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Interprofessionelles Ausbilden in Schweden: Zukunft oder Utopie?

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Dr. Beat Sottas

Dr. Beat Sottas, Mitglied des Leitenden Ausschusses der Careum Stiftung, schilderte seine Erkenntnisse aus dem Besuch der «Interprofessional student led clinic training ward» an der Linköping University, Schweden. Besonders beeindruckte sein Vergleich des Mind Sets in den Bildungstraditionen: im Deutschen Sprachraum steht das Meisterprinzip mit einem hierarchischen Denken im Vordergrund, in Schweden geht das Prinzip der Wohlfahrt viel stärker mit interprofessionellem Zusammenarbeiten einher.

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Interprofessionelles Ausbilden in Schweden: Zukunft oder Utopie?

  1. 1. 1 Interprofessionelles Ausbilden in Schweden: Zukunft oder Utopie? Dr. Beat Sottas Dozierendentreffen KFHG - 21.10.15
  2. 2. WHO 2010. Framework for Action on Interprofessional Education & Collaborative Practice (WHO/HRH/HPN/10.3) Geneva p.18 Vernetzte Praxis erfordert vernetzte Ausbildungen Und: Interprofessionalität ist auch ein Korrektiv der Spezialisierung Bildungsgewinne - Echte Welt erfahren - Neuartiges Lehren - Von anderen lernen Gesundheitsgewinne - Bessere Praxis - Mehr Wirksamkeit - Mehr Patientennutzen - Arbeitszufriedenheit - Patientensicherheit - bessere Erreichbarkeit
  3. 3. „professionals are not being educated in the number and kinds, and with the attitudes most congruent with the needs of society“ OECD, 1975 Conference on Health Universities
  4. 4. 4 Deutsches Modell Meister- / Kapitänsprinzip Novize - ….  Meister(Chef) Vorsprung bei: Können / Wissen Fertigkeiten Fähigkeiten (Profession) Autorität  Hierarchie (Der Chef hat immer recht) Korporatismus (Zunftdenken): ökon. Interessen schützen «Therapeutische Zweierkiste» Ich & mein Patient Individualtherap. Ansatz Bildungstraditionen schaffen mind set warum fällt IPE so schwer? Angelsächsisches Modell Innovation/Kompetition Opportunitäten erkennen Wissen & Status wenig formal Versuch und Irrtum Mut haben, etwas wagen Überzeugen können Autorität  Entrepreneurship (Erfolg gibt Recht) Allianzen schmieden Konkurrenten besiegen «Patientengut» Gesundheit als Ware Marktanteile Skandinavisches Modell soziale Wohlfahrt Versorgung / health for all Sehr egalitär – wenig Status Profil statt Profession miteinander reden Team Performance Autorität  Integrationsfähigke (erfolgreiches Case Management Kooperationskompetenz Wohlfahrtsstaatsmodell «Handlungsgemeinschaft» Gesundheit als gesellsch. Gut Schnittstellen-Management
  5. 5. 5 Mutual trust among members A sense of group identity  a feeling among members that the group is unique and worthwhile A sense of group efficacy  the belief that the team can perform well and that group members are more effective working together than apart Bildung & Bilder Totsünden für Teamarbeit: Angst Furcht Neid Egoismus Feindbilder Apathie Gier Zorn Hass Hammick et al 2009, 52 Organ- bzw. Pathologiezentrierte Intervention; therap. Beziehung see one – treat one Science System
  6. 6. 6 Schwedische Lösungen
  7. 7. Strategiewechsel  weg von Monoprofessionalität 1976 (Linköping) / 1998 (national) Careum Sottas “All health professionals should be educated to deliver patient-centered care as member of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics” Paradigmenwechsel “Gemeinsam lernen, zusammen besser zu werden” Zentrale didaktische Instrumente - Clinical Training Centers (Skills labs) - Interprofessional Clinical Trainings Wards/Outpatient clinics + Orthopedics
