Developing and Evaluating Teamwork Skills using an Interprofessional Simulated Discharge Planning Meeting

Purpose: The Clinical Discharge Scenario (CDS) provides students the opportunity to work as an interprofessional team in a simulated scenario. Evaluating student competence in teamwork skills provides insight into their ability to work as effective team members. Background: A literature review reveals the majority of tools assessing student learning in interprofessional education (IPE) measure satisfaction, attitudes and knowledge (Abu-Rish et al., 2012). Kirkpatrick’s evaluation model proposes a hierarchy of changes as a result of training (Kirkpatrick, 1979). At the highest level is transfer of learning to change behavior. Assessment of IPE influenced behavior change is limited (Abu-Rish et al., 2012). Description of Intervention: Interprofessional student teams participate in a simulated discharge planning meeting with an elder female patient and her adult daughter (standardized patients). Student teams develop a discharge plan for the patient. Teamwork is assessed via Team Observation checklists (Herge, et al, 2015) completed by faculty observers and standardized patients. Students debrief with faculty and standardized patients and complete a posttest identifying one thing they learned from the experience. Results: Three years of data spring 2014-2016 was analyzed. Preliminary results indicate students were rated as above average on team skills. Thematic analysis of the posttest revealed 7 themes: communication, client centered care, meeting structure, IPE teams, family/caregiver, student experience and difficult patient. Conclusion: The CDS is an effective way for students to practice teamwork skills in a simulated environment. Evaluating student behavior in this setting provides data regarding student ability to apply learning and demonstrate teamwork skills. Relevance to Interprofessional Education: The Institute of Medicine report (IOM, 2015) calls for greater measurement of IPE impact on practice and behavior change. Simulated patient encounters provide students the opportunity to practice teamwork skills and faculty to measure student teamwork skills as related to IPE. Learning Objectives: At the conclusion of this session participants will: Recognize the value of simulated learning activities in interprofessional education. Describe the learning outcomes of an interprofessional simulated team activity. Identify ways to evaluate performance as an outcome of interprofessional education in their own educational/clinical setting. References: 1. Abu-Rish, E., Kim, S., Choe, L., Varpio, L., Malik, E., White, A. A. & Thigpen, A. (2012). Current trends in interprofessional education of health sciences students: A literature review. Journal of Interprofessional Care, 26(6):444-451. 2. Kirkpatrick, D. L., (1979). Techniques for evaluating training programs. Training and Development Journal. 33(6):178-192. 3. Herge, E. A., Hsieh, C., Waddell-Terry, T. & Keats, P. (2015). A simulated clinical skills scenario to teach interprofessional teamwork to health profession students. Journal of Medical Education and Curricular Development. 2:27-34. doi:10.4137/JMECD.S18928 4. Institute of Medicine (2015). Measuring the impact of interprofessional education on collaboration and patient outcomes. Washington, D.C.: The National Academies Press

Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale.

BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. HYPOTHESIS: Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. STUDY DESIGN: REHAB-HF is a multi-center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. CONCLUSIONS: REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities

Leading an Interprofessional Geriatric Clinical Skills Fair: A Train the Trainer Seminar

Objectives • Practice teaching skills related to interprofessional education (IPE) and geriatric competencies • Formulate an Action Plan and prepare to introduce an Interprofessional Geriatric Clinical Skills Fair at their own institutions • Recognize essential elements of a measurement tool that evaluates the effectiveness of an Interprofessional Geriatric Clinical Skills Fai

Evaluation of an Interprofessional Geriatric Clinical Skills Fair

Objectives •Describe the utilization of an interprofessional geriatric clinical skills fair to impart knowledge and skills pertaining to both core geriatric and IPE competencies. •Prepare to introduce an Interprofessional Geriatric Clinical Skills Fair at one’s own institution •Recognize essential elements of a measurement tool that evaluates the effectiveness of an Interprofessional Geriatric Clinical Skills Fai

