MONDAY 27TH AUGUST 2018 - AMEE
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MONDAY 27TH AUGUST 2018
team leaders with conceptual frameworks that promote
3HH: Posters: Interprofessional contextual awareness, so as to enhance interprofessional
Education - Postgraduate communication and decision-making during team
Location: Hall 4.u, CCB meetings.
Date: Monday 27th August
Time: 1015-1200 hrs 3HH2 (1625)
Enhancing Interdisciplinary Patient Care via Patient-
3HH1 (1662) Centered Interprofessional Collaboration Computerized
Understanding context in collaborative decision making Platform
at interprofessional team meetings (IPTM) using the
Cynefin framework Authors
Yen-Ling Ko, Chimei Medial Center, Tainan, Taiwan
Authors Kun-Ming Chung, Chimei Medial Center, Tainan, Taiwan
Keng Teng Tan, Tan Tock Seng Hospital, Singapore Ya-Wei Kuo, Chimei Medial Center, Tainan, Taiwan
Mary Lee, National Healthcare Group, Singapore Chia-Jung Chen, Chimei Medial Center, Tainan, Taiwan
Yu Han Ong, National Healthcare Group, Singapore Chung-Feng Liu, Chia Nan University of Pharmacy and
Wee Shiong Lim, Tan Tock Seng Hospital, Singapore Science, Tainan, Taiwan
Hung-Jung Lin, Chimei Medial Center, Tainan, Taiwan
Presenter: Keng Teng Tan, Tan Tock Seng Hospital,
Singapore Presenter: Yen-Ling Ko, Chimei Medical Center, Tainan,
Taiwan
Background: Leading an interprofessional team is a
complex task which healthcare professionals seldom Background: Interprofessional collaboration among
receive training in. IPTMs provides an important platform healthcare workers improves outcomes of medical care
for the interprofessional team to come together to provided to the patient and is also an important element
discuss patients with multifaceted needs and formulate a of continued medical education and professional
shared care plan. The Cynefin framework helps leaders development. Multidisciplinary meetings can be
determine the prevailing context to facilitate decision- conducted for having a holistic patient-based discussion.
making in different situations. We aim to evaluate the However, these timed discussions may not be conducted
discursive strategies used in the IPTM of geriatric medicine frequently enough to serve the purpose of "real-time"
teams and how collaborative decision making is carried patient care. To truly provide continuous interdisciplinary
out can be enhanced using the Cynefin framework. care, a patient-centered communication platform is
Method: Tape-recorded observations of IPTM chaired by 6 helpful. Chimei Medical Center organized a project to
different senior doctors were transcribed and analysed to develop a patient-centered computerized platform to
identify what discursive strategies were used in patient fulfill interprofessional collaboration needs for
case discussions, the complexity of the prevailing context, hospitalized patients. The computerized platform features
and the effectiveness of collaborative decision was a spiral-shaped integrated care area which provides
reached. updated information on patient progress and a
Results: Using the Cynefin framework, patient case communication area that allows instant communication,
context was categorized into 4 categories: simple, virtually putting all the different professionals on the same
complicated, complex or chaotic. Team members and page. Besides providing the means for timely
leader adopted discursive strategies such as structured communication, more importantly, this platform can also
sequence narrative, story –telling and questioning. Team provide learning and teaching resources.
leaders who were better able to adapt discursive Method/Results: A five-scaled online survey with
strategies to manage the prevailing context were more convenience sampling by referring to Technology
effective in collaborative decision-making. For complex Acceptance Model (TAM) was used to get feedback from
and chaotic cases, repeated IPTM discussions over 2 or pilot users of this computerized platform. In total, there
more weeks were necessary to sort out the complex were 108 valid copies of the questionnaire obtained from
medical, functional or social issues. 35 respiratory therapists, 22 nurses, 21 nurse practitioners,
Collaborative decision-making in interprofessional teams 10 doctors, 8 rehabilitation therapists, 6 pharmacists, 3
occur within varying complexities of patient context. nutritionists, 2 quality managers, and 1 administrative
Without structured training, physicians and other personnel. The responses, with respect to the platform,
healthcare professionals are often tasked to lead show high approval for perceived usefulness and
discussions and decision making which will impact perceived ease of use (mean > 4.0) as well as high
significantly on patient’s care. The Cynefin framework behavioral intention to use (mean > 4.2).
provides a feasible model for team leaders to appraise the Conclusion: Multidisciplinary teamwork can achieve
prevailing context in IPTMs so that discursive strategies greater efficiency and provide better quality in patient
can be tailored to improve team decision-making. care. But scheduled multidisciplinary discussions at set
Conclusion: A keen understanding of context while intervals are inadequate and more frequent meetings can
deliberating care decisions during IPTMs can enable add on clinical burden. Thus, a dynamic, integrated and
interprofessional teams to adopt discursive strategies for updated information platform that also allows
effective collaborative decision-making. Our findings multidirectional communication facilitates simple and
corroborate the importance of equipping interprofessional
AMEE 2018 ABSTRACT BOOK 1MONDAY 27TH AUGUST 2018
efficient interprofessional communication and 3HH4 (980)
collaboration. Unmet needs in communication between residents and
Medical professionals need to be equipped with the ability nurses in internal medicine wards: at a university
to work in interdisciplinary teams to provide the best teaching hospital in Korea
quality patient care. By using this newly developed
computerized information and communication platform, Authors
members of the health care professions can come Kyong Hwa Park, Korea University Anam Hospital, Seoul,
together at all times to give professional advice for Korea
optimal patient care. Yoon-Ji Choi, Korea University Anam Hospital, Seoul, Korea
Young Mi Lee, Korea University, Seoul, Korea
3HH3 (1350)
Knowledge and Attitude towards Interprofessional
Presenter: Kyong Hwa Park, Korea University Anam
Collaboration among Postgraduate Medical Students of
Hospital, Seoul, Korea
Bangladesh
Background: Inter-professional communications between
Authors the healthcare practitioners is an important issue for
S M Tajdit Rahman patient safety. Residents and nurses in our hospital also
Adiba Tarannum perceived that inter-professional conflict has been
increased after introduction of new regulation on resident
Presenter: S M Tajdit Rahman, National Institute of duty hours. The purpose of this study was to assess unmet
Diseases of the Chest & Hospital, Dhaka, Bangladesh needs in communication between residents and nurses,
which may cause interprofessional conflict.
