Автор неизвестен - Mededworld and amee 2013 conference connect - страница 47

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Summary of work: The study uses grounded theory which provides a systematic approach to explore multiple viewpoints and discover how meaning and interactions are constructed. It explores teaching competencies' perspectives and priorities from individuals in diverse professions and teaching roles. Approximately 25 individual, semi-structured interviews will be conducted between January and March 2013. Summary of results: A coding structure will be developed based on thematic analysis of major themes and applied to the data set using Nvivo software. Findings including developmental indicators for teaching excellence and lessons learned will be shared.


Conclusions: Discussion will focus on how identified competencies/priorities are used to inform domains of an organizational Interprofessional FD Framework to and how the work contributes to the articulation of a skills development continuum that shape a common language for expectations, support, and outcomes for professionals expected to perform in various teaching roles.

Take-home messages: Identification of teaching competencies for FD framework domains.


The production of learning objects in a Family's Health course for the multiprofessional teams of the Primary Health Care

Alessandra Dahmer (Federal University of Health Sciences, Education Information and Health, Sarmento Leite, 245, Demetrio Ribeiro, 499, Porto Alegre 90010310, Brazil)

Maria Eugenia Pinto (Federal University of Health Sciences, Department of Public Health, Porto Alegre, Brazil)

Eduardo Zanatta (Federal University of Health Sciences, Education Information and Health, Porto Alegre, Brazil) Carlos Borba (Federal University of Rio Grande do Sul, Department of Public Health, Porto Alegre, Brazil) Otavio D'Avila (Federal University of Rio Grande do Sul, Department of Public Health, Porto Alegre, Brazil)

Background: The clinical content of post-graduation course of Family Health, offered by the UFCSPA in the UNA-SUS system, in distance education, is organized in complex cases that describe ordinary clinical situations in Primary Health Care (PHC) for doctors, nurses and dentists.

Summary of work: The development process of the course's material involves many stages, some of them simultaneous, because each one of the cases is divided in content for each one of the 3 professional areas. In the beginning, the teachers with experience in PHC planning and creating the content, were supervised by coordinators of each area. In the following stage, a content coordinator reviews the material and suggests alterations. In the production, the contents are changed into many media, like videos, comics, podcasts, texts and exercises. These files are organized in learning objects and packed in the SCORM format. The contents of the three professional areas are put in an unique learning object.

Summary of results: Ninety learning objects for thirty complex cases were developed and validated. The material was already used for more than one thousand students and these materials are available at the Brazilian Ministry of Health's library of educational resources in Portuguese.

Conclusions: The use of virtual learning environment as tools of production management makes faster the process of development and validation of the educational material.

Take-home messages: The organization of the contents in an unique learning object creates an environment

that integrates the students of the multiprofessional team, qualifying their training in Primary Health Care.


Exploring Stereotypes in Healthcare Professions

Kanika Batra (National Healthcare Group, Health Outcomes Medical Education Research, Ren Ci Hospital Level 15, 71 Irrawaddy Road, Singapore 329562, Singapore)

Jill Thistlethwaite (The University of Queensland, School of Medicine, Brisbane, Australia)

Background: Stereotypes are beliefs that groups of people (e.g. professional group) are associated with certain traits. Intergroup behaviors could be guided by established stereotypes and may serve as a means to deal with an outgroup efficiently by expending minimum energy. Stereotypes act as shortcuts for healthcare professionals to cope with the demands placed on them during their interactions with patients and other professionals. However, stereotypes may generate negative expectations of another group's attitudes and behaviors. Therefore, the aim of this pilot study was to understand both the negative and positive perceptions of doctors and nurses by healthcare professionals in Singapore.

Summary of work: Forty participants from different professional backgrounds (doctors, nurses, allied health professionals, administrators, social workers) were asked to choose 3 negative and 3 positive adjectives out of ten options describing both nurses and doctors. Summary of results: The top three negative adjectives chosen to describe doctors were: arrogant, detached, not a team player; and to describe nurses were: lacks leadership, lacks initiative, low confidence. The top three positive adjectives chosen to describe doctors were: knowledgeable, confident, professional; and to describe nurses were: compassionate, dedicated, team player.

