordinators MGH IHP
Clinical Instructors RNs, PTs, SLPs
CI Staff Educators PT & SLP
CI training
Teaching across disciplines
One hour simulated session mandatory for all
clinical instructors
51. The Clinical Day
Each student does clinical preparation prior to
clinical day
Dyads present prep to each other as well as
nursing CI on the morning of clinical- allows for
awareness of varied approaches of chart
review as well as importance of roles
52. Engaging Students Across
Disciplines
Communication
Balance/Fall Prevention
Interdisciplinary Rounds
Vital Signs/Physiologic
Response
Edema Management
Activity
Instruction/Sternal
Precautions
Medications
Endurance
PATIENT &
FAMILY
CENTRIC
CARE
Integument
Cognition
Patient & Family
Positioning
Swallowing
Ethical Issues
Consultations
Patient & Family
Education
Medical
Management
Ventilation/Gas Exchange
53. Debriefings &
Reflective
Component
Weekly Debriefings
Common themes within the
objectives are discussed; facilitates
self reflection and critical thinking
Bi-monthly Reflections
Reflections read by coordinators,
comments provided
Final Seminar
“Interprofessional Rounds”
Held at the end to demonstrate
growth of the student, as well as
awareness of value of other team
members
54. Evaluation Plan
Case based analysis of student experiences
Evaluation plan awaiting IRB approval
Generation of additional research questions
55. Qualitative Comments
Able to communicate to patient with more knowledge
and expertise
Improved understanding of patient because they
understand team members and their roles
Having dyad partner and primary CI allows for creation
of ‘safety net’ where they can ask questions, receive
feedback, non threatening environment
Seeing things from a different perspective forced you to
think about the patient and how they are affected
56. Qualitative Comments
All of the disciplines blend in a way that supports patient
care and the patient would not receive the best care if it
weren’t for the interprofessional practice.
I have a better understanding of what my role is with PT
and SLP
I think the debriefing sessions were…influential. It was
great having all of the disciplines present and hearing their
perspectives and contributions to difficult problems.
57. Future
Directions/Considerations
Involvement of other disciplines including medical
learners
Expansion of the IPDEUs beyond the current two
clinical units; the model may need to be adapted
Assess impact of this model to patient outcomes
Longitudinal implications on interprofessional
practice
Hinweis der Redaktion
DEU Video:
http://www.youtube.com/watch?v=cvfDh0ep_zo
Blue Ribbon Pane; for Future of Ns Edu Research and Think Tank on Trasnfoming CNE i/d’d 3 major areas of focus for future research in NE: new models of CNE fostering relationships betw school and agencies that ALIGN cliical learning w contempr practice and hc needs
What Constitutes Clinical Education as well as relationship bet instructinoal approach used and students’ abilities to practice not definitively documented.
LACK of EVIDENCE to support pedagogical decision abou clinical educ
However, succinctly defining clinical education quality with an established set of process and outcome indicators remains elusive.
Coordination v Cooperation
Coop- no formal rules, each instit has indep goals, no vertical or horizontal linkages few personnel resources and little threat to autonomy for either organ.
Contrast Corporat Coordination: a foraml agreement bet both parties based on joint goals and activities acchieved via mechanisms external to members’ personal relationships We had formal CP agreements, however not on these particular units. Deemed Innovation Units by both CNOs ND agreement WE did come together and drew up a tacit agreement- Our Tenets of Understanding- brings reasonable level of fidelity to the Innovation
Partnership building takes time
Strong relationships between academia and service
(Deans, Chairs, CNOs, Education/Prof.Devt./QI,
Directors, Faculty, Staff, and Students)
Commitment, contact , communication
Resource allocation required
Benefits in collaboration at all levels
Results of Pilot Study are The pilot phase evaluation dem- onstrates the DeU clinical education model clearly facilitated teaching and learning of quality and safety compe- tencies. in addition, the education- practice partnership, initially created to implement the clinical education delivery model, was strengthened as a result of performing this prelimi- nary evaluation. Focus gps led to PCA and stipends and providing grad courses
A common early theme was articulated as “Were they actually ‘teaching’ enough? And “Were they were holding the students to high enough standards?” With continual role development the confidence of these skilled practitioners has grown and the expectations of the students have also increased. The eighteen students involved reported a sense of accomplishment and some have expressed amazement at how much they had learned thus far by mid-semester. Overall, the first half of the semester of this pilot program has been evaluated as a positive experience for all involved.
The purpose of the formal evaluation study under a controlled design was to examine the innovation’s effectiveness, efficiency, and ability to build capacity. An overarching question to be addressed by the evaluation is, “How does the DEU intervention support the development of new instructors, thus building capacity, enhancing faculty worklife, and sustaining recruitment, retention, and productivity?” Specific statements germane to our thinking include:
If staff nurses are provided with specific orientation by Clinical Faculty Coordinators (CFC) and unit support, then they can be recruited and function as new DEU instructors.
If staff nurses are provided with ongoing support by CFC and unit, then they will be satisfied as new DEU clinical instructors (CI), and then other staff may become interested and recruited as new CIs.