  8. 8. 1 Identifizieren & Beschreiben der professionellen Kompetenzen, der Fachpersonen, mit denen ich zusammenarbeite ( Identität) 2 Fähig sein, mit anderen Fachpersonen so zusammen zu arbeiten, dass bessere Ergebnisse in Versorgung und Rehabilitation resultieren ( Good Practice) 3 Fähig sein, zu analysieren und zu reflektieren, wie interprofessionelle Kooperation zu mehr Wirksamkeit, mehr Patientensicherheit und mehr Gesundheitsnutzen führt ( Value / Metakognition) Bei den Training Wards zusätzlich zu Level 3 a im Team – auf Basis ethischer Prinzipien - den Patientennutzen analysieren und Behandlungseffekte evaluieren b Grenzen der eigenen Kompetenzen reflektieren (Wirkung, Nutzen, Sicherheit) sowie Kooperation /Ko-produktion belegen (mit Patienten, anderen Fachpersonen, Angehörigen) Taxonomische Ebenen des Kompetenzerwerbs (learning outcomes)
  9. 9. 11 Careum Sottas Linköping University LiU Faculty of Health Sciences Pionier IPE 1976 Goldstandard !
  10. 10. 12 Interprofessionelles Lernen im Studiengang  Kooperation wird systematisch gelernt  Lernarrangements mit + in der Praxis Taxonomie der Lernarrangements Interprofessional Student led Clinical Training Ward Health Ethics Learning Health Ethics Learning Careum Sottas Inter Professional Learning Units Year 1 Year 2 Year 3 Year 4 Year 5 3 Year Programmes: Midwifery, Nursing, Occupational Therapy, Physiotherapy, Podiatry, Radiography and Social Work Common LearningLearning in Common Profession specific learning Key Common LearningLearning in Common Profession specific learning Key 4 Year Programmes: Audiology, Medicine (BM4), Pharmacy 5 Year Programmes: Medicine
  11. 11. 13 Interprofessionelles Lernen im Studiengang Careum Sottas Inter Professional Learning Units Year 1 Year 2 Year 3 Year 4 Year 5 3 Year Programmes: Midwifery, Nursing, Occupational Therapy, Physiotherapy, Podiatry, Radiography and Social Work Common LearningLearning in Common Profession specific learning Key Common LearningLearning in Common Profession specific learning Key 4 Year Programmes: Audiology, Medicine (BM4), Pharmacy 5 Year Programmes: Medicine
  12. 12. Careum Sottas Zentrale didaktische Instrumente - Clinical Ausbildungszentren (Skills labs) - Interprofessional Clinical Trainings Wards/Outpatient clinics Unterstützende Didaktik
  13. 13. 15 Student led Clinic Ward
  14. 14. 16 Interprofessional Training Ward Interprofessional Besprechungszimmer Student led + Zugang Dossiers/Technik Clinical Training Ward Sofas od. Sitzecke Careum Sottas
  15. 15. IPE = bessere Learning outcomes Ergebnisse LiU
  16. 16. Careum Sottas Grosse Teile der Ausbildung in Praxis Beispiel KI-Netz in Stockholm
  17. 17. Careum Sottas Steuerung und Aufbauorganisation (Beispiel KI)
  18. 18. 1 Studiengänge und Institute müssen zu allen 3 Taxonomie-Ebenen interprofessional learning outcomes definieren (und validieren lassen) 2 Alle Studiengänge erhalten Support (IPE Promotors), um - Taxonomieziele zu erreichen - IPE-Aktivitäten zu entwickeln - Kompetenzen und Zielerreichung formativ zu evaluieren 3 Regelmässige ERFA-Gruppen und Weiterbildungen für IPE Promotoren 4 Fast alle Weiterbildungen der Dozierenden werden in interprofessionellen Gruppen und Settings durchgeführt 5 Strukturierte Evaluationen und Qualitäts-Assessments nach IPE Clinical Training Wards Sequenzen bei Klinik und Patienten 6 Aufbauorganisation ist robust verankert, Teil der OE und Kultur 7 Enge Zusammenarbeit mit Aufsicht in County Council / Feedback-Kultur über “workplace learning” in der Praxis (Akkreditierung!) 7 Strategische Fördermassnahmen Besten Dank

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