Conclusions: This pilot study provided us with an understanding of the perceptions of doctors and nurses by healthcare professionals. The next step is to explore whether the healthcare professionals have an implicit bias towards their own professional group which may affect their interactions with others. We are currently in the process of furthering the research to investigate implicit attitudes among doctors and nurses using implicit association test.


Educating the Hospital on Sepsis and Making Changes to Improvement Management: A Quality Improvement Project

John Sykes (North Bristol Trust, Foundation Year 1 Doctor - Elderly Medicine, Bristol, United Kingdom) Oliver Pearce (North Bristol Trust, Foundation Year 1 Doctor, Bristol, United Kingdom)

Alex Gray (North Bristol Trust, Foundation Year 1 Doctor, Bristol, United Kingdom)


James Peters (North Bristol Trust, Foundation Year 1

Doctor, Bristol, United Kingdom)

Anni Dong (North Bristol Trust, Foundation Year 1

Doctor, Bristol, United Kingdom)

Elizabeth Ivey (North Bristol Trust, Foundation Year 1

Doctor, Bristol, United Kingdom)

Dave Higgie (North Bristol Trust, Foundation Year 2

Doctor, Bristol, United Kingdom)

Iram Parwaiz (North Bristol Trust, Foundation Year 2

Doctor, Bristol, United Kingdom)

Laura Corbett (North Bristol Trust, Foundation Year 2

Doctor, Bristol, United Kingdom)

Fionnuala Ryan (North Bristol Trust, Foundation Year 2

Doctor, Bristol, United Kingdom)

Kyron Chambers (North Bristol Trust, Foundation Year 2

Doctor, Bristol, United Kingdom)

Benjamin Plumb (North Bristol Trust, Clinical Fellow,

Bristol, United Kingdom)

Background: Surviving sepsis requires early recognition and treatment to maximise chances of a positive outcome. Delivering this requires increased awareness of sepsis in all members of the multidisciplinary team. Summary of work: This is a foundation doctor-led project implementing quality improvement methodology by using small interventions and assessing them regularly. We aimed to increase the multidisciplinary team's knowledge of sepsis using a multimodal approach and hence improve its recognition and treatment on our acute admissions ward. Summary of results: An initial audit was conducted looking at sepsis recognition and treatment on an acute medical ward. A questionnaire was formulated assessing junior doctors' and nurses' knowledge of sepsis. Hospital-wide teaching presentations, patient experience lectures and interactive teaching to junior doctors, senior doctors and nursing staff were organised. Additionally a 'sepsis sticker' has been produced to aid junior doctors and others on the ward to recognise sepsis. We have conducted several PDSA cycles and made alterations to the sticker at each stage to make it more effective.

Conclusions: The questionnaire showed only 11% correctly identified SIRS criteria. The audit showed only 27% of those with sepsis were correctly recognised and none had sepsis 6 as per guidelines. Our latest PDSA cycle shows 90% of ward admissions are using the 'sepsis sticker'. We plan to re-audit notes on acute medical wards soon to show that the many education sessions and educational 'sepsis sticker' have improved sepsis recognition and treatment of sepsis. Take-home messages: A multiprofessional education programme involving teaching sessions, patient experience lectures and interventional aids increases recognition and management of sepsis.


Inter-professional Collective Learning among Emergency Medicine Health Care Professionals: An Exploration of Needs, Desires and Opportunities

Jennifer Riley (St. Michael's Hospital, Emergency Medicine, 30 Bond Street, Toronto M5B 1W8, Canada) Melissa McGowan (St. Michael's Hospital, Emergency Medicine, Toronto, Canada) Linda Rozmovitz (Toronto, Canada)

Background: The Emergency Department (ED) is unpredictable with constant demands on time and resources. Owing to this and shift work, emergency physicians (EP), nurses (RN) and other health professionals (HP) in the ED are infrequently afforded time to debrief their clinical experiences in a collective forum. The objective was to explore ED stakeholder's perspectives of current culture of interprofessional education (IPE) and value of new opportunities. Summary of work: Twelve semi-structured interviews were conducted with ED professionals (6 RNs, 5 EPs, 1 social worker) in an academic, inner city hospital. Method of constant comparison was used for analysis, including searches for disconfirming evidence. Summary of results: While stakeholders reported good working relationships in the clinical setting, current culture for discussion was identified as largely informal, brief, ad hoc and siloed within professions. Few formal opportunities exist and are EP focused, as the absence of paid education and limited access during shifts due to high clinical volumes prevents involvement of other HPs. Lack of IPE was perceived to negatively impact team dynamics and limit team members' understanding of roles. New IPE opportunities were recognized as offering enrichment to the ED through: improved patient care; process and innovation; burnout prevention; and understanding roles and perspectives. Suggestions included simulation, timely formal debriefings and regular IPE grand rounds. To maximize attendance outside of clinical shifts, these must be substantially value-added with high impact to clinical practice, compelling subject matter, and accessible to all. Conclusions: The ED is a fast paced, high stress environment with many different HPs and external pressures. IPE and discussions support enhancement of not only care of the patient, but also the experience of the HP. Future work will include formation of an IPE Steering Group and program planning to develop innovative IPE in the ED.


