Evaluation of patient perceptions of team based care in a Geriatric Oncology Clinic

Purpose: To measure patient perceptions of collaborative practice in an interprofessional team providing geriatric oncology assessments to older patients with cancer. Background: The Senior Adult Oncology Clinic (SAOC) at Thomas Jefferson University’s Kimmel Cancer Center utilizes an interprofessional team approach to provide comprehensive geriatric oncology assessments and treatment plans for older patients with cancer. The importance of team-based healthcare delivery is well documented, however, experts agree that there is a need for more tools to assess the skills required to become a high-functioning team and a need to study the impact of collaborative practice on patient reported outcomes and satisfaction. For this study, we sought to evaluate patients’ experience and perception of our SAOC team function. Description of Intervention: Upon completion of a SAOC visit, patients were asked to participate in a short voluntary survey to assess team performance. The Jefferson Teamwork Observation Guide (JTOG) is a validated survey used with learners that has been adapted to elicit patient perspectives of five domains of interprofessional collaborative practice, including communication (C), values/ethics (V/E), teamwork (T), roles/responsibilities (R) and patient-centeredness (PC). The Patient JTOG includes eight competency–based Likert Scale questions as well as one open-ended question. The survey was administered on secure mobile tablets by trained research assistants (RAs) who were not part of the healthcare team. The study received exempt approval by our Institutional Review Board. Results: A total of 13 patients completed the survey. Seven respondents were female, and six were male. Seven identified as Caucasian, four as African American and two as other. One hundred percent responded “Strongly Agree” to a global question about the importance of teamwork in patient care (mean 4.0). Overall satisfaction with the SAOC team was 3.92 out of 4.0. For the eight questions relating to each of the five collaborative practice competencies noted above, the team received an average score ranging from 3.69 to 3.77 out of 4.0, for a global score of 29.66 (out of 32 possible), placing this team in the highest quartile of teams surveyed at our institution to date (n=407). In addition, all 13 respondents completed the open-ended qualitative comments with 12 out of the 13 being positive with multiple references to effective listening and communication, team coordination, and patient-centered care. Conclusion: The SAOC has a relatively unique model of providing interprofessional geriatric oncology assessments. The Patient JTOG tool was easy to incorporate into a busy clinic and provided valuable feedback to our providers, demonstrating that our patient’s perceive the team as highly functioning and effective. Based on these early results, our high functioning interprofessional consultative team model may serve as a model for replication for team based care delivery at other institutions Relevance: Incorporation of an easy to use tool to assess interprofessional team function and patient perceptions of collaborative practice Learning Objectives: Define methods for evaluating patient perceptions of collaborative practice in an outpatient geriatric oncology practice (Knowledge) Describe a replicable model for interprofessional collaborative practice (Comprehension/Application) Apply lessons learned for engaging students in and preparing faculty for interprofessional team-based care delivery (Comprehension/Application

iPads, iBooks, Apps! What\u27s all the iFuss about?

The iVolution is here. It is iThis and iThat every way you turn. Is this just another iFad, or is it truly revolutionizing education? In a recent survey conducted by EDUCAUSE Center for Analysis and Research on undergraduates and technology, 31% of students reported owning tablet technology a 15% increase from the previous year and 76% of students reported owning smart phones. This finding was a 14% increase from the previous year. Students also reported using smart devices in class to access material, participate in activities, look up information and photograph material as learning strategies. Thomas Jefferson University is riding the iWave and taking strides to better integrate technology at all levels of medical training; leading the forefront of the iVolution, syllabi, course materials, and textbooks are now delivered in some of our courses via iPads. In the past few years, the Jefferson Health Mentors Program has embraced the use of new technologies, including Wikis, online discussion boards, Google docs, and Skype platforms to facilitate asynchronous IPE interactions. These platforms have helped to promote IPE by easing scheduling logistics and by allowing students to collaborate electronically on team-based assignments. Over the past summer, JCIPE, the Jefferson Health Mentors Program (JHMP), faculty from Jefferson Medical College and the School of Health Professions, Academic & Instructional Support & Resources (AISR) and Jeff Information Technology (IT) assembled a working group and developed yet another innovative tool to better integrate technology into our IPE efforts – the product was a new iBook, entitled “Assessing Patient Safety.

From the Editors

As the spring semester comes to a close, we in the Jefferson Center for InterProfessional Education (JCIPE) reflect on the last year. In the Fall 2014 edition of the Interprofessional Education and Care Newsletter, we presented several innovative IPE projects from students, faculty and our colleagues overseas. The articles in this edition build on that progress, high-lighting our efforts, redefined during a January 2015 Jefferson IPE retreat facilitated by Dr. Malcolm Cox, to more closely link IPE and clinical practice. To this end, the spring semester marked the conclusion of the first administration of our revised Jefferson Health Mentors Program (JHMP) Module 4. During the new module, students select one Learning Activity from a menu of 13 offerings, including clinical observations, simulations and collaborative practice opportunities. They then reflect on their participation in their selected Learning Activity in light of their experience with their Health Mentor. Two student essays, one discussing our new, student-led IPE Grand Rounds program detailed in the Fall 2014 edition of the newsletter and the other describing a TeamSTEPPS® training, demonstrate the impact of such clinically-focused activities and their application in students’ training and lives