If staff nurses are provided with modest incentives (stipend), then they will be retained and sustained as CIs, and they will advance on their units (ladder/productivity).
If staff nurses as DEU CIs are provided with incentives (voucher) then they will return for advanced education.
If staff nurses are utilized as clinical instructors, then college faculty can shift roles and take on new responsibilities, and then be satisfied and produce in new ways, and then be retained. (satisfaction/productivity/retention).
If staff nurses are utilized as clinical instructors, then college clinical instructors can be utilized as instructors in new placements with enrollments of new students in new program (accelerated option) and/or existing program expansion(capacity)
If the task force provides dedicated support and oversight, then the innovation can be productive, sustained, and replicated.
Internal Validity:
RCT (causality, selection)
Two threats: Hawthorne,
attrition
Replication
Triangulation of data and
methods
External Validity:
Subjects are typical
nursing students
Are sites/people typical?
Student Evaluation of Clinical Education Experience (SECEE) inventory was used to measure student perceptions of clinical instruction and clinical learning opportunities (Sand-Jecklin, 2009).
Original Response Scale: Growth in Clinical Learning A great deal of growth=5 to No growth=1
Remainder time Pt Care
Opportunities for Professional Growth .05 level signif
Hourly RoundingAlternatives to Restraints
Pressure Ulcer Prevention Presentation
GRANd ROUNDS
Fall Prevention
Enhancing CAPD Procedures
Quiet Hours
Post op Pressure Sore Prevention
Unit is the driver for sustainability – Academic-Practice Partnership is key
Cycle of Sustainability:
More nurses are educated over time (incentives)
DEUs can mentor growth of new DEUs
Students benefit from quality clinical education
DEU students are hired on unit as new RNS
Staff Nurses become CIs
CIs become more skilled in clinical instruction with CFC coaching
Students, nurses, the nursing unit and educational program benefit
DEU students are hired as RNs on DEU units, supporting the DEU model; nurses return for advanced degrees
With changes in the healthcare system including the ACC (Supreme court ruling June 28, 2012), rising costs and increased focus on Q&S, efficiency, effectiveness and pt centeredness, this is the perfect time to re-examine how health care professionals are educated, not only within their profession but also as members of interprofessional teams.
Accountable care organization, value based purchasing. Linking quality to costs
Executive Summary: Terry Fulmer, RN, PhD, FAAN June 28, 2012
Keeping pace with the changes in healthcare
Mismatch of competencies for needs: EXAMPLE
“When I was in medical school I spent hundreds of hours looking into a microscope – a skill I never needed to know or ever use. Yet, I didn’t have a single class that taught me communication and teamwork skills – something I need every day I walk into the hospital.” (Pronovost & Vohr, 2010, p 46) IPEC 2011, p.22
In Washington last week discussing curricular desing. More evidence is needed about what are the best models of education for all disciplines.
The four competencies focus on knowing not only your own professional role, ethics, responsibility etc, but also other professions. “Knowing” makes the communication process clearer, including clarifying communications received from others.
Standardized language SBAR– Situation, Background, Assessment and Recommendation
Sentinel events are unanticipated events in health care resulting in death or serious injury, physical or psychological
Interprofessional Education is Defined as: “Members or students of two or more professions associated with health or social care, engaged in learning with, from and around each other”
Provides ability to share knowledge and skill set between professions and allows for a better understanding of the healthcare process
Desired outcome is to develop an interprofessional team-based, collaborative approach that will improve patient outcomes and quality of care while hospitalized.
Collaboration between MGH/IHP
Academic Practice Partnerships
Team Based care
Care coordination
Mutual trust and respect, and understanding other disciplines
Source: WHO, p. 9, 2010 (Geneva). IPEC p. 16.
Think locally – dose of team
Focus on collaborative practice
The WHO Framework highlights curricular and educator mechanisms that help interprofessional education succeed, as well as institutional support, working culture, and environmental elements that drive collaborative practice. The framework incorporates actions that leaders and policymakers can take to bolster interprofessional education and interprofessional collaborative practice for the improvement of health care. At the national level, positive health professions education and health systems actions are pointed to that could synergistically drive more integrated health workforce planning and policymaking.
In order to advance this agenda, the Health Resources and Services Administration (HRSA) just awarded a 4 million dollar grant to University of Minnesota Academic Health Center to provide national leadership in the filed of Interprofessional education and collaboration
IPEC:
Interest in promoting more team-based education for US health professions is not new. At the first IOM Conference, “Interrelationships of Educational Programs for Health Professionals,” and in the related report “Educating for the Health Team” (IOM, 1972), 120 leaders from allied health, dentistry, medicine, nursing, and pharmacy considered key questions at the forefront of contemporary national discussions about interprofessional education.
Core Competencies published May 2011, sponsored by IPEC (Interprofessional education collaborative)
Report of an Expert Panel: May 2011
Values/ethics : Background / Rationale: Values & ethics are considered an element of professionalism, which has significant overlap with constructs of humanism and morality (Baldwin, 2006). These values become a core part of professional identity. Dombeck (1997) has labeled the moral agency associated with that identity as “professional personhood.” Gen Competency Statement-VE. Work with individuals of other professions to maintain a climate of mutual respect and shared values.