Background: Interdisciplinary healthcare teams are Method: Residents and nurses in the internal medicine
central to improve patient outcomes. Strong wards at the Korea University Anam hospital (Seoul,
interprofessional education (IPE) is fundamental for Korea) were invited to participate in the survey. A
effective team performance. IPE is also essential for a questionnaire asking perception towards competencies in
good healthcare system. But, in Bangladesh, there is lack interpersonal/teamwork skills of each counterpart,
of knowledge and process to develop a positive attitude frequency/main causes/resolving methods of conflicts, and
towards Interprofessional education and collaboration. the actual vs. preferred tools of communication was
Method: A cross sectional type of descriptive study was developed.
conducted to assess the knowledge and attitude of Results: Twenty-four residents and 213 nurses voluntarily
postgraduate students of BSMMU, Dhaka towards participated in the survey. The mean score of satisfaction
interprofessional collaboration. 300 students were level of inter-profession communication in nurses was 4.1
purposely selected for study. Data were collected by face out of 10, but it was 5.1 out of 10 in residents. About 70.1%
to face interview from the respondents through semi‐ of the nurses reported stressful conflicts and the mean
structured questionnaire. number was 8.75 over the last 12 months. About 54% of the
Results: Majority of the students showed lack of residents experienced conflict with nurses and the mean
knowledge (70.33%) about interprofessional collaboration. was 4.9 over 12 months. Most of the nurses regarded
Most of the Students did not know the importance residents’ disrespectful attitude (75%) and unwanted way
(79.33%) of interprofessional collaboration and education. of communication (23%) as causes of conflicts. More than
Very few students enjoy team work (24.67%). Majority of 50% of residents claimed that clinical competency of
them do not know how to implement (69 %) nurses was unsatisfactory. In addition, residents were not
interprofessional collaboration. satisfactory about nurses’ choice of communication tools;
Poor knowledge of postgraduate trainees is a sequel of inappropriate considering medical urgency. Currently,
lack of introduction in undergraduate level. Without cellphone was the most popular communication tools
proper knowledge and application of IPE a good (85%), followed by mailbox (10%), face-to-face (5%).
healthcare system would not be possible. Measures like However, 60% of nurses wanted to communicate using
classes from under graduation, campaigning, review of intranet messenger, followed by face-to-face (27%),
curriculum, collaboration with other countries, student cellphone (13%). On the other hand, residents wanted to
exchange etc. should be taken. use cellphone in 50%, followed by intranet messenger
Conclusion: It can be concluded that knowledge and (40%), face-to-face (10%).
attitude about interprofessional collaboration of There was considerable amount of inter-professional
postgraduate medical students of third world country like conflicts due to discrepancies in communication methods
Bangladesh is very poor. For future doctors it could be according to medical urgency. We also found that intranet
difficult to take part in the era of interprofessional messenger and discussion about appropriate use of
collaboration which is very important for patient care. communication methods are urgently needed to foster
Take-home message: Poor knowledge and attitude about inter-professional collaboration.
interprofessional collaboration between postgraduate Conclusion: Various strategies and investment are needed
medical trainees of Bangladesh. to improve inter-professional communication. Smart
application of technology-based communication tools
might contribute to decrease unnecessary conflicts in
clinical field.
AMEE 2018 ABSTRACT BOOK 2MONDAY 27TH AUGUST 2018
3HH5 (1820) 3HH6 (2090)
Analysis of Learning Behavior and Learning Performance Physicians and nurses in simulation: Perceptions of
in Blended Learning of IPP/IPE to Clinical Nurse interprofessional Collaboration in Trauma-team
Simulations
Authors
Li-Chen, Lin Authors
Ying-Jung, Lai Alexander von Wendt
Tsung-Kun, Lin Eeva Pyörälä
Leila Niemi-Murola
Presenter: Li-Chen Lin, Tri-service General Hospital, Taipei
city, Taiwan Presenter: Leila Niemi-Murola, Helsinki University, Espoo,
Finland
Background: Our hospital used Blended Learning to
provide interprofessional education. Health care teams Background: There is a wealth of simulation studies on
with basic knowledge of case demographics, health care learning knowledge and technical skills in a single
matrix and the integrated medical care notification on the profession. However, there are fewer studies about non-
intranet teaching platform. The day of the seminar will be technical skills in interprofessional clinical simulation; and
conducted by simulation and video recording to model studies about perceptions of interprofessional teamwork
appropriate interprofessional teamwork. Nurse can are rare. This phenomenographical study focuses on work-
watching and learning online after the seminar. based, high-fidelity simulations of interprofessional
Method: Nursing department has been using both the trauma-teams; and aims to explore how the participants of
course satisfaction and test scores, only know the reaction these simulations percieve teamwork in interprofessional
and learning situation in Kirkpatrick Model. We start used healthcare teams.
Interdisciplinary Education Perception Scale (IEPS) to Method: Our data consist of semi-structured interviews of
monitor changes in attitudes and perceptions of nurse. ten healthcare professionals at Töölö Hospital in Helsinki.
The analysis was conducted in March to October 2017, Participants were selected using purposive sampling
after nurse participating in seminar, in addition to online aiming at a variation between professions, and their
satisfaction, completing the quiz and study sheet, need to working-life experiences. Four residents, three
write the IEPS. The original 4 subscales version of the IEPS experienced nurses, and three experienced clinicians who
was published by Luecht et al. (1990, Journal of Allied have participated in trauma-team simulations were
Health, 181-91). that can be used to assess the effect of recruited for the study. Data were transcribed word for
interprofessional education experiences on Nurse. word and analysed using phenomenographic research
Results: Total of 789 Nurse completed the learning, only methodology, which explores differences between
640 completed the questionnaire. The proportion of participants’ perception of a phenomenon.
