The Interprofessional Team Immersion (IPTI) offers students across 13 health professions opportunities to apply their skills in cross-professional communication, teamness, and patient-centered engagement. The experience is characterized by high stakes cases carefully designed to cultivate an atmosphere conducive to rapid teambuilding and compassionate patient care. Within a safe learning environment, faculty and students acquire understanding of roles and responsibilities as well as skills to manage complex cases. This presentation will describe and demonstrate the rationale, design, and implementation of IPTI over a three-year period. Findings suggest significant increase in IPTI students’ perceptions of cooperation, resource sharing and communication skills for team-based practice. Programmatic evaluation substantiates the value students place on practicing interprofessional clinical skills before and while in their clinical-community rotations. Debriefing sessions with standardized patients enhanced students’ knowledge and appreciation for patient engagement and shared decision-making culminating for some in scholarly products. In total, findings provide beneficial insight for other interprofessional educational and collaborative practice initiatives taking place at the University and in the community. Learn more about IPEC at University of New England ipec(at)une(dot)edu or follow us on Twitter @UNEIPE

1. Welcome! Before We Begin...
Today’s Presentation will include 2 audience
interactive exercises….
Please be sure to sit with NEW friends!

2. Interprofessional Team Immersion:
Cultivating the “Ah-Ha” Moment
Presented by:
Jim Cavanaugh
Dawne-Marie Dunbar
Kris Hall
Shelley Cohen Konrad
Kira Rodriguez

3. Why, What, How
• Theoretically framed rationale
• Co-designed programming
• Rapid cycle evaluation
• Replicable, streamlined implementation
• Assessment

4. How we plan to use your time today
Brief interactive team activity
Project Background & Supporting Theory
Case Building
Brief interactive team activity
Simulation Design & Implementation
Assessment Design & Results
Other Outcomes
Questions/Comments

5. Orientation:
Team Identity

6. What just happened?
Constructivism
Multiple Perspectives
Reflective/Reflexive Learning
Relational-Cultural
Learning in Relationship
“A foot in both worlds”
Active Producers of
Knowledge
Team-based Models
Communities of
Interest
Learning
Theories

7. Planning for Patient Interaction:
Roles, Responsibilities, Teamwork

8. Team Activity
• As Individual Team Members (5 minutes):
– Share personal and professional reactions to the case.
– What can each team member contribute to help Lori
with her stated needs?
• As a Team (5 minutes):
– Identify and discuss potential barriers and
opportunities to providing Lori with effective care.

9. What just happened?

10. Case Construction By Design
Steps Lori & Ryan
1. Identify a “Difficult Conversation” that could
occur anywhere in patient care
Issues of sexuality and intimacy
2. Add complicating medical factors Paralysis; chronic pain
3. Add complicating psychosocial factors Sudden onset catastrophic
disability; altered family dynamics
4. Add complicating social determinants of health Access to care; financial stressors
5. Use multiple stakeholders to inform and
integrate case elements into realistic narrative
Individual with spinal cord injury;
health professions faculty;
Tactics:
1. Create opportunities for input from multiple members of the health care team
2. Create sufficient case complexity so that the team must set priorities, address
dilemmas, and identify sociocultural factors that affect the patient care plan

11. Goal of Case Construction
Good cases foster
healthy team behaviors:
1. Understanding individual
roles & responsibilities
2. Practicing the blending of
diverse professional skills
into effective team
behavior
3. Evaluating impacts of
social determinants and
health inequities on health
4. Discovering flexible
approaches to team
leadership
Add still image of Lori and Ryan
from 30 second film providing the
team with feedback.
“The people made all the
difference.”

12. • Two simulation days; 2 patient visits per session
• Team Debrief between sessions;
-Faculty Advisor Focus: clinical content
• Large Group Debrief after second session:
– Patient and family member feedback
– Faculty Focus:
• Teamwork
• Roles & Responsibilities
Simulation Overview

13. Simulation Design Considerations
• Professional Actors vs. High
Fidelity Simulators vs.
Standardized Patients
• Individual Team Care Plans
• Faculty Debriefing Skills
• Scheduling challenges

14. Simulation Lessons Learned
• Faculty Debriefing
– IP Faculty Teamwork Role Modeling & New Collaborations
– Recruiting Champions: proven strategy
– Trusting the Pedagogy
– Start Small, Repeat, Share
• Student’s Response Themes:
– The importance of teamwork
– Appreciation of “shared knowledge” and of roles &
responsibilities
– Sim helps practice difficult conversations & communication
– More sim please!