Roles/Responsibilities: Background / Rationale: “Front line” health professionals identify being able to clearly describe one’s own professional role & responsibilities to team members of other professions & understand others’ roles & responsibilities in relation to one’s own role as a core competency for collaborative practice. GCS-RR. Use the knowledge of one’s own role & those of other professions to appropriately assess & address the healthcare needs of the patients & populations served.
IP Communication: Background / Rationale: Communication competencies help professionals prepare for collaborative practice. One of the five IOM core competencies (IOM, 2003) is the ability to use informatics. GCS-CC. Communicate with patients, families, communities, & other health professionals in a responsive, responsible manner that supports a team approach to the maintenance of health & the treatment of disease.
Teams / Teamwork: Background/Rationale: Learning to be interprofessional means learning to be a good team player. GCS-TT. Apply relationship-building values & the principles of team dynamics to perform effectively in different team roles to plan & deliver patient/population-centered care that is safe, timely, efficient, effective & equitable.
3 Tiers:
Jointly conceived by leadership
Support from patient care unit leadership and clinical department managers
Model and process developed by clinical education faculty from both institutions
Clinical and Academic Partnership
Model:
- unit staff nurses selected as CIs (minimum BSN, 5 yrs experience)
- Clinical Faculty Coordinator (CFC), an MGH IHP School of Nursing faculty member, serves as the iaison between the MGH IHP and MGH.
- The CFC supports the staff nurses in their development as CIs
- the CFC conducts initial workshops, orients CIs to MGHIHP, introduces concept of IP-DEU, learning objectives for each of the programs, course objectives, the IPEC competencies, principles of adult learning and student evaluation
- one CI is responsible for working with one student dyad, each including one nursing student and one SLP or PT, throughout a clinical semester.
- Multiple dyads are providing care on the clinical unit at any given time
- The CIs facilitate multiple dyad participation in interprofessional rounds and in clinical conferences
- this assures that all students are exposed to perspectives from each of the 3 professions
Overarching objectives:
Nursing/PT/SLP students' achievement of the IPEC Core Competencies for Interprofessioanl Collaborative Practice
2. Safe, effective patient care through use of high functioning collaborative interprofessional health care teams
3. Commitment to life long learning through active collaboration in the educational process
Visual representation of the IP-DEU model.
The patient is the center nucleus of the model. A mixed discipline dyad pair cares for their patient throughout the clinical day and interfaces with the CIs from the program disciplines as they work with the patient. A strength of this model is in the dyad remaining with the patient throughout consults and nursing assessments the students are able to understand the patient’s story.
What is not represented in this picture in the academic support provided to the unit via the CFCs in this case an IP faculty group that are regularly present on the unit to mentor both students and clinical staff. The 3 of us here today are the CFCs for the IP-DEU program.
Communication amongst the 3 of us and the entire team is instrumental in the success of this program.
-
Ideally our goal will be to have all students working on one clinical day.
-Each dyad spends two weeks with each other, Nsg/PT, Nsg/SLP, and CSD/PT and then rotate through so each have an opportunity to learn from each other
Nursing/Physical Therapy/Speech-Language Pathology
Nursing, PT & SLP staff as clinical instructors
IP dyads
MGH IHP faculty and MGH Senior staff in Nursing, PT, SLP provide support and coaching for CIs
RN: Second semester of their first year.
Will be last medical/surgical clinical
Last semester they did not pass medications, this semester they will be passing medications.
PT: Second or third semester of their first year.
Gross Anatomy and Professional Socialization coursework completed.
Limited to no experience in the inpatient setting.
Beginning pharmacology coursework.
SLP: First or second semester of their second year.
They have an active interest in medical speech pathology.
They have had no formal introduction to pharmacology or pathophysiology.
They have had a clinical but not in the medical setting.
Methods: four phases
Phase 1: ethnography, participant observers. Traditional ethnography – data collected via field notes which will be coded and analyzed by the research team on an ongoing basis. An ethnography consultant will provide independent analysis of selected data to strengthen findings.
Phase 2: Nature of student experience, participant observers. Use IPEC competencies as a lens for coding and analysis – theory guided ethnography (Bernard, 2002). Supplement with student interviews
Phase 3: begin with a crosswalk of the IPEC competencies with the data from phases 1&2 to produce an inventory of the competencies required by faculty and clinical staff to teach in an interprofessional clinical environment.
Phase 4: development and testing of an empirically based instrument to assess student achievement of specific milestones in the achievement of the IPEC competencies.
Research questions:
What is the nature of the student experience and in particular interprofessional student interaction between nursing students and students from the rehabilitation disciplines (PT & SLP) on the IPDEU?
What are objective milestones of achievement of the IPEC competencies in real world clinical experiences?
What are the competencies required of both clinical instructors and clinical faculty coordinators for teaching/learning on the IPDEU?
What is the impact of the IPDEU model on faculty productivity and satisfaction?
IRB:
Do you have comments for this slide?
?? Something from the CFCs?