satisfaction was 91.9. The IEPS 4 sub-scale: competency Results: The analysis of the data revealed an interesting
and autonomy was 5.45±0.70, perceived need for dichotomy related to the professional experience of the
cooperation was 5.44±0.68, perception of actual physicians. The more experienced physicians focused on
cooperation was 5.50±0.76 and understanding others' medical and logistical problems which made teamwork
roles was 5.35±0.64. more difficult. Senior physicians expressed that the
Further analysis of the sub-questions「Individuals in my teamwork itself worked well, while residents and nurses
profession have a higher status than individuals in other indicated several flaws in the collaboration.
professsions」 show a lower degree of Interprofessional tension, lacking communication, and
feedback(5.15±1.02). lacking leadership was frequently brought forth as
Using of Blended Learning to provide interprofessional examples of suboptimal teamwork. As participants gave
education care team, the content of the course and the examples of problematic teamwork, blame was usually
video on the process of testing and discussion on the assigned to a member of another profession. However,
network, the scene by the all health professions use and participants sometimes also expressed flaws inside their
learn from others to solve problem, the core knowledge, own profession. The experienced nurses described their
skills and attitudes converted to the contextualized-KAS. role in the simulation as being co-instructors; to actively
That means Clinical nurses have less affirmation of their support junior physicians’ learning.
own professional, but also look forward to their Conclusion: This study recognised divergent views about
performance in the interprofessional care team. interprofessional teamwork between residents, senior
Conclusion: Clinical nurse in addition to by the education physicians, and nurses. These observations are valuable for
and training courses, nursing division intensified the future, especially when designing interprofessional
recognition of care team, we should also organize and simulation exercises, when planning how to choose
summarize Nursing professional knowledge and skills to participants, and when conducting the debriefing of an
demonstrate the uniqueness of the nursing profession in exercise.
the clinical care process and teamwork. The junior physicians, senior physicians, and experienced
nurses had differing perceptions of collaboration. Senior
physicians focused on factors outside the teamwork which
made interprofessional collaboration challenging, while
the junior physicians and the nurses focused on analysing
the teamwork.
AMEE 2018 ABSTRACT BOOK 3MONDAY 27TH AUGUST 2018
From this review, medical and health sciences programs
3HH7 (2351) will be able to develop better initiatives and workshops
Interprofessional collaboration education initiatives: allowing for more effective IPE initiatives through, for
what works for whom, how and under what example, the clarification of the activity terms or by
circumstances leveraging the challenges encountered by the trainees.
Authors 3HH8 (167)
Isabelle Gaboury, Université de Sherbrooke, Longueuil, The interprofessional collaborative care in primary
Canada healthcare setting in Indonesia: a mixed method study
Frédéric Pinard, Université de Sherbrooke, Sherbrooke,
Canada Authors
Dave Bergeron, Université de Sherbrooke, Longueuil, Canada Ardi Findyartini, Department of Medical Education & Medical
Véronique Lisée, Université de Sherbrooke, Sherbrooke, Education Center Indonesia Medical Education and Research
Canada Institute Faculty of Medicine Universitas Indonesia, Jakarta,
Chantal Lemire, Université de Sherbrooke, Sherbrooke, Indonesia
Canada Diantha Soemantri, Department of Medical Education &
Hélène Corriveau, Université de Sherbrooke, Sherbrooke, Medical Education Center Indonesia Medical Education and
Canada Research Institute Faculty of Medicine Universitas Indonesia,
Jakarta, Indonesia
Presenter: Isabelle Gaboury, Université de Sherbrooke, Daniel Richard Kambey, Indonesia Young Health
Longueuil, Canada Professionals’ Society (IYHPS), Jakarta, Indonesia
Rezki Yeti Yusra, Medical Education Center Indonesia Medical
Background: An optimal collaborative practice is rooted in Education and Research Institute Faculty of Medicine
the exposition of future healthcare professional to Universitas Indonesia, Jakarta, Indonesia
interprofessional education (IPE). IPE initiatives are Amandha Boy Timur, Faculty of Medicine Universitas Sebelas
defined as “occasions when two or more professions learn Maret, Solo, Indonesia
with, from and about each other to improve collaboration Chandrika Dini Khaerani, Medical Education Center Indonesia
and the quality of care”. However, few research have Medical Education and Research Institute Faculty of
studied the facilitating or impeding factors and the Medicine Universitas Indonesia, Jakarta, Indonesia
underlying mechanisms to this apprenticeship.
Method: This project aims to achieve a realist review of Presenter: Ardi Findyartini, Department of Medical
the literature to understand context and underlying Education & Medical Education Center Indonesia Medical
mechanisms related to successful and unsuccessful IPE Education and Research Institute Faculty of Medicine
initiatives for medical and health sciences trainees. This Universitas Indonesia, Jakarta, Indonesia
presentation focuses on the Context-Mechanism-Outcome
(CMO) configurations developed through this research Background: Interprofessional collaborative practice
project. This review was built on an initial framework (IPCP) is important for high quality health care. The
combining theories about the development of prejudice, dynamics of IPCP depends on the setting in which it
the intergroup contact, self-efficacy belief, and self- operates. This study aims to explore the perceptions of
development. From the 6178 articles identified through a health professionals on IPCP in a primary health care
search of Medline, CINAHL, PsychInfo, and Google Scholar setting in Indonesia.
(1997 to 2017), 367 were considered for directed content Method: A mixed method design was conducted. A
analysis. validated Collaborative Practice Assessment Tool (CPAT)
Results: The review included trainees from various was administered. FGDs involving health professionals
disciplines including medicine, nursing, rehabilitation were completed afterwards. Comparative analyses among
sciences, social work and psychology. The analysis shed groups based on demographic characteristics were
light on CMO chains allowing for a better understanding of conducted. Verbatim transcriptions and thematic analyses
the successes and failures of various IPE learning were completed.
situations. Notably, a clear learning context (e.g. explicit Results: A total of 303 health professionals (61.8%
goals of the IPE initiative, roles and expectations of the response rate) from 35 primary health centers in Depok-
participants, multidisciplinary representation of the Indonesia participated. A total of 9 FGDs involving 74
participants, and qualified educators) and concrete informants were completed. The CPAT score of the health
examples from the trainees’ hands-on practice led to professionals is at 74-77% of total score 265. Of 8 subscales,
openness (or not) to learning IP, attitudinal change, and there were differences of leadership and vision-mission-
self-reflexivity; which in turn resulted in improved aims subscales between medical doctors and other health
(perceived or measured) collaborative skills, teamwork, professional groups. There were also differences of the
and understanding of one's role. score in decision making subscale based on the length of
Conclusion: This study is the first one to highlight CMO work experience, and in patient involvement subscale
chains that apply to an IPE context within an academic based on the age group. Five themes and 36 subthemes
setting. It emphasizes the need to carefully plan IPE were identified from the FGD data. The five themes were:
initiative set-up in order to maximize the outcomes of the forms, supporting factors, inhibiting factors, perceived
intervention. benefits and challenges of IPCP.