From the Editors

Welcome to the Spring 2014 edition of the Jefferson Center for Interprofessional Education (JCIPE) newsletter. In this edition of our newsletter, you will have a chance to read about two new innovations in technology designed to enhance interprofessional education and collaborative practice. We believe that integrating technology into IPE will be central to aligning health care education reforms with changes in healthcare delivery. This Spring also marks the graduation of our 6th cohort of JHMP students at TJU. Now, over 4,100 students have completed this longitudinal IPE curriculum; feedback from graduates has been highly positive, detailing the impact of IPE experiences in better preparing them for teamwork as well as providing them with an unexpected advantage in employment opportunities, where competency as an effective team player is highly valued by employers

On Glauber modes in Soft-Collinear Effective Theory

Gluon interactions involving spectator partons in collisions at hadronic machines are investigated. We find a class of examples in which a mode, called Glauber gluons, must be introduced to the effective theory for consistency.Comment: 19 pages, three figures. Uses JHEP3.cl

From the Editors

This fall has seen a flurry of activity at the Jefferson Center for InterProfessional Education (JCIPE). In September, Lauren Collins, MD, Associate Director of JCIPE, was selected as one of five recipients of the prestigious Macy Faculty Scholars (MFS) program, a two-year career development award supported by the Josiah Macy Jr. Foundation. She now joins a national network of other MFS recipients in helping to re-envision training of health professions students and delivery of collaborative care. Elizabeth Speakman, EdD, RN, ANEF, FNAP, JCIPE Co-Director, completed her three-year Robert Wood Johnson Executive Nurse Fellowship and was recently selected to attend the Institute of Medicine Future of Nursing: Campaign for Action Summit 2015. In addition, Nethra Ankam, MD, from the Department of Rehabilitation Medicine and Sidney Kimmel Medical College, and Tracey Vause Earland, MS, OTR/L, from the Department of Occupational Therapy of the College of Health Professions, both longtime faculty champions of IPE at Jefferson, have recently been appointed to serve as the new Co-Directors of the Jefferson Health Mentors Program (JHMP), overseeing dynamic changes in one of our flagship activities

From the Editors

Welcome to the Fall 2014 edition of the Jefferson Interprofessional Education and Care Newsletter. It has been a busy Fall at Jefferson and we are excited to share several new developments which have been pushing the envelope in IPE. In October, we hosted our 4th biennial conference, Interprofessional Care for the 21st Century: Redefining Education and Practice. This year we had a record number of conference participants and presenters joining us from a variety of national and international academic and service organizations. Our keynote speakers, Dr. George Thibault, President, Josiah Macy Jr Foundation; Dr. Barbara Brandt, Director, National Center for Interprofessional Practice and Education at the University of Minnesota; Dr. John Gilbert, Principal & Professor Emeritus, University of British Columbia College of Health Disciplines, Co-Chair of the Canadian Interprofessional Health Collaborative; and a team from the Veterans Administration, including Dr. Malcolm Cox, Dr. Stuart Gilman, Dr. Richard Stark and Dr. Kathryn Rugen, collectively challenged and inspired us to re-conceptualize interprofessional education and collaborative practice opportunities for students as we prepare them for a healthcare delivery system that will focus on the triple aim of improving a patient’s care experience, improving the health of patient populations, and reducing the per capita cost of healthcare. One of the articles that follows will highlight the conference presentation of the innovative work of Dr. Susanne Boyle from the University of Glasgow, Scotland and her colleagues. Dr. Boyle’s team explored the area of augmented reality and its applicability to enhancing online interprofessional education through virtual communities

A Qualitative Analysis of Student Understanding of Team Function Through the use of the Jefferson Teamwork Observation Guide (JTOG)

Background: Several early IOM reports identified the need to educate medical and health professions students in delivering patient-centered care as members of interprofessional teams (IOM, 2001; IOM, 2003). Evidence shows that conducting interprofessional education during education and training prepares student learners for collaborative practice when they enter the workplace, which in turn helps to achieve the Triple Aim of 1) enhancing the patient experience; 2) improving the health of populations; and 3) decreasing costs (WHO, 2010; Berwick, et al., 2008). One way to prepare students for collaborative practice is to have them observe real teams in action. Thus, the Jefferson Teamwork Observation Guide (JTOG) was created to serve as an educational tool in aiding students to better recognize the characteristics of effective teams. It has since been used to assess teams in the majority of clinical observation, simulation and collaborative practice activities offered by Jefferson Center for Interprofessional Education (JCIPE). The JTOG is a two-part assessment comprised of identifiable characteristics of well-functioning teams drawn from the literature about teamwork. The first part consists of Likert Scale questions (strongly disagree to strongly agree) regarding the behavior of the interprofessional team observed in the domains of Values/Ethics in Interprofessional Practice, Roles/Responsibilities, Interprofessional Communication, Teams and Teamwork, and Leadership (IPEC, 2011; IPEC 2016). The second part includes qualitative questions relating to team-based care, patient-centered care, and teamwork