Joni Fowler, PharmD, BCPP President/CEO Creative Educational Concepts, Inc. Tel:

Joni Fowler, PharmD, BCPP President/CEO Creative Educational Concepts, Inc. Tel: 859.260.1717 Email: jfowler@ceconcepts.com John JD Juchniewicz, MCIS, CHCP President American Academy of CME, Inc. Tel: 609.921.6622 Email: jjuchniewicz@academycme.org

The presenters of this session, Joni Fowler and John Juchniewicz, have nothing to disclose with regard to relevant relationships with commercial interests.

At the conclusion of this session, you should be better able to: Predict barriers which may be encountered when developing interprofessional continuing education (IPCE) and form strategies for avoiding or addressing them. Discuss approaches to improve the effectiveness of your IPCE activities.

Interprofessional Education (IPE): When students from two or more professions learn with, from and about each other to enable effective collaboration and improve health outcomes (WHO, 2010) Interprofessional Continuing Education (IPCE): When members from two or more professions learn with, from and about each other to enable effective collaboration and improve health outcomes (ACCME, ACPE, ANCC, 2015)

What it is: What it is not: Education designed for multiple professions Focuses on conceptual knowledge but is also procedural and systems based Takes into account roles of all team members and their interdependency Education planned by the team for the team Adding multiple certifications on an activity Education planned by members of a single profession (eg physicians) even if it s intended for HCPs from multiple professions Inter : Latin root word; in between, showing relationship

IOM 2015

HCPs are inadequately prepared to work together, especially as part of interprofessional teams Consequences: Lower provider and patient satisfaction Greater numbers of medical errors and other patient safety issues Lower workforce retention System inefficiencies resulting in higher costs Suboptimal community engagement IOM 2015

Values/ethics in professional practice: Work with individuals of other professions to maintain a climate of mutual respect and shared values. Roles/ Responsibilities: Use the knowledge of one s own role and those of other professions to appropriately assess and address the healthcare needs of the patients and populations served. Interprofessional Education Collaborative Expert Panel. (2011).

Interprofessional Communication: Communicate with patients, families, communities, and other health professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and the treatment of disease. Teams and Teamwork: Apply relationship building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient-/populationcentered care that is safe, timely, efficient, effective, and equitable. Interprofessional Education Collaborative Expert Panel. (2011).

IOM Competencies Provide patient-centered care Work in interdisciplinary teams Employ evidence-based practice Apply quality improvement Utilize informatics ACGME Competencies Patient care Medical knowledge Practice-based learning and improvement Interpersonal and communication skills Professionalism Systems-based practice

Which competencies do you employ in planning IPCE? Other 5% IPEC 15% IOM 43% ACGME 37% N=38

Collaboration Among Multiple Accredited Departments/Organizations ACCME ANCC ACPE AAFP AAPA AANP NASW AOTA CDR AOA Joint Accreditation for Interprofessional Continuing Education Currently includes ACCME, ACPE and ANCC For more information: http://www.jointaccreditation.org/

Competing professional identities, values and professional/institutional cultures (including language and jargon) Identifying faculty who value IPE and can incorporate team perspectives Differences in schedules and professional routines Stereotyping other professions Profession protecting its territory Sources: Ginsburg 2005; Carpenter 2008; Reeves 2009; Sargeant 2009; Barr 2009; Headrick 2000; Ho 2008; Steinert 2005, Altin 2014.

Differences in accountability, payment, and rewards Learner perceptions of what IPCE is and its value to them Time System/organizational Funding for IPCE Sources: Ginsburg 2005; Carpenter 2008; Reeves 2009; Sargeant 2009; Barr 2009; Headrick 2000; Ho 2008; Steinert 2005, Altin 2014.

Which barriers have you experienced planning & executing IPCE activities? Identifying faculty to teach blended audience Competing professional identities/values; stereotyping 58% 58% Identifying faculty who value IPE/others 52% System/organizational barriers or silos Turf wars/territorial behaviors Working under varying accreditation standards Communication issues Time Different schedules and professional routines Financial resources 42% 39% 39% 36% 36% 33% 33% Use of different jargon and acronyms 24% Cultural issues 18% Other 12% N=38

Identifying faculty who can effectively teach a heterogeneous audience with varying educational/experiential backgrounds Competing professional identities and values; stereotyping Identifying faculty who value IPE and can incorporate other team members' perspectives System/organizational barriers or silos Working under varying accreditation standards/reporting to different accrediting bodies Turf wars/territorial behaviors Time Communication issues Financial resources Different schedules and professional routines Use of different jargon and acronyms Cultural issues