AMEE 2018 ABSTRACT BOOK 4MONDAY 27TH AUGUST 2018
Conclusion: The CPAT result indicates that the perceptions naloxone kits (mean score = 2.19). Paradoxically, there
of health professionals on the collaborative practice was were high levels of agreement on the ATHCT, with the
good. Given burden on the individual based and highest positive mean score of 4.25 on interprofessional
community based health care, IPCP is considered a must. practice improving healthcare quality.
The forms are flexible according to the needs. Role of Conclusion: The survey provides useful data on how
professions are blurry in the community based and are trainees perceive their self-efficacy and teamwork when
clearer in the individual based health care. Sociocultural managing chronic pain and co-morbid mental health
issues such as power differentials among health conditions. This data support the benefits of leveraging
professions, the need of clear standard operational IPE to enhance the recognition and collaboration required
procedures, and the art of communications between to address mental health when managing chronic pain.
groups are evident in this study. These issues can become Ultimately, trainees in both medical and health professions
strong supporting or inhibiting factors of IPCP. training programmes will inherit the clinical care of
Exploration of IPCP requires understanding of specific patients affected by the current, and often deadly, opioid
characteristics of the healthcare settings and sociocultural crisis.
factors at the organization, group and individual levels. Take-home messages:
Studies on IPCP are very important for health 1. GME learners need curricula around chronic pain
professionals in improving the collaborative competences management
continuously and constructive for the development of IPE. 2. Leveraging IPE is a potentially feasible way of
addressing the competencies required to treat
3HH9 (3293) chronic pain and mental health co-morbidity
Targeting Interprofessional Education to Address Chronic 3. Due to the unique nature of most GME programmes,
Pain and Mental Health Co-Morbidity novel ways of integrating IPE to address the opioid
crisis may need to be considered
Authors
Juliette Perzhinsky, Central Michigan University College of 3HH10 (2913)
Medicine, Saginaw, USA KAS thinking template improves hospital
Chin-I Cheng, Central Michigan University College of Science interprofessional practice and education
and Engineering, Mt. Pleasant, USA
John Lopes, Central Michigan University College of Health Authors
Professions, Mt. Pleasant, USA Tzu-Chao Chung, Division of Neurosurgery, Tri-Service
Margaret Chisolm, Johns Hopkins University Department of General Hospital, Taipei, Taiwan
Psychiatry and Behavioral Sciences, Baltimore, USA Yuan-Hao Chen, Division of Neurosurgery, Tri-Service General
Hospital, Taipei, Taiwan
Presenter: Margaret Chisolm, Johns Hopkins University Chiung-Hsi Tien, Division of Pediatrics, Tri-Service General
Department of Psychiatry and Behavioral Sciences, Hospital, Taipei, Taiwan
Baltimore, USA Hui-Fang Yang, Division of Family Medicine, Tri-Service
General Hospital, Taipei, Taiwan
Background: Currently, no standardized formats exist for Tai-Long Cha, Division of Urology, Tri-Service General
Interprofessional Education (IPE) curriculum integration to Hospital, Taipei, Taiwan
address the opioid crisis, due to the unique structure of Feng-Cheng Liu, Division of Rheumatology, Tri-Service
each institutions’ programmes. This project describes the General Hospital, Taipei, Taiwan
results of a needs assessment (directed at trainees)
conducted prior to the staged implementation of an IPE Presenter: Feng-Cheng Liu, Tri-Service General Hospital,
curriculum with a focus on managing chronic pain and Taipei, Taiwan
mental health co-morbidity.
Method: The Attitudes Toward Health Care Teams Background: The ultimate goal of today’s medical care is
(ATHCT) scale and a self-efficacy questionnaire for to improve the quality of holistic health care. By exploring
identifying, screening and effectively treating patients interprofessional practice and education, we can learn
with mental health conditions and chronic pain was how professionals in diverse fields interact and collaborate
employed. Ten training programmes were contacted, with each other in a mutually respectful and task-oriented
including local residency and health professions manner to learn the knowledge and skills necessary for
programmes, and 6 agreed to participate. Using a 5-point effective teamwork. In addition, we can understand how
Likert-scale (1=strongly disagree, 5=strongly agree), the to approach patients in ways that meet their needs and
40-item survey instrument addressing interprofessional when to call for timely assistance. The health care system
practice, mental health and chronic pain was administered can also be strengthened in order to provide patient-
to 125 trainees. centered medical services that improve prognoses.
Results: N=73 trainees participated in the survey with a This study examines a case of spontaneous intracerebral
58.4% response rate. A Cronbach alpha was 0.86 hemorrhage where the KAS (Knowledge, Attitude, Skill)
consistent with good internal consistency. The survey thinking template is incorporated into the cooperative
revealed trainee self-efficacy was lowest in managing health care and teaching methods. Through cross-
mental health and chronic pain conditions, particularly on disciplinary case discussion, new trainees are able to learn
items suggesting that mental health is no longer about professional expertise in other disciplines, thereby
stigmatized (mean score = 2.23) and on prescribing home gaining valuable knowledge about the different roles the
AMEE 2018 ABSTRACT BOOK 5MONDAY 27TH AUGUST 2018
members of an interdisciplinary team play in the health confirmed by practice. Much development and
care process. consolidation of IPL theory is needed.
Method/Results: Among the 226 participants in IPP during Take-home message: No one healthcare profession can
this neurosurgery transdisciplinary curriculum, 95 of them give complete healthcare single-handed.