How do academic specialists impact team-based care in the community?

Rene Wong (University of Toronto, Medicine, 200 Elizabeth Street, 12-EN-217, Toronto M5G 2C4, Canada) Henry Halapy (St. Michael's Hospital, Pharmacy, Toronto, Canada)

Catherine Yu (University of Toronto, Medicine, Toronto, Canada)


Background: Little evidence exists in the interprofessional education literature that discusses the impact of the relationship between specialist facilitators and primary care participants at the post-licensure level. We explored if and how the nature of this relationship impacts team function in a multidisciplinary primary care setting.

Summary of work: A university-affiliated, multidisciplinary team of specialists led longitudinal educational sessions for community-based multidisciplinary primary care teams. We collected data through interviews, facilitator field notes and transcripts of communications between facilitators and participants. We used a constructivist, grounded-theory approach with the social interaction between facilitators and participants as the unit of analysis. Summary of results: Facilitator-participant interaction fostered team-based learning through identity construction and development. Three intertwining themes emerged: 1) fostering a learning community: specialist presence was an impetus for team members to congregate and share ideas, 2) specialists as a platform: facilitator-participant interaction provided opportunities for non-physician members to promote their ideas, worth and value to their team, 3) specialists as an informal resource: in between sessions, non-physician participants sought 'curbside' clinical advice from facilitators. Unexpected effects were observed: the ability to directly contact specialists undermined contact within the primary care team. Increased recognition of team members came with requests for increased support or remuneration that were not possible. Conclusions: Academic specialist facilitators can have both positive effects on team-based care and unintended negative effects on boundaries within the team.

Take-home messages: With universities playing roles in continuing education, faculty development should address how facilitators could mitigate their potential to impact participant team dynamics.


The Development of Dental Care Professionals as Educators in an Orthodontic Outreach Training Centre

Richard Cure (University of Warwick, Warwick Dentistry, Coventry, United Kingdom) Alyson Quinn (University of Warwick, Warwick Dentistry, Warwick Medical School, Gibbett Hill Road, Coventry CV4 7AL, United Kingdom)

Background: DCPs who have trained in the same outreach environment as Orthodontic Therapists and Orthodontic Nurses have worked as a team in an inter­professional learning environment. They have further developed as educators and are integrally involved in the education of postgraduate MSc, Orthodontic Therapy and Orthodontic Nurse students. This educational development is being evaluated with a view to further expansion and development.

Summary of work: DCPs are actively engaged in the education of postgraduate dental students and other DCP students. They have initially been mentored by the Course Directors and have initiated change and improvements to teaching practice. They are part of the University of Warwick tutor development programme. Assessment and appraisal is carried out by the Course Directors and University Education Director. Summary of results: Dental Care Professionals are a valuable addition to the teaching Faculty and, based upon feedback received, their role is clearly valued by students and colleagues. They have been trained and work in an inter-professional learning environment and are ideally suited for teaching roles in the education of students.

Conclusions: Outreach based training in dentistry is proving to be enhanced by the involvement of Dental Care Professionals. An interprofessional education environment allows both educators and students to interact and enhance each other's development. Take-home messages: Dental Care Professionals are a valued part of both the academic and clinical training for dentists and dental care professionals.


