Learn together, work together: Promoting interprofessional learning – LK Chan, Fraide Ganotice, and Frances Wong
Literature has established the strong link between inadequate training of health professionals for working together as an interprofessional team and a range of adverse outcomes, such as patient dissatisfaction, medical errors, patient safety issues, and system inefficiencies (WHO, 2010). Looking closely, the current fragmented approaches in teaching and learning must be examined to promote collaborative practice among students in different disciplines.
Interprofessional teamwork and collaborative practice are considered as primary elements in meeting today’s complex medical needs. Breaking the traditional disciplinary boundaries is therefore necessary if the goal is to prepare the students to value being able to work as a healthcare team and eliminate the preconceived hierarchy among healthcare professionals. This challenge is an invitation for educators to re-examine the curriculum provided to the students vis-a-vis the competencies they should demonstrate. The “Interprofessional Team-Based Learning (IPTBL) for Health Professional Students” endeavors to respond to this invitation.
In the Interprofessional Team-Based Learning programme, we used team-based learning (TBL) (Michaelsen, Knight, & Fink, 2002) as the pedagogy for the attainment of interprofessional education (IPE) outcomes. With the support of an UGC grant in 2014 (Funding Scheme for Teaching and Learning Related Initiatives – 2012-15 Triennium), this large-scale programme involves 12 undergraduate health and social care programmes from two universities: The University of Hong Kong (Biomedical Sciences, Chinese Medicine, Medicine, Nursing, Pharmacy, and Social Work) and The Hong Kong Polytechnic University (Medical Laboratory Sciences, Nursing, Occupational Therapy, Physiotherapy, Radiography, and Social Work). IPTBL aims to prepare students for collaborative practice by providing opportunities for them to learn with, about, and from one another, so that they will be enabled to (a) collaborate with students in other professions in solving clinical problems; (b) compare roles, responsibilities, expertise, and limitations of different health professions; (c) communicate views to other professionals and listen respectfully to others’ opinions; (d) critically reflect on their relationships within a team; (e) recognize the need to work collaboratively in the best interest of the patient; (f) recognize the stereotypical views of other healthcare providers held by themselves and others; (g) recognize that views held by other healthcare providers are equally valid and important (Centre for the Advancement of Interprofessional Education, 2002; WHO, 2010).
The scale and innovation of IPTBL demand much preparatory work, in additional to the complex coordination of 11 programmes. Interprofessional teams of teachers (called content experts) developed content materials for the six instructional units, each focusing on a clinical issue which offers rich opportunities for interprofessional learning. The six units involved the following topics: anticoagulation therapy, multiple drugs, developmental delay, depression, fracture, and cancer. In collaboration with the Technology-Enriched Learning Initiative (TELI), a new online platform was developed for the programme, using the Learning Activity Management System (LAMS), to allow a large number of students (up to 500 in one instructional unit) simultaneously going through the TBL process, and to allow the content experts to track team performance and progress.
For each instructional unit, there are three activities: pre-class study, readiness assurance tests, and application exercise. Prior to face-to-face session, students study several assigned materials (e.g., journal articles, book chapters, videos, etc.). When they come to class, they will form interprofessional teams, consisting of students from two or more disciplines. They will then take the readiness assurance test individually (called iRAT) and then as a team (called tRAT). It is in the tRAT that they start to learn with, about, and from one another. They are provided with immediate feedback on their answers and are given the opportunity to appeal. The next activity is the application exercise which is central to IPTBL process. Students are given an authentic clinical scenario and each team will discuss and answer several questions designed to stimulate interprofessional discussions. Each team will raise a colored card bearing the selected answer simultaneously, followed by interteam discussions facilitated by the content experts.
This project is an innovation in constructing a curriculum model to facilitate interprofessional learning using team-based learning. Each year, IPTBL involves 11 programmes, over 40 teachers and 1,000 students from the two universities that offer the full range of health and social care programmes in Hong Kong. The model and content built can be sustained for continued use at the completion of the project. The stringent evaluation of the operation process allows the IPTBL team to further improve the delivery of the programme. Research elements have been built in the programme to collect data in examining the learning effects. Our experiences for the first two years have been very encouraging, with documented positive impact on students’ attitude toward collaborative practice. The teachers are just as excited, because teachers from different professional disciplines rarely get the chance to work together in constructing common curriculum content, clinical cases and test questions. They are in fact role models for collaborative practice.
References
- Centre for the Advancement of Interprofessional Education (CAIPE). (2002). Interprofessional Education – A Definition. Available from: http://caipe.org.uk/resources/defining-ipe/.
- Michaelsen, L.K., Knight, A. B., & Fink, L. D. (2002). Team-based Learning: A Transformative Use of Small Groups. Westport, Conn: Praeger; 2002.
- WHO (2010). Framework for Action on Interprofessional Education and Collaborative Practice. Geneva.