Targeting Frailty in Older Patients with Heart Failure: The REHAB-HF Experience

Presentation: 53:0

Students’ Perspectives on a Two-Year Longitudinal Interprofessional Education (IPE) Experience

The purpose of this seminar is to present the perspectives and reflections of students relative to their participation in a two-year longitudinal interprofessional education (IPE) experience and the impact the program has had on their clinical and academic work. A multiprofessional teaching institution has provided a two-year longitudinal IPE experience for the past 5 years. The program includes faculty and students from couples and family therapy, medicine, nursing, occupational therapy, pharmacy and physical therapy. Continuous improvement of the program has largely been based upon the feedback provided by students. The two-year longitudinal program brings together students from two or more disciplines and pairs them with a health mentor, a community adult volunteer who is living with one or more chronic conditions or disabilities. Student teams, together with the mentor, complete four curriculum modules over two years. The overarching goals of the program are for the students to: 1) understand the roles of other members of the healthcare team; 2) value the perspective of the patient and patient-centered care; and 3) appreciate the interface between a person’s health condition(s) and his or her personal and environmental factors. Faculty are often the presenters at conferences on IPE curriculum and its outcomes relative to student participation. This seminar will provide an opportunity to hear directly from the students. The student panel will provide candid responses to open-ended questions posed by faculty. There will be time during the session for the audience to question the student panelists as well. Students who have completed a two year IPE experience, and have had time for reflection, offer unique perspectives on IPE curriculum. This seminar will be of interest to those who are developing new and/or are changing existing IPE experiences. Learning Objectives: Following participation in this seminar, attendees will be able to: 1. Discuss the variety of student responses to a two-year longitudinal IPE experience. 2. Use feedback garnered from the students to develop and/or make changes to IPE experiences at their institution

Recruitment and Sustainability in an Interprofessional Student Run Rounds

The purpose of this paper is to discuss physical therapy student and faculty involvement in Jeff-Chat, a student-run organization modeled after Schwartz Center Rounds®. These rounds provide the opportunity for interdisciplinary clinicians to share their experiences in an open dialogue that promotes compassionate healthcare, as well as strengthen the relationship between caregiver and patient. There were a number of students participating in the clinical Schwartz Center Rounds held on our campus and it became apparent that there was a need for rounds targeted towards students. In December of 2010,ThomasJeffersonUniversitypiloted its first student-run Schwartz Rounds entitled Jeff-CHAT. Students from all disciplines who have completed clinical rotations are invited to attend monthly meetings to discuss various topics that are frequently encountered during a caregiver-patient relationship. Three panelists begin each session with a narrative of his or her experiences about the given topic. Previous topics are “Feelings of Failure When Things Don’t Work” or “A Difficult Patient”. After the panelists have spoken, discussion is opened to the audience to participate with the panelists and each other. As the session concludes, each person is asked to complete a survey about the quality of the day’s round. These surveys are collected and analyzed for future improvement. The highest numbers of students participating in the rounds have been from physical therapy and they are seen as leaders within the organization. They also report the highest clinical importance and high satisfaction with the meetings. Effective strategies for garnering involvement and engaging students as organizers, panelists and active listeners, in the monthly meetings will be discussed. This paper will be of interest for those developing similar models of rounds at their university and who would like to learn more about methods for promoting leadership and increasing and maintaining student involvement in such an organization. Learning Objectives: 1. Discuss strategies to recruit panelists, leaders, and attendees for interprofessional Schwartz Center Rounds. 2. Define and value the role of faculty in student-run organizations in order to address sustainability

An Interprofessional Geriatric Clinical Skills Fair: A “Train the Trainer” Workshop

