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Following this IPE simulation, students will be able to

1) Use knowledge of one’s own role and those of other professions to appropriately assess and address patient, family and population health needs

2) Apply relationship-building values and the principles of interprofessional team dynamics

3) Work with individuals of other professions to maintain a climate of mutual respect and shared values

4) Communicate in a responsive and responsible manner that supports a team approach to optimal care

Prior to IPE Session

· Review assigned Patient Summary document

· Review IPE module in Appendix A (#1)

· Prepare for interacting with Embedded Simulated Person (student serving in the role of patient or family member) - if assigned to your session. See instructions below.

· Review references in student instructions documents

· Generic IPE case scenario references and resources (Appendix A)

· Proposed roles of health and human service disciplines (Appendix B)

· IPE session roles (Appendix C)

· IPE core competencies (Appendix D)

· Resources on Implicit Bias (Appendix E)

· Identify your professional role in the patient’s care from the Patient Summary report.

· Review Introduction to Implicit Bias video (video will be provided by faculty in advance of the session).

· Please know that it is not expected for you to fully understand each other’s discipline progress reports or terms used in providing patient care. One of the goals of this IPE simulation is to develop an understanding about each other’s roles so you may ask your peer colleagues other about those roles and terms you may not understand.

During the IPE Session

· After introductions and pre-briefing on the scheduled case scenario, you will be introduced to the patient (live standardized patient or video of patient/family members).

· If a live standardized patient is scheduled for the session, the IPE team will briefly meet to discuss roles for interviewing the patient on current condition and concerns

· If a video of the patient/family member’s perspective is shown, the IPE team will consider the patient and family member’s perspectives before proceeding with a discussion on a recommended plan of care

· At an interprofessional healthcare team roundtable meeting, you and your team will work together to develop a plan of action for the patient’s care with the other disciplines, using the information from your specific discipline progress report.

· Note that the team will also be meeting to determine the patient’s current needs, such as: managing associated co-morbidities of the patient’s current condition, specialist referrals, transportation/food insecurity, care coordination needs, social networks, and ability to support the patient and her household members.

· For the assigned case, you will need to examine the effect that implicit bias has on patient care, how healthcare professionals integrate clinical care and public health interventions to address healthcare disparities in vulnerable populations and implement shared patient-centered and population focused problem-solving that address health disparities and promotes health equity.

· Consider the following questions:

1) What additional information have we missed here that you might want to help evaluate the patient’s/caregiver’s current presentation? How can you obtain the information? From whom?

2) What are your observations of this encounter related to potential bias?

3) How might judgement or bias affect the patient’s outcome?

4) What can you do if you’re in a situation similar to this one in the future? ​

5) What did you learn from the patient and/or family member that emphasizes or highlights specific aspects of the patient’s condition or care needs?

6) What are the physical, social and mental health needs of this patient and her family?

a. What biological factors may contribute to the patient or family member’s mental health presentation?

b. What psychological factors may contribute to the patient or family member’s mental health presentation?

c. What are the social contributors that may contribute to the patient or family member’s mental health status?

d. How might the patient’s history of impact the mental health needs of Ann now?

e. What other factors do you think are playing a role at this time?

7) What do you need to know about the other student interprofessional roles? How will this information impact the patient and family’s plan of care?

8) How does an IPE approach address this patient’s needs?

Immediately following IPE Session: all students (participants and observers) will complete a survey on their self-reflections of the Sim-IPE session. The survey will be posted on Chat at the end of the IPE session and is expected to complete before ending the session. In addition, faculty may work student participants and observers on with you on reflections on the case scenario following the IPE session.

If ESP Assigned to the IPE Session: Once the introductions and briefing sections of the IPE session are completed, the faculty facilitator will introduce IPE student participants to the ESP and ask you to briefly interview them before initiating your 30-minute discussion on a recommended plan of care for the patient.

In the encounter, you have approximately 5 minutes to speak with your patient and/or family member. Please remember, the purpose of the brief encounter is to provide an opportunity for you to interact with the patients and families in your care, so that learners can gain insights into the experiences and emotions of patients and families in difficult situations.

In your interactions, you might consider focusing on the following:

1. How is the patient/family doing?

2. How are they feeling?

3. What are the things you find most difficult right now?

4. What are the ways we can best help you?

For Students Assigned as ESPs: Students assigned to ESPs will be prepared in advance by faculty to assume the role of the patient or family member for the assigned case scenario at the scheduled session. This includes general guidance on the role and expectations for the role of ESP role and preparation for the brief interview during the IPE session.

