Education for Health

GENERAL ARTICLE
Year
: 2015  |  Volume : 28  |  Issue : 1  |  Page : 58--63

Building an interfaculty interprofessional education curriculum: What can we learn from the Université Laval experience?


…lise Milot1, Serge Dumont1, Michèle Aubin2, Gisèle Bourdeau3, Ginette Mbourou Azizah4, Louise Picard1, Daphney St-Germain4,  
1 School of Social Work, Faculty of Social Sciences, School of Social Work, Québec City, Canada
2 Department of Family Medicine and Emergency Medicine, Faculty of Medecine, School of Social Work, Québec City, Canada
3 Department of Rehabilitation, Faculty of Medicine, School of Social Work, Québec City, Canada
4 Faculty of Nursing Sciences, School of Social Work, Québec City, Canada

Correspondence Address:
…lise Milot
Faculty of Social Sciences, School of Social Work, Québec City; Pavillon Charles-De Koninck, Bureau 5444 1030, av. des Sciences-Humaines Québec (Québec) G1V 0A6
Canada

Abstract

Interprofessional education (IPE) is increasingly recognized as a means to improve practice in health and social care. However, to secure interprofessional learning, it is important to create occasions in prelicensure health and social services curriculum so that students can learn with, from and about each other. This paper presents the process behind the development and implementation of an IPE curriculum in 10 health and social sciences programs by a team of professors from the faculties of medicine, nursing sciences and social sciences at Université Laval in the province of Québec, Canada. The pedagogical approach, description of primary objectives and issues related to its implementation in the curriculum programs are also described and discussed.



How to cite this article:
Milot …, Dumont S, Aubin M, Bourdeau G, Azizah GM, Picard L, St-Germain D. Building an interfaculty interprofessional education curriculum: What can we learn from the Université Laval experience?.Educ Health 2015;28:58-63


How to cite this URL:
Milot …, Dumont S, Aubin M, Bourdeau G, Azizah GM, Picard L, St-Germain D. Building an interfaculty interprofessional education curriculum: What can we learn from the Université Laval experience?. Educ Health [serial online] 2015 [cited 2020 May 30 ];28:58-63
Available from: http://www.educationforhealth.net/text.asp?2015/28/1/58/161896


Full Text

 Background



In recent years, interprofessional collaboration (IPC) has earned a reputation for being the optimal approach for provision of care in healthcare systems. [1],[2] It is defined as a process that brings together professionals from a variety of disciplines to develop and reflect on cohesive and integrated methods of practice to meet the needs of patients, families and communities. [3] Although the body of scientific work on IPC is still evolving, early consensus is that IPC practices are associated with improved access to health care and an increasingly optimal usage of clinical resources, which in turn fosters their renewal and retention. [4] Positive outcomes have been noted specifically in patients suffering from chronic disease and in safety risk reduction. [2],[4] Furthermore, effective collaborative care between different healthcare professions represents an innovative strategy for improving the quality of practices and is a factor in the successful implementation of organizational changes in clinical settings. [5],[6] As a result, professional practices within the healthcare system are faced with the dual challenge of not only gaining a multidimensional understanding of health issues, but also aligning them with collaborative practices proven to be effective.

For future professionals to be better equipped to pool their knowledge and adopt a collaborative approach that benefits health care users, they must be properly prepared. Consensus indicates that interprofessional education (IPE) is essential to break down the disciplinary silos and to train collaborative practice-ready professionals. [3],[5],[6],[7],[8] IPE occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. [9] This paper presents the process behind the development and implementation of an IPE curriculum in 10 health and social sciences programs at Université Laval in the province of Québec, Canada. The pedagogical approach, description of primary objectives and challenges related to its implementation in the curriculum programs are also described and discussed. The main purpose of this paper is to share some key elements that should be considered in the development of similar initiatives.

Implementation of an IPE curriculum at Université Laval

Located in the heart of Québec city, Université Laval is a complete 17 faculties campus university that offers over 350 programs at both the undergraduate and graduate levels. Well-known as the first and the largest French-language university in the Americas, Université Laval offers all the programs in humanities and health. Its community is composed of over 40,000 students and 3200 regular professors, lecturers and other members of faculties' teaching staff.

Implementing an IPE university-based curriculum where health and social sciences students share the same learning environment involves numerous challenges. The success of such initiative requires a harmonization of the institutional, paradigmatic and pedagogical cultures of the faculties involved. This is further complicated by the constant addition of new educational material to programs with relatively inflexible curricula and timetables. As such, implementing an IPE curriculum is no mean feat.