Purpose: The purpose of this “train the trainer” workshop is to provide faculty participants with the skills needed to develop, implement and measure the effectiveness of an interprofessional geriatric clinical skills fair. Background: The need to expand geriatric education for health professionals at all levels of training has been well described (1). Geriatric clinical skills fairs are a fun, interactive way for student learners to gain practical, evidence-based skills and knowledge pertaining to the care of older adults and provide an ideal opportunity to introduce interprofessional education for health professions students. Description of Intervention or Program: This “train the trainer” workshop will introduce faculty to developing and implementing an interprofessional geriatric clinical skills fair at their own institution. Workshop participants will engage in six interactive stations addressing cognitive assessment, gait evaluation, older patient simulation, medication management, code status conversation, and disposition discussion. Each station will run for 10 minutes and will include time for debriefing to review and discuss learning objectives and teaching methods. The six stations will be led by experienced interprofessional faculty facilitators, including a geriatrician, palliative care specialist, clinical pharmacist, occupational therapist, and physical therapist. After completing the simulated “fair” portion of the workshop, faculty participants will be introduced to a method for evaluating the effectiveness of a clinical skills fair and will have the opportunity to share teaching strategies and ideas for successful implementation. Results: Interactive “train the trainer” programs are an effective method for faculty development and can assist in the wide dissemination of innovations in education to prevent “reinventing the wheel.” By engaging in a simulated geriatric clinical skills fair and debriefing with interprofessional faculty, participants will be able to implement and measure a similar skills fair at their own institutions. Conclusion/Relevance to interprofessional education: Based on our own experience, Interprofessional Geriatric Clinical Skills Fairs are highly rated by learners at various levels of training from multiple professions. These fairs can serve as a fun and effective method for providing education addressing geriatric competencies and should be implemented at more institutions as a way to introduce interprofessional education. Reference: InstituteofMedicineof the National Academies. Retooling for an AgingAmerica: Building the Health Care Workforce.Washington,DC: The National Academies Press; 2008. Learning Objectives: By participating in this interactive “train the trainer” workshop, participants will: 1. Practice teaching skills related to Interprofessional Education and geriatric competencies 2. Formulate an Action Plan and prepare to introduce an Interprofessional Geriatric Clinical Skills Fair at their own institutions 3. Review measurement strategies and choose one method to measure the effectiveness of an Interprofessional Geriatric Clinical Skills Fai

Keeping it Real—Using Standardized Patients to Improve Learning Outcomes

Objectives: 1. Describe how simulation is used in pre-licensure education in a variety of disciplines. 2. Examine the challenges and benefits to integrating simulation activities into a course. 3. Apply strategies to integrate simulation learning activities in attendees’ curriculum. Presentation: 44 minute

Program Evaluation of an Interprofessional Educational Program

In recent years, interprofessional education has received increased attention. However, much of the literature in this area is a theoretical and lacking models that can be followed, suggesting the need for more conceptual development of approaches. IPE is a complex process and needs to be based on factors specific to institutions and participants, not on the assumption that one size fits all. Therefore, ongoing program evaluation is a critical activity in determining the effectiveness of various components of these programs. This presentation will highlight the development and significant evaluative contributions of the evaluation of a 2-year longitudinal university wide interprofessional education experience atThomasJeffersonUniversitysince 2007. The program studied brings together teams of students from medicine, nursing, physical therapy, occupational therapy, public health or pharmacy, who visits an individual with one or more chronic health conditions. Students work collaboratively to conduct life and health histories, review healthcare issues, and discuss expectations of patients related to healthcare providers. Evaluation began with the inception of this IPE program including student and faculty surveys, focus groups, reflection papers and course evaluations. Program evaluation is an iterative process. Surveys were administered to students at the beginning and end of their terms. While results reflected student attitudes were ‘high’, focus groups and course evaluations help dig deeper and led to several program changes including shortening some of the assignments and changing the logistics of the team meetings. Attitude surveys can provide information on a broad scale. However, by themselves, their value is limited. While, qualitative approaches also have limitations, they may provide more valuable in-depth information to identify strengths and weaknesses of a program. As a result, this project is now leaning more heavily on these approaches to gain valuable information from both students and faculty. Learning Objectives: Upon completion of this learning activity, participants should be able to: 1. Relate the evaluative contributions of the 2-year longitudinal university wide interprofessional education experience atThomasJeffersonUniversityto their own intuition. 2. Assess the various types of program evaluation methods discussed and apply them to their own needs