(42 %) are clinical doctors; 45 of them (20 %) are clinical ‘Whenever people listen to one another humbly and openly,
nurses; 41 of them (18 %) are the intern doctor; 45 of them their shared values and aspirations become all the more
(20 %) are medical personnel. Most of the participants (224 apparent. Diversity is no longer seen as a threat, but as a
participants, 99%) were satisfied with the course. The source of enrichment.’ Pope Francis
effectiveness of these lectures is compared before (60.42
%) and after (82.33 %) the class, with an average of 22 % of 3HH12 (2751)
the participants’ progress. Learning Effect Analysis of Implementing Inter-
Our results show that integration of KAS model with Professional Education (IPE) Teaching Template
IPP/IPE role playing can be an effective innovation in
transdisciplinary teamwork, guarantees that our patients Authors
receive the best level of care. This cultivates respect for Wei-Fang Wang, National Cheng-Kung University Hospital,
the specialties of various professions, enables the sharing Tainan, Taiwan
of expertise and experience, and initiates a shared Ying-Shu Wang, National Cheng-Kung University Hospital,
decision-making process that places patients at the center, Tainan, Taiwan
whereby their health problems are solved in a cooperative Chiung-Yu Chen, National Cheng-Kung University Hospital,
manner. Tainan, Taiwan
Conclusion: This KAS model can be routinely applied to
clinical healthcare to help promote continuous learning of
Presenter: Wei-Fang Wang, National Cheng-Kung
team members at work and enhance their ability to care
University Hospital, Tainan, Taiwan
for patients.
Background: The purpose of Inter-professional Education
3HH11 (2575)
(IPE) is to educate students or trainees on how to enhance
Conscious Competence in IPL in Healthcare Education
their ability toward Inter-professional Practice (IPP)，of
which the ultimate goal to enhance Holistic Health Care
Authors quality. At Domestic, currently the most common way to
Annwyne Houldsworth Carried IPE out is participating combined conferences,
however it is easy to become "learning together with
Presenter: Annwyne Houldsworth, HECL, Plymouth, UK different professions" (Multi-professional Education, MPE)
rather than emphasizing "interactions between different
Background: The delivery of effective, high-quality patient professions".
care is a highly complex activity, demanding health and Method: In order to avoid IPE turn to MPE in Inter-
social care professionals to collaborate in an effective professional combined conferences, this study is designed
manner. IPL (IPL) is professionally relevant, intellectually the "IPE Teaching Template" for Inter-professional
stimulating and evidence based. The evolution of Education using. By a good "teaching" and "learning"
healthcare professional cultures has developed, as the interaction between clinical teachers and students, the
individual professions have developed, and are influenced students effectively learn operations of Inter-professional
by gender and social class issues.New learning paradigms Practice, and due knowledge, skills, and attitudes. For
for healthcare professionals explore new ways to combine understanding the effectiveness, advantages and
expertise, delivering IPL programmes where patient safety disadvantages of the "IPE Teaching Template", we regard
and quality of care can be improved (WHO 2010). clinical cases in combined conferences as course contents,
Intervening early in the health professional’s career with and collect learners’ course satisfaction, quantitative and
collaborative activities with IPL is now considered qualitative feedback. This study applies reaction level,
important in healthcare training. Development of learning level, behavior level of Kirkpatrick model to
multidisciplinary student centred ideas hopefully results in evaluate learning effectiveness.
the enhancement of patient-centred care. Conscious Results:
competence in understanding human factors and the 1. 695 trainees responded.
benefits of IPL is needed to recognise those that are naïve 2. Reaction level: Response of participating IPE help to
to IPL and competent professionals who are able to design understand Inter-professional Practice operating is
new curricular and deliver training to address unconscious 4.75 and to improve service quality is 4.74 (in 5-point
incompetence to IPL. Considering the values and ethics scale).
associated with IPL involves participants gaining mutual 3. Learning level: The learners have significant
respect for each other and their roles and responsibilities improvement in knowledge (80.1%), skill (79.4%) and
but also in shared values and concern for their patients. attitude (77.5%) with the application of IPE Teaching
Being clear about the respective roles that each Template.
professional plays, in responsively addressing the needs of In addition to the current quantitative evaluation and
the patients, is an important factor in understanding Kirkpatrick level III outcomes, we will analysis qualitative
respective responsibilities. are many diverse theories evaluation to understand phenomena to explore the
applied to IPL where theory is observation of practice, impact of our IPE Teaching Template on the learner
outcome.
AMEE 2018 ABSTRACT BOOK 6MONDAY 27TH AUGUST 2018
Conclusion: The results of this study are review bases and workplace), and leaders of clinical units (about IPE, IPO,
improved references, which will be helpful in the future IPC).
development of the teaching strategy. And also look Conclusion: Formative evaluation of IPE, IPO and IPC is
forward to this teaching strategy experience could be a expected to improve health-related clinical outcomes.
domestic medical education implementation Inter- Summative evaluation at multiple institutions may
professional education reference. consolidate evidence for the usefulness of
Take-home messages: Interprofessional initiatives. SIPEI promises to facilitate
1. IPE & IPP enhance Holistic Health Care quality. both. SIPEI next will be validated by a panel of experts.
2. IPE Teaching Template has positive results. When finalized, SIPEI will enable multisource evaluations
of output and outcomes of IPE, IPO and IPC in educational
3HH13 (3491) institutions for health professions and in health care
Development of a toolbox for multisource evaluation of institutions in Switzerland.