Working together, Learning together: A Study of Interprofessional Education in Primary Care

E Forde (Wessex Deanery, Centre for General Practice, Royal London House, Bournemouth University, Christchurch Road, Bournemouth BH1 3LT, United Kingdom)

C Wedderburn (Wessex Deanery, Centre for General Practice, Bournemouth, United Kingdom) E Farrell (NHS Dorset, Bournemouth & Poole, Poole, United Kingdom)

A Mistry (NHS Dorset, Bournemouth & Poole, Poole, United Kingdom)

E Monks (NHS Dorset, Bournemouth & Poole, Poole, United Kingdom)

T Odetoyinbo (NHS Dorset, Bournemouth & Poole, Poole, United Kingdom)

Background: Interprofessional Educational (IPE) is promoted by the World Health Organisation. However few studies exist in primary care and the evidence for its benefits were equivocal in a recent review (Layzell, 2012). Studies suggest that doctors find it more useful than other participants, and often dominate discussions (Underwood et al., 2002). This study assesses the effectiveness of an IPE programme delivered to a wide range of staff within primary health care teams. Summary of work: NHS Dorset, Bournemouth & Poole PCT appointed four GPs to deliver one hour workshops in 103 GPs practices. The workshops were designed to raise awareness and knowledge of dementia and all members of primary health care teams (clinical and non-clinical) were invited to attend. Qualitative and quantitative data were sourced using pre and post workshop questionnaires.

Summary of results: Preliminary data suggest that participants found the workshops useful, their


knowledge improved and learning as a team enriched the experience. A more detailed analysis will be provided by participant group (e.g. comparing GPs, nurses, reception staff, management), as well as a qualitative analysis of their comments. Conclusions: Preliminary data suggest that Interprofessional Education is useful and valued by primary care teams. Participants commented that learning together allowed them to "know the views of others" and have a "better understanding of objectives". We propose that patients benefit when primary care teams have a mutual understanding of care pathways, particularly for chronic conditions such as dementia. Take-home messages: Interprofessional Education can enrich learning in a primary care setting.


Interprofessional Collaboration between Residents and Nurses on a Simulated General Internal Medicine Ward: Behaviors Enhancing Teamwork Quality

Virginie Muller-Juge (Faculty of Medicine, University of Geneva, Unit of Development and Research in Medical Education, Rue Michel-Servet 1, Geneva 4 1211, Switzerland)

Stephane Cullati (University Hospitals of Geneva, Quality

of Care Service, Geneva, Switzerland)

Katherine S Blondon (University Hospitals of Geneva,

Division of General Internal Medicine, Geneva,


Nu V Vu (Faculty of Medicine, University of Geneva, Unit of Development and Research in Medical Education, Geneva, Switzerland)

Georges L Savoldelli (University Hospitals of Geneva, Division of Anaesthesiology, Geneva, Switzerland) Mathieu R Nendaz (University Hospitals of Geneva, Division of General Internal Medicine, Geneva, Switzerland)

Background: Understanding of nurse-resident interactions in Internal Medicine is insufficient. The aim of our study was to describe behaviors enhancing teamwork quality in this setting. Summary of work: 14 Internal-Medicine resident-nurse pairs volunteered. They managed two cases, using high-fidelity simulation. Recordings were transcribed and analyzed, using template analysis. Three researchers coded the videos independently, then discussed to reach consensus. Teamwork quality was scored according to patient management efficiency and atmosphere of the interaction. Summary of results: Preliminary results suggest that nurse-resident pair efficiency was associated with the presence of common goals for patient management and shared decision making within the pair. Residents' and nurses' leadership played a major role on overall efficiency but nurses' autonomy appeared even more important in urgent cases. A harmonious atmosphere during the interaction was related to nurses' leadership, as well as residents' and nurses' mutual listening and help. Behaviors enhancing team building, such as

providing feedback and controlling own negative emotions also influenced atmosphere. This favored shared decision making and establishment of common goals. Additionally, residents' and nurses' expressions of leadership tended to increase when they decreased in the other team member.

Conclusions: Efficiency in patient management seems to depend on the presence of common goals within nurse-resident pairs and on behaviors enhancing harmony. Residents' leadership is traditionally expected but nurses express their leadership even more when residents are less autonomous. Behaviors enhancing teamwork quality in Internal Medicine should be included in interprofessional education. Take-home messages: Some behaviors can be identified as enabling factors for teamwork quality in Internal Medicine settings.


Interprofessional simulation training: is it what the students want?