Student ESPs will join the scheduled session 15 minutes in advance of the start time to huddle with faculty and review their role. They will keep their camera off and remain muted until introduced by the faculty facilitator. Once the brief interview is completed, the ESP student will turn camera and audio off and observe the remainder of the session.

Health and human service student participants will meet together as a virtual roundtable to review the patient summary and discipline-specific progress reports to develop the patient’s plan of care. Discussion will include specific patient needs, any additional information needs, and how to ensure that the patient and family have the necessary resources and understanding to adequately manage the patient’s optional care and planned recover needs.

Zoom Pre-brief: The IPE session will begin with students completing a brief survey on Implicit Bias. Faculty will then lead student and facilitator introductions. The facilitator will prompt students to offer something fun about themselves as an Icebreaker. Students will come prepared to ask a question of at least one the other profession included in the scenario. Faculty facilitators and students will use video to view each other throughout the scenario (unless the session is hosted in-person or hybrid). Observers will mute Zoom audio and video throughout the session. Faculty facilitators will provide an overview of the organization of the IPE session, prompting students to move through the scenario as outlined below, and lead the debrief with students following the scenario.

Patient Perspective: Following introductions and pre-brief, students will be asked to meet with a patient (if live standardized patient scheduled for the event) or view a video on the patient and family’s perspective of the current situation and any concerns. If a live SP is available, IPE participants will be asked to take five minutes to discuss roles for the patient interview. If a video is used, IPE participants will spend 5 minutes after viewing the video to discuss implications of the patient and/or family member’s presentation of the case.

Simulation IPE Case Discussion:

· Students will proceed with a multidisciplinary discussion of the patient’s plan of care, based on the professional notes in the patient summary record and information gained from the patient and family member. Each student participant will provide their professional assessment of the patient and her family/household members’ current status and establish an action plan to address specific patient and family needs, any additional information needed, and a recommended plan of care.

· Current data on the patient and family will be shared (X-ray, scans, lab data, mental health, nutritional and physical assessments as relevant) in the patient summary report. Focus topics will include issues surrounding, but not limited to, transportation/food insecurity, coordinating needs, social network ability to support the patient and her family and specific education relevant to the patient’s relevant environmental assessment.

· The interprofessional team will develop recommendations on referrals, additional treatment consideration, and community, social and public health interventions specific to the patient and their family’s needs, and discuss next steps on how to implement the plan of care in the next stage of the patient’s care continuum.

Zoom Debrief: Following the IPE case discussion, faculty will lead a de-brief session to reflect on the experience of working with an interdisciplinary team of health and human service professions, and to identify specific implications in the experience that supporting development of any of the four IPE core competencies. In addition, the debrief will reflect on case-specific considerations for the specific scenario and reflections on Implicit Bias that may be triggered during the presentation and discussion of this case. All members of the Sim-IPE are expected to actively participate in the debriefing discussion, and student observers are encouraged to share comments and ask questions on the Chat.

Materials and Equipment: all participants in virtual sessions will participate on computer with internet access, working audio and webcam, login to Zoom, and the case scenario patient summary report. Instructions for in-person or hybrid IPE sessions will be provided separately, based on arrangements and location for the session.

1) Please review the following module prior to the simulation:

Interprofessional Communication & Teams/Teamwork IPE modules:

Student Participant: students representing registered disciplines for scheduled session that are designed to directly participate in the interdisciplinary discussion of the scheduled case scenario. The student participants will review the case scenario materials in advance (Patient Summary), in addition to the desired skills domains for interdisciplinary team performance during the IPE simulated session. Student participants are encouraged to login from a laptop or PC with access to Zoom. The student participants will be required to have video and audio functions ON during the Zoom session to participate in the team discussion.

Student Observer: student observers are those students who will be virtually observing live event from classes registered for event. The student participants will review the case scenario materials in advance (Patient Summary), in addition to in addition to the references in the student instructions in advance of the IPE simulated session. The student observers will be asked to remain on mute and turn video OFF , and they may participate from any device, as long as the Zoom application is downloaded on the device prior to the event. Student observers may post questions or comments on the chat function of Zoom. These questions will be addressed by the IPE facilitator(s) upon completion of the debriefing period at the end of the session.