Interprofessional Education and Interprofessional
Collaboration in Switzerland 3HH14 (1696)
Verifying the reliability and validity of the Japanese
Authors version of Interdisciplinary Education Perception Scale
Florian B. Neubauer, Institute of Medical Education, Bern, (IEPS)
Switzerland
Felicitas L. Wagner, Institute of Medical Education, Bern, Authors
Switzerland Hyuga Suzuki, Nagoya University School of Medicine,
Andrea C. Lörwald, Institute of Medical Education, Bern, Nagoya, Japan
Switzerland Mina Suematu, Department of Education for Community-
Sissel Guttormsen, Institute of Medical Education, Bern, Oriented Medicine, Nagoya University Graduate School of
Switzerland Medicine, Nagoya, Japan
Sören Huwendiek, Institute of Medical Education, Bern, Noriyuki Takahashi, Department of Education for
Switzerland Community-Oriented Medicine, Nagoya University Graduate
School of Medicine, Nagoya, Japan
Presenter: Florian Neubauer, Institute of Medical Kentaro Okazaki, Department of Education for Community-
Education, Bern, Switzerland Oriented Medicine, Nagoya University Graduate School of
Medicine, Nagoya, Japan
Background: There is no standardized toolbox to evaluate Masafumi Kuzuya, Department of Community Health and
outcomes of Interprofessional education (IPE) and Geriatrics, Nagoya University Graduate School of Medicine,
Interprofessional Collaboration (IPC) from the Nagoya, Japan
perspectives of different stakeholders (multisource) which Kenta Murotani, Division of Boistatistics, Clinical Research
is validated for the context of the Swiss health care Center, Aichi Medical University, Nagakute, Japan
system. Based on an assignment by the Swiss Federal
Office Of Public Health, we aim to provide such a toolbox, Presenter: Hyuga Suzuki, Nagoya University School of
the Swiss InterProfessional Evaluation Instruments (SIPEI). Medicine, Nagoya, Japan
Method: We scrutinized theoretical models in the
literature which depict the chain of causes and effects Background: In recent years, the necessity of
present in the sequence of IPE -> IPC -> health-related Interprofessional Education (IPE) for undergraduate
outcomes, and identified conceptual weaknesses that healthcare professions students has been increasing
seem to hinder meaningful evaluations of worldwide. Interdisciplinary Education Perception Scale
Interprofessional activities. We created an adjusted model (IEPS), one of the global evaluation scales measuring the
which stresses the multi-causality of IPC by adding the effect of IPE, was originally reported by Luecht RM et al. in
domain of organizational factors (IPO), i.e. management 1990. In Japan, Itakura et al. translated into Japanese and
decisions and supporting institutional frameworks which created the Japanese version of IEPS in 2012, but it was
also must be present in an institution for IPC to happen. not sufficiently considered about reliability and validity.
Using this model and observing project specifications Therefore, we analyzed its reliability and validity along
about cost efficiency, we defined final purposes, objects with its sub-scales.
and methods of evaluations using SIPEI: SIPEI is a toolbox Method: Subjects were 186 health care professions
of questionnaires designed to enable multisource students which were composed of 99 medical students
evaluation of the entire chain of causes and effects in the (5th year), 21 nursing students (4th year), and 66
field of IPE/IPO/IPC with the purpose of formative use on a pharmacy students (5th year) who participated in one-day
local institutional scale and the summative purpose of IPE session conducted as a part of clinical training at
gaining knowledge about outcomes of Interprofessional Nagoya University Medical School from April 2017 to
initiatives on a federal scale. November 2017. We asked them to answer the Japanese
Results: We present a preliminary concept for SIPEI which version of IEPS before and after this IPE. This scale is
stipulates five questionnaires for different stakeholders, composed of 18 items, scoring on a 6-point Likert scale
i.e. health professions as learners in educational settings which ranged from 1 (strongly disagree) to 6 (strongly
(asking about IPE), directors of educational programs agree). Statistical software (IBM SPSS 24.0 Statistics) was
(asking about IPE), patients (about perceived IPC), health used for factor analysis and factor reliability was verified
professions in clinical settings (about IPE, IPO, IPC at their
AMEE 2018 ABSTRACT BOOK 7MONDAY 27TH AUGUST 2018
(Cronbach α). After that, content validity was verified by pharmacist), debriefings were performed after the
several experts familiar with IPE. sessions. Open questions about HFS´ pros and cons were
Results: From the factor analysis, three factors were evaluated, as interactions between team members.
extracted from 15 items excluding 3 items. The value of Faculty discussion was also completed after the sessions.
Cronbach α was the following: factor 1 was 0.861, factor 2 All participants referred that the simulation was a good
was 0.882, and factor 3 was 0.785. Three factors ware method for training their specific professional
named "self-respect for own professions", "cooperation competencies and their relation with others health
with other professionals", "fundamental ability of own professionals. They would like to include HFS in their
professions" respectively. The content was validated by undergraduate curriculum.
several experts. Conclusion: It´s important for all healthcare professionals
Since the each value of Cronbach α was more than 0.7, the to interact and know better the role of each other in the
three factors proved to be reliable. We expect that the patient care to establish better interactions and improve
Japanese version of IEPS will be widely used as a measure individual and team performance. Some difficulties
of the educational effects of IPE, especially three sub- observed about the HFS were: time constrain, restricted
scales: "self-respect for own professions", "cooperation physical space, and limited access to clinical information.
with other professionals", and “fundamental ability of All participants gave positive remarks about the
own professions". simulation, valued the importance in their individual area
Conclusion: This Japanese version of IEPS will lead to the and interaction with other health professionals.
dawn of international collaborative research related to Interprofessional HFS appears to be feasible and positively
IPE. accepted by students from different healthcare areas.
3HH15 (2294) 3HH16 (2313)
Interprofessional high-fidelity simulation: a pilot project Interprofessional Training, is not just Education, but
Collaboration
Authors
Ricardo Tjeng, University of Beira Interior, Faculty of Health Authors
Science, Covilha, Portugal Joseph House, University of Michigan Medical School, Ann
Paula Carvalho, University of Beira Interior, Faculty of Arbor, MI, USA
Humanities and Social Sciences, Covilha, Portugal Amber Dallwig, University of Michigan, School of Nursing,
Maria Barbosa, University of Beira Interior, Faculty of Ann Arbor, MI, USA
Humanities and Social Sciences, Covilha, Portugal Leslie Smith, University of Michigan-Flint, Flint, MI, USA
Idalina Freira, University of Beira Interior, Faculty of Health Karen Farris, University of Michigan, College of Pharmacy,
Science, Covilha, Portugal Ann Arbor, MI, USA
Antonio Sequeira, Polytechnic Institute of Guarda, Superior
School of Health, Guarda, Portugal Presenter: Joseph House, University of Michigan Medical
Miguel Castelo-Branco, University of Beira Interior, Faculty of School, Ann Arbor, USA
Health Science, Covilha, Portugal
Background: There is an increased emphasis on including
Presenter: Ricardo Tjeng, University of Beira Interior, Interprofessional Education (IPE) in all healthcare training.