In 2005 a team of professors from the faculties of medicine, nursing sciences and social sciences at Université Laval decided to tackle the challenge. An undergraduate IPE curriculum of three courses configured and scheduled in a consecutive and sequential manner was designed and implemented. The general aim of those sequential courses was to introduce future healthcare and social services professionals to the fundamentals of IPC centered on patient and their families and allow them to acquire a practical grasp of the core competencies necessary to engage in collaborative practices. To our knowledge, Université Laval was the first Canadian university to offer a series of courses like this, where teaching responsibilities are shared among a team of professors from a variety of disciplines and faculties.

The implementation process

The IPE curriculum developed jointly and collaboratively by a team of professors resulted from a six-step process: (i) Reviewing the existing course content in Université Laval's different programs' curriculum as related to collaborative practice or interdisciplinary work; (ii) Synthesizing theory-based concepts and practical knowledge on IPC; (iii) Identifying the best pedagogical strategies for promoting the acquisition of theory and practical skills, including information and communications technologies (ICT); (iv) Planning an integrated and progressive IPE curriculum covering core complex and advanced concepts over the course of three mandatory one-credit courses; 1 (v) Developing a framework for evaluating the knowledge and skills acquired and benefits for students; (vi) Implementing the evaluation framework and rigorously analyzing the results.

Throughout the process, professors from the various faculties benefited from a strong support from deans and directors of their faculty in terms of implementing the IPE curriculum, which greatly facilitated its roll-out within the programs' curriculum.

Today, the IPE curriculum is managed primarily by three teaching teams made up of a full professor and a lecturer, who are joined from time to time by experienced clinicians who mentor small groups of students during experiential learning activities. The teaching teams also receive support from administrative staff and ICT specialists. The IPE curriculum program is divided into three one-credit courses, with each of the three teaching teams overseeing a single course. The pedagogical strategies used in the IPE program are based on a blended learning format structure, which integrates experiential classroom activities with online learning and homework. The pedagogical approach offers greater scheduling flexibility due to reduced class time, without compromising discussion and networking among students. Each teaching team's primary responsibilities consist of updating the course content and training the mentors who guide students during experiential activities. They must also prepare for in-class activities, which represent a significant logistical task due to cohort size. This is particularly challenging since cohorts of more than 400 students must be broken down into small working groups of interprofessional teams, so they can put into practice the acquired knowledge and skills during role play activities.

Implementing course content

The development and design of the IPE curriculum at Université Laval is based on the conceptual framework of the Canadian Interprofessional Health Collaborative (CIHC) [10] [Figure 1]. Illustrates how the six competency domains identified by the CIHC are integrated in the IPE curriculum of three courses. These competency domains highlight the knowledge, skills, attitudes and values essential to IPC practice. They are: (i) Patient/client/family/community-centered care; (ii) interprofessional communication; (iii) role clarification; (iv) team functioning; (v) interprofessional conflict resolution; (vi) collaborative leadership.{Figure 1}

The first course is overseen by the Faculty of Nursing Sciences and familiarizes students with the theoretical and conceptual foundations of IPC in person and family-centered care, with a specific focus on interprofessional role clarification and communication. Overseen by the School of Social Work (Faculty of Social Sciences), the second course exposes students to group processes in order to develop their IPC skills in a teamwork context. The third and final course is run by the Faculty of Medicine and aims to foster understanding of current IPC practices in various fields of practice and encourage students to critically examine such practices. Detailed objectives and contents of the IPE curriculum are shown in [Table 1].{Table 1}

Students

The IPE curriculum is mandatory for undergraduate students in occupational therapy, physiotherapy, social work, kinesiology, medicine, nursing, nutrition, pharmacy and for graduate students in speech and language therapy. Psychology graduate students also have access to the IPE curriculum as optional courses.

Curriculum courses are offered on timetable every semester (fall, winter, summer) as part of a 45-h program divided into three courses. Students may choose to complete all three courses within a single semester or at different times throughout their academic career. However, the courses must be taken in order, as the content of each is a prerequisite for the next.

Pedagogical perspective of the IPE curriculum

Given the pedagogical objectives and constraints associated with large student cohorts from a variety of disciplines mentioned above, a blended learning format structure that combines both e-learning and face-to-face activities was chosen.

Inspired by the flipped mastery classroom model, [11] the first part of each of the three courses in the curriculum is designed in a self-study e-learning format, while the second part takes an action learning approach where students work in small groups. Therefore, students have the opportunity to learn together by tackling real issues and reflecting on their actions. In the classroom, students are mentored by experienced clinicians from the 10 discipline involved who received specific training to facilitate interprofessional learning.