15. Evaluation Design
• Multiple theoretical frameworks
– Utilization-focused evaluation (Patton 2008)
– Rapid feedback cycle evaluation (e.g. Zakoc 2015 Data-to-Action)
– Modified Kirkpatrick learning outcomes (Freeth et al 2002)
– Canadian (CIHC 2010) & American (IPEC 2011, 2016) Interprofessional
Core Competencies
• Mixed methods
– Quantitative: pre-post student surveys
• 12 item version of the IP Education Perceptions Scale (IEPS) - McFayden,
Maclaren, & Webster, 2007
• 11 selected items from the IP Collaborative Care Coordination – Global Rating
Scale (ICCC-GRS) - Hunter et al, 2015
– Qualitative: feedback cards & post survey with open-ended questions

16. Survey Participants
Health Profession Enrolled Pre Post Matched Pre-
Post
# % # % # % # %
Social Work 5 12% 2 7% 4 13% 2 9%
Occupational Therapy 6 14% 3 10% 5 16% 3 13%
Nursing 4 10% 3 10% 1 3% 1 4%
Physical Therapy 6 14% 4 13% 6 19% 3 13%
Osteopathic Medicine 6 14% 6 20% 4 13% 4 17%
Dental 5 12% 5 17% 5 16% 4 17%
Pharmacy 3 7% 2 7% 2 6% 2 9%
Physician Assistant 1 2% 1 3% 0 0% 0 0%
Dental Hygiene 6 14% 4 13% 5 16% 4 13%
TOTAL 42 100% 30 71% 32 76% 23 55%

17. Survey Quantitative Results
Interprofessional Education Perceptions
Scale (IEPS)
Subscales & Summative Score
Median of
Summed Ratings
Wilcoxon Sign Rank
Test (related samples)
Pre Post p-value
Perceived Need for Cooperation Subscale 11 11 0.353
Perception of Actual Cooperation Subscale 25 25 0.220
Competency and Autonomy Subscale 25 25 0.023*
IEPS Summed Score 60 62 0.046*
Global Rating Scale (GRS)
Competency Areas & Summed Score
Median of
Summed Rating
Wilcoxon Sign Rank
Test (related samples)
Pre Post p-value
GRS Collaboration Competency Items 20 21 0.019*
GRS Communication Competency Items 20 20 0.014*
GRS Summed Score 44 45 0.009*

18. Survey Qualitative Results 1
What surprised or challenged your previous perceptions?
• “I was surprised to learn just how little I knew about what
every other profession does and has to offer their patients.
It was a bit challenging for me to accept this …[it] made me
realize how little I actually knew about those professions.”
Lack of knowledge about
others’ scope of practice
• “I was surprised at how much we focused not only on our
own field but also on others. I thought each member would
be focused on their field, but it seemed that we all pitched
in for every aspect of our patients care.”
Appreciation for
knowledge of other
health professions
• “Many professions overlap and complement one another,
and it can be challenging to fit all of the pieces together.”
Unanticipated
“professional overlap”
• “I was amazed at how well we all worked together…the
dental medicine student didn't overpower every aspect of
the oral health situation and actually was interested in what
I had to say and what I wanted for the patient …”
Ease of collaboration

19. Survey Qualitative Results 2
How influence your health care practice in the future?
“I have a better understanding about what each profession
does, and how each profession is interrelated. I feel more
confident in my ability to reach out to other professions in
order to treat clients as a whole. “
Increased likelihood of referring/consulting with other health professionals in
practice
Increased confidence in ability to actively participate in collaborative teamwork
Increased knowledge about other health providers’ roles and scopes of practice

20. Other Outcomes

23. University of New England
326/7 Hersey Hall
Portland, Maine USA 04103
207/221-4114 ipec@une.edu
Facebook: Interprofessional Education Collaborative
Twitter: @UNEIPE or #IPEUNE
Resources: Access support materials for Team Immersion
http://bit.ly/2b8ggNE
Keep in Touch!