Faculty of Health Science, Covilha, Portugal However, IPE is not enough as shown by the WHO
Framework for action on IPE and Interprofessional
Background: Simulation in health professions education is Collaborative (IPC) practice. It is the job of schools to
an important tool for development of technical and non- create opportunities for students to work together, not
technical skills. Patient care requires good teamwork and just learn together.
coordination between different healthcare professionals. The College of Pharmacy already had an IPE course which
Experiential learning strategies, e.g. high-fidelity involved 8 classroom sessions which discussed the Social
simulation (HFS), could provide opportunity for Ecological Model of Health along with 20-hours of
undergraduate students of different health professions to community service. All students participated in the IPE
improve effective interprofessional (IP) collaboration and classroom sessions. A group of Interprofessional faculty
teamwork. modified one community service site, Ypsilanti Meals on
Method: This pilot project was a cooperation between Wheels (YMOW), and intentionally create
three faculties from two institutions. It included medical, interprofessional collaborative teams. All students
nursing, psychologist, and pharmacy last year reflected on "What insights have you gained about how
undergraduate students, and faculties from all four different professionals think about the factors in the social
healthcare areas. An IP HFS scenario was created, and ecological model of health?" A comparison of reflections
faculty-facilitated debriefing was conducted after each from students who participated in the intentionally
simulation. Objectives of the pilot-project included: the created IPC with a random sample of all other sites was
feasibility of an IP HFS, and if the students could completed, and themes in the reflections were identified,
demonstrate through a simulated scenario their relational quantified, and compared.
skills with the patients, family members and other health Method: There were 72 students enrolled in the course.
professionals. Thirteen students were assigned to YMOW. During the
Results: Four HFS sessions were conducted with four YMOW service house, students completed nutritional
students each (medical, psychologist, nurse, and assessments during at least six sessions with students of
AMEE 2018 ABSTRACT BOOK 8MONDAY 27TH AUGUST 2018
their same profession and six sessions as part of questionnaires. An analysis of variance indicates significant
intentional IPC teams. Their reflections were qualitatively changes (p = .04) with reported improvements in
analyzed by 3 members of the research team. Twelve students’ opinions of interaction and values. Review of
themes were identified. The reflections from the 13 IPC the open-ended questions indicates that the students
and 12 non-IPC students were analyzed. enjoyed the various experiences and discovered many new
Results: Roles/Responsibilities was reflected on by 13/13 aspects of the various other professions involved.
(100%) of IPC and 5/12 (42%) non-IPC and learning about Conclusion: While our results are preliminary, it is clear
another health professional was reflected on by 9/13 IPC that our efforts to encourage IPE are proving to be
(70%) and 1/12 (8%) non-IPC, both are significant. There successful. Our assessment method has indicated
were no other significantly difference in themes. significant positive changes from pre- to post-experience
Conclusion: Intentionally creating IPC teams in an IPE for the students.
course, significantly affected what and how students Planning for IPE experiences can be challenging from a
learned about each other and learning the roles and planning standpoint. Determining the effectiveness of
responsibilities of other health professionals. Educating that planning is incumbent upon the instructors. We have
students needs to include collaboration (IPC) as well as shared one method for measuring the impact of the IPE
education (IPE). experiences.
Take-home message: When developing IPE session,
creating an accompanying IPC experience should be 3HH18 (2214)
considered. How the presence of social work students influences
multi-disciplinary decision making in IPE
3HH17 (3019)
An Outcome Measure of Inter-Professional Education Authors
Experiences: One Method to Consider Kumiko Yamaguchi, Tokyo Medical and Dental University
(TMDU), Tokyo, Japan
Authors Chiharu Kawakami, Tokyo Medical and Dental University
W. David Carr, Missouri State University, Springfield, MO, (TMDU), Tokyo, Japan
USA Mina Nakagawa, Tokyo Medical and Dental University
Michelle L. Dugan-Day, Missouri State University, Springfield, (TMDU), Tokyo, Japan
MO, USA Kanako Noritake, Tokyo Medical and Dental University
Natalie Curry, Missouri State University, Springfield, MO, (TMDU), Tokyo, Japan
USA Jun Tsuruta, Tokyo Medical and Dental University (TMDU),
Tokyo, Japan
Presenter: David Carr, Missouri State University, Kazuki Takada, Tokyo Medical and Dental University (TMDU),
Springfield, MO, USA Tokyo, Japan
Background: An Inter-Professional Education (IPE) Presenter: Kumiko Yamaguhi, Tokyo Medical and Dental
collaborative was started within the College of Health and University (TMDU), Tokyo, Japan
Human Services amongst the faculty from each academic
unit. The purpose of the collaborative was to create and Background: In super-aged societies, the patient-
encourage IPE experiences for the students. centeredness in care provision as well as home health care
Method: The initial structure focused IPE planning around and/or regional health care will be of prime importance.
four types of experiences; simulation, journal club, case Common interprofessional education (IPE) programs,
study, and grand rounds. An outcome measure was added however, invite students of care-providing professions
to assess the effectiveness of the experiences. The such as medical, nursing, and dental students and not care-
outcome measure was based upon the work of Lockeman coordinating professions. We therefore investigated if and
(Lockeman et al, 2016) who identified 16 variables to how the addition of social work students helps improve
measures two domains of IPE; professional interaction and multi-disciplinary decision making in our IPE program.
values. Method: A total of 367 final-year students from eight
The questionnaire was created in an online survey health professions, including 106 medical students,
platform for ease of distribution to the many cohorts of participated in a two-day IPE program which included a
students from across multiple departments that would be mixed-small-group case study. Among the total of 48
involved in IPE experiences. A pre- and post-experience groups, 31 had a social work student. After the completion
measurement methodology was adopted to determine if of the case study, participants answered a questionnaire
the students reported a change in their opinions of concerning "how the presence of social work students
professional interaction and values. A series of open- helped multi-disciplinary decision making". Of the 367
ended questions were added to the post-experience attendees, 350 students completed questionnaire. The
questionnaire. Instructors incorporated one of the four results were analyzed quantitatively, and the comments
types of experiences into their coursework, students were from 105 medical students were analyzed qualitatively.