Ben Lovell (Royal Free Hospital, Simulation centre, Pond Street, London NW32QG, United Kingdom) Nick Murch (Royal Free Hospital, Simulation centre, London, United Kingdom)

Background: Interprofessional simulation is a growing field in undergraduate education. Team-working and communication within interdisciplinary teams is essential in delivering high quality healthcare. Summary of work: We are currently in the third year of our simulation training programme for third year medical students and second year nursing students, with the aim of increasing interdisciplinary communication at an early stage of training. Simulation scenarios were developed to with reference to both medical and nursing curricula to develop non-clinical skills, including communication, patient safety, handover and safeguarding. Feedback from the students was collected and analysed.

Summary of results: 36 medical students and 32 nursing students submitted feedback. Mean pre-session confidence score was 1.4/5 (medical students) and 2.1/5 (nursing students). Post-session confidence scores were 3/5 (medical students) and 3.8/5 (nursing students).All students recorded that it was the first time they had worked with undergraduates from a discipline. All students indicated that they found the sessions beneficial, and have better understanding of the roles within a multidisciplinary team. All students indicated they would like further interprofessional training. Conclusions: Studies have suggested that by final year of training, attitudes towards other healthcare professionals are entrenched and can act as a barrier to teamwork. Both nursing and medical students enjoy training in high fidelity simulation scenarios, and feel their understanding of each other's roles is enhanced. Take-home messages: Interprofessional simulation training fosters enhanced communication and mutual respect amongst nursing and medical students. Students of both professions feel that they have limited exposure

to each other during training, and are keen to correct


4BB Posters: Curriculum Evaluation

Location: South Hall, PCC


Self-directed learning - evidence based algorithm

Sankaranarayanan Ramachandran (The University of Manchester, Manchester Academic Health Science Centre, Lancashire Teaching Hospital NHS Trust, Medical Education, Headington, United Kingdom) Bhanumathi Lakshminarayanan (Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Paediatric Surgery, Oxford, United Kingdom)

Background: There are many articles on self-directed learning, but not many evidence based algorithms in medical education.

Summary of work: I have presented the self-directed learning flow chart, incorporating various theories and evidence. Self-directed learning is a student centred approach to learning where the learners take control of their own learning processes and experiences. This flow chart forms a tool emphasising on how the students will be able to acquire new skills associated with self-directed learning.

Summary of results: This algorithm has resulted in the generation of simple, stepwise and easy to follow approach in motivating and facilitating student self-directed learning.

Conclusions: Self-directed learning is a complex process with many factor determining the outcome. Self-directed learning allows the students to have freedom and flexibility.

Take-home messages: Self-directed learning is an effective way of learning in modern medical education.


Medical interns' participation in improving medical training in a growing organization

Martin Berntsson (Sahlgrenska University Hospital, Medical Intern Administration, Fyrverkaregatan 11D, Gothenburg 41321, Sweden)

Angela Falk (Sahlgrenska University Hospital, Medical Intern Administration, Gothenburg, Sweden)

Background: Since 2009 the Sahlgrenska University Hospital (SU) has doubled its number of medical interns. The Intern Council (IC) has been implemented by the SU Intern Administration Office since October 2009. Summary of work: Interns with an interest in organizational structure and leadership are recruited to join the IC. These interns are assigned one or several clinical rotations to supervise. They receive input on a monthly basis from their fellow interns on each clinical rotation. Ideas for improving the medical training are referred to each rotation director, by the IC, through regular meetings. Issues raised at these meetings are implemented through development plans, when needed, to improve clinical training. Furthermore, the IC has regular group meetings to continuously improve its own structure.


Summary of results: The IC has generated a forum for the growing number of interns at SU to discuss their clinical experiences and ideas for improvement. It is a structured feedback process whereby input is fast-tracked to the executive rotation directors. Interns' influence on their training is hence increased. Moreover, several minor and major improvements in various areas have been made by the clinics as a result of suggestions from the interns.

Conclusions: Interns are interested in improving their clinical training and have many ideas. In a large and continuously growing organization, a structured input to the executive directors is of great importance. One way to achieve this is by the representative structure of an


Take-home messages: Growing organizations need structured feedback loops in a bottom-up approach.


Diagnostic assessment during a new curriculum implementation: How are our medical students doing?

Adrian Martinez (UNAM Faculty of Medicine, Secretariat of Medical Education, Public Health, Canaverales 60 casa 18 Rinconada Coapa, Tlalpan C.P. 14330 Mexico 14330, Mexico)

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