Many of the benefits of flipping the classroom identified by Bergmann and Sams [11] can apply to the situation of the university students participating in the IPE curriculum. First, flipped classes work well for learners who are extremely busy, as videos and other learning material can be viewed at convenient time. As students become more comfortable with technology, it seems increasingly practical to use these tools. Using online pedagogical tools to facilitate learning enables students who are struggling with a certain concepts to stop, pause and replay the content as many times as needed. All students can move through content at their own pace to meet the learning objectives at different time frames. For McDonald and Smith, [12],[ p. 438] "flipping the classroom provides unique advantages for the professional development arena, where greater levels of flexibility and scheduling are valued by learners with other time commitments and varied schedules". During the in-class activities the mentors guide the students to explore and further develop their knowledge to create richer learning opportunities. Hence, using the flipped mastery classroom model requires a shift in the learning culture: The mentors are no longer the presenters of information; instead, they take on more of a tutorial role, [13] which is an important prerequisite for interprofessional learning to occur.

Online: The e-learning phase

During the e-learning phase, students are given roughly three weeks to independently complete the preparatory activities available through the Université Laval digital learning environment. Those activities come in a variety of forms: Online courses, videos, preparatory readings, written exercises and formative and summative quizzes. The formats are varied to facilitate optimal learning based on different learning styles or preferences. For instance, interactive videos with integrated quizzes reinforce learning and can help deepen understanding of concepts and principles explained. Furthermore, repetitive access can foster the integration of new learning materials. [14],[15] Students can access content on demand to review concepts for better understanding and engage themselves in a reflexive and autonomous learning process.

The objective of the preparatory exercises during the e-learning phase is to acquire an understanding of the theory involved in the learning together phase.

In class: The Learning Together phase

All registered students are asked to participate in the integration and evaluation activities, as they learn about, from and with each other in concrete, clinical situations over weekend intensive sessions. At this point, students from different disciplines are teamed up (8-10 students per team) to experience collaborative process and perfect their learning. Student teams are mentored by experienced clinicians who have been selected based on three criteria: (i) Relevant IPC experience as a clinician in health care; (ii) ability to lead small groups; (iii) potential to act as a role model. Throughout the three-course program, the ratio of mentors to teams varies from 1:2 to 1:3. Their primary mandate is to help students consolidate their learning through a series of activities that foster knowledge and skills' integration (e.g. role play followed by discussion). They also provide clarification regarding the materials studied and help solidify knowledge through the skill-based learning activities proposed. For example, mentors may provide examples from their own practice, thereby providing complementary content. Thus, mentors act as facilitators who guide interprofessional team members in their learning process by facilitating discussions, interactions and critical reflection on actions.

 Discussion



The IPE curriculum has been successfully implemented and more than 1200 students benefit from it each year. Feedback from the clinical settings that employ interns and new professionals has been overwhelmingly positive. It can therefore be said that some key elements have to be considered in the development of similar initiatives.

First, strong institutional support from faculties' deans and directors, including academic program directors, is crucial. Getting such support at the beginning of the project makes it possible to overcome the various challenges such as those posed by recruiting and managing mentors or setting up timetables and schedules that fit with the specific academic programs of all disciplines involved.

Then, recruitment of qualified staff, including lecturers and mentors, has to be planned. Since the IPE curriculum is mandatory in 10 health and social sciences academic programs at Université Laval, student cohorts are quite large. More than 400 students take the courses each semester. This requires considerable human and financial resources. Also, due to the different program structures and different numbers of participating students from each discipline, it can sometimes be difficult to put together heterogeneous student teams during the learning together phase where every discipline should be represented.

Although the importance of IPE education is increasingly acknowledged, the impact of such university-based courses on students' competencies, and the quality of the healthcare services they will eventually provide, has yet to be rigorously demonstrated. [16] A longitudinal study of student cohorts would allow us to better document the real impacts of the Université Laval's IPE curriculum on professional practice and on quality of the resulting care and services from patients, families and communities' perspectives. That represents a relevant area for further research.

 Conclusion



To foster interprofessional learning, a team of Université Laval professors has developed and implemented an IPE university-based curriculum where health and social sciences students learn with, from and about one another. The aim of this initiative was to prepare collaborative practice-ready professionals.

As Freeth and colleagues point out, [17] developing an IPE program has to be a collaborative task. This paper demonstrates that to be successful, the implementation of an interfaculty IPE curriculum necessitates a deep commitment on behalf of participating faculty and strong support of professors involved at both the faculty and institutional levels.

Lastly, one approach that could have a significant impact on improving the Université Laval IPE curriculum would be to get several patient-experts involved in all the students' interprofessional learning process. Although few studies have documented the benefits of such an approach for preparing future health and social services professionals, it appears quite promising. [18],[19]

Note:

1 At Université Laval, 1 credit represents 15 h of class time and 45 h of study.

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