given a link to the questionnaires via an online course Results: Seventy percent of students answered
management tool. affirmatively that the presence of social work students
Results: Data collection is ongoing, to date over 100 helped group's decision making. Affirmative answers were
students (male = 27, female = 63, average age = 27 ± 6.82 more common among students whose group had social
years) have completed the pre- and post-experience work students (73.6%) than those whose group did not
AMEE 2018 ABSTRACT BOOK 9MONDAY 27TH AUGUST 2018
have them (60.4%, P=0.009). Also, the percentage of various duties such as conducting health questionnaire,
students answering affirmatively was the highest among providing basic health check, giving health and medication
medical students (76.2%) and the lowest among social safety education to the service participants.
work students (45.2%). Qualitative analyses revealed that Results: Totally 480 students and professional volunteers
the knowledge of the social welfare system increased the participated in the outreach program. The team
use of various services available for home health care. successfully reached out to 4235 Hong Kong citizens, most
Discussion with social work students broadened the of them were elderly. Evaluation surveys among CUHK
perspectives, added the focus on cost and financial student volunteers showed significant improvement in
resources, and brought more patient-centered medical knowledge, skills, confidence, and program
conclusions. satisfaction. There was an 11.6% increase in medication
Conclusion: In the previous study, our IPE program helped safety knowledge, 17.1% increase in dementia
students understand the roles and responsibilities of other understanding, 29% increase in atrial fibrillation
healthcare professions (Yamaguchi et al., AMEE 2014), and knowledge, and a 19% increase in geriatric care knowledge.
the importance of patient-centeredness (Yamaguchi et al., Conclusion: CU CHAMPION successfully demonstrated
AMEE 2017). In this study, the addition of social work interprofessional service learning to improve students’
students brought more patient-centered conclusions. attitudes toward geriatric medicines, elderly care, and
Mixed-small-group IPE programs with multiple healthcare enhancing their awareness of health needs in the
professionals better prepare students for coordinated and community.
collaborative care needed in aging societies. In addition, Interprofessional outreach program is a significant and
the addition of social work students to IPE programs may useful addition to undergraduate medical education. The
improve patient-centered decision making. increase in students’ understanding for community
patients can highly enhance their empathy toward their
3HH19 (529) future patients. Students can also exchange their medical
The Impact of Interprofessional Education in the knowledge and specialty with peers of other disciplines. In
Community short, such collaboration will induce positive influence on
interprofessional team work in healthcare frontline, and a
Authors very positive impact on patient care in the long run.
Vivian Lee, School of Pharmacy, The Chinese University of
Hong Kong, Hong Kong 3HH20 (2263)
Janita Chau, The Nethersole School of Nursing, The Chinese Clinical Reasoning for Inter-Professional Pregnancy Care
University of Hong Kong, Hong Kong – Everyone on the Same Page!
Ann Lau, School of Biomedical Sciences, The Chinese
University of Hong Kong, Hong Kong Authors
Michael Chung, School of Chinese Medicine, The Chinese Michelle Schlipalius, Monash Health, Melbourne, Australia
University of Hong Kong, Hong Kong Clare Delany, Melbourne University, Melbourne, Australia
Samuel Wong, The Jockey Club School of Public Health and
Primary Care, The Chinese University of Hong Kong, Hong Presenter: Michelle Schlipalius, Monash Health,
Kong Melbourne, Australia
Wallace Chan, Department of Social Work, The Chinese
University of Hong Kong, Hong Kong Background: Inter-professional collaboration is crucial to
provide women with safe and effective team-based
Presenter: Enoch Ng, School of Pharmacy, The Chinese pregnancy care. However, it can be challenging for all
University of Hong Kong, Hong Kong team members to develop shared mental models and the
required clinical reasoning and thinking steps. This paper
Background: Developed in 2013, CU CHAMPION is a joint reports on the development of an inter-professional
school outreach team of the Faculty of Medicine, The workshop aimed at facilitating the development of shared
Chinese University of Hong Kong (CUHK). understanding regarding clinical reasoning.
Interprofessional collaboration and service learning are Method: The workshop comprised a one hour, face to
integral parts of CU CHAMPION’s outreach program every face, interactive session using typical case studies. A
year. It aims to offer students of different healthcare common framework and set of thinking steps necessary
disciplines the opportunities to work together as an for formulating a pregnancy care plan was presented.
interprofessional team and engage them in raising health Four thinking steps were developed to “make thinking
promotion in the community. visible”.
Method: In 2017, CU CHAMPION conducted a large-scale 1. Issue identification - What medical, psychological and
community outreach program in Hong Kong, which social issues are relevant to this woman’s pregnancy
focused on improving the public's awareness on disease and birth?
prevention and medication safety. Enrolled student 2. Issue management - How will we manage each issue,
volunteers had to attend training workshops to learn integrating clinical guidelines and the woman’s
about the outreach logistic, and participate in case preferences?
discussion. They were also enrolled in an e-learning course 3. Evaluation of care type - Does this woman require
called CATALYST 2017, which provided a cross-disciplinary low, medium or high-risk care?
platform in health sciences education. During the outreach
services, student volunteers were assigned to carry out
AMEE 2018 ABSTRACT BOOK 10MONDAY 27TH AUGUST 2018
4. Communication / Documentation - Clearly and
concisely communicate with the woman. Document
the issues, management plan and care type.
Results: 103 midwifery and medical learners attended a
workshop. The majority (94%) agreed or strongly agreed to
better recognising the need, acquiring the skills and being
more confident to develop a pregnancy care plan.
Learners liked the structure provided by the thinking
steps, realistic case studies, relevance to their work,
opportunity to ask questions and interactive approach.
Apart from the opportunity to complete more case
studies, no areas for improvement were noted.
Conclusion: Although pregnancy care is provided by an
inter-professional team, there is often a presumption that
inter-professional collaboration will automatically occur.
This workshop suggests deliberate practice enables
learners to apply their own clinical reasoning to pregnancy
care and also consider that of their colleagues. The
workshop made visible the ‘practices’ of a community,
with discussions at inter-professional meetings providing
ongoing feedback to staff. Overall, clinicians were very
positive about the workshop.
Take-home messages: Clinicians value explicit education
on clinical reasoning. This assists them to provide
pregnancy care to women and ensures all members of the
inter-professional team are on the same page!
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