A collaborative approach to embedding IPL in practice

Dr Milika Matiti
University of Lincoln
Interprofessional Education

Summary

The importance of Inter-professional Education is well documented.  In 2009, while working with students in clinical practice at Pilgrim Hospital (United Lincolnshire Trust). It was realised that clinical support was required for inter-professional education.  This led to approach other universities within the East Midlands to ascertain which Universities had clinical placement provision at Pilgrim Hospital and whether they would wish to participate in the development of an Undergraduate inter-professional Education (IPE) project.

Therefore, the project is a collaborative development between the Trust and several universities across the East Midlands. The project has three parts: Inter-professional Education in practice, Simulation and E-learning resource Hub (Under development).  Only IPE in practice will be presented here.

The project is guided by the University of British Columbia (UBC) model of inter-professional education (Charles, et al., 2010).The main components of the model are: Exposure, Emersion and Mastery. According to Charles, et al., (2010), theoretical knowledge is a prerequisite for effective learning. In this project, exposure stage entails introducing students to concepts of Inter-professional Education, for example, being exposed to different professional roles and understanding themes of the project. Emersion involves undergraduate students from different healthcare professions participating in the Inter-professional activities to learn with, from and about one another to improve collaboration and the quality of care (WHO, 2010).  Like the UBC framework the goal of ‘mastery’ is  to  “Encourage  the development of  advanced level of critical  thinking skills, a high degree of self-reflection and a deeper  understanding of the contribution of one’ s own and the other professions within the health and health delivery” (Charles, et al., 2010 p 16).

Using the themes of dignity, communication and safeguarding, students from different professions students carry out inter-professional learning activities. The following are clinical areas within Pilgrim Hospital which have been involved in this project: Gynaecology and Midwifery, Gastroenterology and Endocrinology and Stroke Unit. Building on the success of these pilot clinical areas, there is a plan to expand these IPE learning opportunities to other clinical areas and other hospitals within the Trust.  This initiative has particular significance in contemporary practice as dignity, communication and safeguarding form the central themes in a number of recent government strategy documents.

What are the Aims?

This project aims to promote inter-professional learning in all clinical areas and departments within the Trust. Central to the success of this project is creating an IPE culture in practice where by every staff is aware of IPE, establishing an IPE learning environment for students. The ultimate goal is to enhance the quality of care through inter-professional working.

Who was/is involved?

The project is fully supported by the Director of Medical Education, Senior Academics and Clinical Educational Leads across the Trust and partner universities.

However, there is a project team:

Dr Milika Matiti Senior Lecturer, University of Lincoln

Kerry Lewis, Senior Lecturer, University of Lincoln

Dr Damion McCormick. Assistant professor, University of Nottingham

Dr A Rizvi, Clinical Teaching Fellow, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust

Claire Marshall, Junior Sister, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust

Kathryn Kelly,  Site Lead Dietitian, Grantham and Pilgrim Hospital, United Lincolnshire Hospitals Trust

Judith Mohammed. Senior Lecturer, University of Lincoln

 Onje Yuill, Assistant Professor, University of Nottingham

April Buckthorp, Practice Learning Manager, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust

Judy Skipworth, Staff nurse, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust

Students who have  participated in the project are for example from the following universities : Sheffield Hallam University, University of Derby, University of Nottingham, Sheffield Hallam University, University of Lincoln, Open University, University of Leicester

What has changed/will change?

There is an increased of Inter-professional activities in practice.

More staff are aware of the IPE activities reinforcing   inter-professional   working.

Below are sample of students’ comments from different profession and Universities   on what they had learned from the IPE activities: 

Learnt how different roles are involved and to what extent they are involved. Good communication between all health professionals can facilitate high quality patient centred care and ensure that the patient is looked at holistically. (Student nurse: University of Lincoln)

Other profession point of view. Consider things   from every point   of view, know when to refer patients on and gain extra advice (Student Nurse: University of Lincoln)

The role of each profession in the medical intervention of the patient. What available medical help   for a specific condition. To be able to   know   who to get in touch   or refer the patient. (Student nurse: Open University)

 I found explaining the roles of each professional valuable as it gave me a better insight into their roles. (Dietetics Student: University of Nottingham)

Able to know what to do for discharge within MDT. The discussions have helped me to put views across   (Student nurse: Nottingham University)

It will encourage me to continue to approach all disciplines of the MDT for information about the patient and to consider their wider needs.” (Physiotherapy students: University of Nottingham)

Encourage good communication and effective referrals for smooth care for patients (Physiotherapy student: Sheffield Hallam University)

The roles  of different practitioners  in planning  a complicated  discharge , know  who  to communicate  with  what and  what to do myself . I will not   be challenged if  I encounter  similar  scenario  in future. (Medical  students: University of Nottingham)

Various Views of other professions. Practical aspects of communication, things I can do to improve patient care …. Appreciation of patient dignity. (Medical student: Medical Student University of Leicester)

Role of MDT and how communication can be effective. Enjoyed the session. (Occupational Therapy: Derby University)

What lessons have we learnt?

This  an ambitious and complex project to manage and implement, due  to number of universities and clinical staff engaged in the project and  also the challenges of developing IPE learning opportunities to meet the needs of a wide range of students from different healthcare professions at different times of the year. Many lessons have been learnt:

  • Establishing a network of healthcare professionals from universities across the East Midlands and the Trust involved.
  • There will always be challenges when implementing Inter-professional Education in practice but what is required is creativity in managing these challenges. In addition, clinical facilitators  who are committed and demonstrate a greater awareness of the value of inter-professional learning and are enthusiastic for engaging students actively in IPE activities.
  • Sustaining IPE activities in practice requires full involvement of the   clinical staff and full support of academic leads and management in clinical practice. Jointly Universities, clinical staff and the Trust invest time, resources and financial support to implement and expand the project. 
  • Embedding a sustainable IPE activities in practice also requires creating a culture of IPE in the clinical practice whereby all clinical staff are aware of the importance of IPE and can make the most of any opportunities to teach students inter-professionally when they arise. Staff should view IPE as an integral part of their clinical practice role.
  •  A staff from any profession can facilitate a group of students from different professions working on IPL activity.
  • The involvement of service users or patient is important.
Contact details

Dr Milika Matiti mmatiti@lincoln.ac.uk

Dr Azhar Rizvi azhar.rizvi@ulh.nhs.uk

Dr Damion McCormick damion.mccormick@nottingham.ac.uk

Claire Marshall Claire.Marshall@ulh.nhs.uk

Links to further information and resources

Charles, G Bainbridge, L and Gilbert, J (2010) The University of British Columbia Model of Inter-professional education, Journal of Inter-professional Care, 24 (1) 9-18

WHO (2010) Framework for Action on Inter-professional Education and collaborative practice, Health professions Networks, Nursing and Midwifery. Human Resources   for Health, Geneva, Switzerland, Available at http://apps.who.int/iris/bitstream/10665/70185/1/WHO_HRH_HPN_10.3_eng.pdf accessed on 26/5/16