Which barrier is MOST problematic in your setting? Identifying faculty who value IPE/others Working under varying accreditation standards/bodies 18.2% 18.2% System/organizational barriers/silos Competing professional identities and values; stereotyping 15.2% 15.2% Cultural issues 9.1% Identifying faculty to teach blended audience Different schedules and professional routines Time 6.0% 6.0% 6.0% Communication issues Turf wars/territorial behaviors 3.0% 3.0% Financial resources Use of different jargon and acronyms 0.0% 0.0% N=38

Which barrier is MOST problematic in your setting? All MECC Acad Hosp Prof Soc N= 38 12 12 4 3 Identifying faculty who value IPE/others 1 1 1 Working under varying accreditation standards/bodies 1 2 1 System/organizational barriers/silos 3 1 Competing professional identities and values; stereotyping It depends on where you are! 3 1 Cultural issues 5 2 2 Identifying faculty to teach blended audience Communication issues 2 3

Many healthcare professionals don t know how to be interprofessional Not trained in interprofessional environments (though this is changing) Contact is not enough to build collaboration among group members Sources: Sargeant 2009, Interprofessional Education Collaborative Expert Panel 2011.

Understanding how professional roles and responsibilities complement each other Recognition of the limits of professional expertise Buy in to the need for cooperation, coordination, and collaboration across professions to promote health and treat illness Source: Interprofessional Education Collaborative Expert Panel 2011.

Source: Interprofessional Education Collaborative Expert Panel 2011.

Identify speakers who practice team care on an ongoing/daily basis Ask for recommendations/referrals from other professions (ie, nurse recommendation of MD) Discussion/interview with faculty to discern interest in actually participating in IPCE Past experience Trial and error This is an area ripe for additional exploration in order to find tools to screen, assess, and improve skills of prospective faculty

Involve all professions in planning and content development process Identify a strong activity chair who values IPE and can model the way Engage or include people who naturally team together Training for planning committee and faculty Set ground rules Follow objectives, reiterate goals of activity Use of respectful group process

What strategies have you employed to remove, overcome, or address barriers as you plan IPCE activities? Involved each profession in the planning process Developed innovative learning methods (tracks, flipped classroom, self-study) 48% 94% Conducted training for the planning team 39% Used alternative forms of communication or asynchronous meetings 33% Other (please specify) 15% Employed conflict resolution or mediation tools 3% N=38

Altin, et al. Barriers in the implementation of interprofessional continuing education programs a qualitative study from Germany. BMC Medical Education. 2014;14:227. Barr H. An anatomy of continuing interprofessional education. JCEHP. 2009;29(3):147 150. Carpenter J, et al. Interprofessional Education and Training. Bristol, UK: The Policy Press; 2008. Edwards PB. Using SMART Goals as a Guide to Planning Continuing Interprofessional Education (CIPE). Almanac. 2013;35(10):9-10. Ginsburg L, et al. New approaches to interprofessional education and collaborative practice: Lessons from the organizational change literature. J Interprof Care. 2005;19(1):177-187. Headrick LA. Learning to improve complex systems of care. In: Collaborative Education to Ensure Patient Safety. Washington, DC: HRSA/Bureau of Health Professions. 2000;75-88. Ho K, et al. Making Interprofessional Education Work: The Strategic Roles of the Academy. Academic Medicine. 2008 Oct;83(10):934-940. Institute of Medicine. 2015. Measuring the impact of interprofessional education on collaborative practice and patient outcomes. Washington, DC: The National Academies Press.

Interprofessional Education Collaborative Expert Panel. Core competencies for interprofessional collaborative practice: Report of an expert panel. 2011. Washington, DC: Interprofessional Education Collaborative. Lifelong Learning in Medicine and Nursing Final Conference Report. 2010. Available at: http://tinyurl.com/7y7st7y. National Center for Interprofessional Practice and Education. Available at: https://nexusipe.org/ Owen JA, et al. Integrating interprofessional education into continuing education: a planning process for continuing interprofessional education programs. JCEHP. 2013;33(2):109 117. Reeves S. An overview of continuing interprofessional education. JCEHP. 2009;29(3):142-146. Reeves S, et al. Key Factors in Planning and implementing interprofessional education in healthcare settings. J Allied Health. 2007;36:231-235. Sargeant J. Theories to aid understanding and implementation of interprofessional education. JCEHP. 2009;29(3):178 184. Sargeant J, et al. Development and testing of a scale to assess interprofessional education (IPE) facilitation skills. JCEHP. 2010;30(2):126 131, Steinert Y, et al. Faculty development for teaching and evaluating professionalism: from programme design to curriculum change. Med Educ. 2005;39(2):127 136.