All students will be required to complete a brief post-survey of the IPE experience. The link to the student IPE survey will be provided upon completion of the IPE session.

Evaluation Observer: In the role of Evaluation Observer, the assigned student will remain muted with video OFF on Zoom , as you serve as a silent observer of student interdisciplinary team performance during the IPE session.

In conducting the assessment of the IPE interprofessional team, the Evaluation Observer describes the performance of the team, rather than the individuals, except with regard to how the individuals influence team performance. Please remember, these are student health and human service professionals who may be participating in their first simulated patient case scenario, and/or their first and only experience with other health and human service professions students.

An electronic copy of the online tool (Word) copy may be used as a guide to assess team performance during the session and submit your results on the online tool within one day of the IPE session

NYSIM Staff: provide virtual platform; support session logistics; participate in live sessions; advance PPE slides during the Sim-IPE session; serve as timekeeper; and post student survey in chat at the completion of session

CUNY Staff: participate as observers in session; facilitate faculty communications on scheduled sessions and registered participants; and aggregate student survey results

Adapted from Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. Washington, DC: Interprofessional Education Collaborative .

BACKGROUND

The Interprofessional Education Collaborative (IPEC) came together in 2009 to develop core competencies for interprofessional collaborative practice to build on each profession’s expected disciplinary competencies. In 2016 the IPEC Board adapted the competencies with the aims to: reaffirm the original competencies, ground the competency model firmly under the singular domain of Interprofessional Collaboration, and broaden the competencies to better integrate population health approaches across the health and partner professions so as to enhance collaboration for improving both individual care and population health outcomes.

The 2016 update, like the initial 2011 IPEC report, is inspired by the vision that interprofessional collaborative practice is key to the safe, high-quality, accessible, patient-centered care desired by all. It also reflects the changes that have occurred in the health system since the release of the original report, two of the most significant of which are the increased focus on the Triple Aim (improving the experience of care, improving the health of populations, and reducing the per capita cost of health care) and implementation of the Patient Protection and Affordable Care Act in 2010. The updated version integrates explicit population health outcomes alongside individual care competencies into an expanded competency model that is needed to achieve today’s health system goals of improved health and health equity across the life span.

OPERATIONAL DEFINITIONS

Interprofessional education: “When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.” (WHO 2010)

Interprofessional collaborative practice:

“When multiple health workers from different professional backgrounds work together with patients, families, [careers], and communities to deliver the highest quality of care.” (WHO 2010)

Interprofessional teamwork:

The levels of cooperation, coordination and collaboration characterizing the relationships between professions in delivering patient-centered care.

Interprofessional team-based care:

Care delivered by intentionally-created usually relatively small work groups in health care who are recognized by others as well as by themselves as having a collective identity and shared responsibility for a patient or group of patients (e.g., rapid response team, palliative care team, primary care team, and operating room team).

Professional competencies in health care:

Integrated enactment of knowledge, skills, values, and attitudes that define the areas of work of a particular health profession applied in specific care contexts.

Interprofessional competencies in health care:

Integrated enactment of knowledge, skills, values, and attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes in specific care contexts.

The core competencies and sub-competencies feature the following desired principles: patient/client and family centered (hereafter termed “patient centered”); community and population oriented; relationship focused; process oriented; linked to learning activities, educational strategies, and behavioral assessments that are developmentally appropriate for the learner; able to be integrated across the learning continuum; sensitive to the systems context and applicable across practice settings; applicable across professions; stated in language common and meaningful across the professions; and outcome driven.

Competency 1

Work with individuals of other professions to maintain a climate of mutual respect and shared values. (Values/Ethics for Interprofessional Practice)

Competency 2

Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations. (Roles/Responsibilities)

Competency 3

Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease. (Interprofessional Communication)

Competency 4

Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population- centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable. (Teams and Teamwork)

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IPEC CORE COMPETENCIES FOR INTERPROFESSIONAL COLLABORATIVE PRACTICE

Values/Ethics Sub-competencies

Work with individuals of other professions to maintain a climate of mutual respect and shared values. (Values/Ethics for Interprofessional Practice)

Roles/Responsibilities Sub-competencies

Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations. (Roles/Responsibilities)

Interprofessional Communication Sub-competencies

Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease. (Interprofessional Communication)

Team and Teamwork Sub-competencies

Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population- centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable. (Teams and Teamwork)

The following reading list and references provided for students who wish to deepen their understanding of implicit bias, its effect on health outcomes, and training interventions.