University of Bergen
At the Centre for interprofessional workplace learning in Bergen, Norway, has implemented some of the aspects of Experts in Teams in the undergraduate course ‘Interprofessional learning’.
How is the course set up?
The centre’s overall goal is to train tomorrow’s health workers interprofessionally, to increase patient safety and care, and to be a part of the municipalities’ quality assurance system for their health services. We focus on:
- developing the students’ interprofessional competencies and innovation potential.
- the alignment of interprofessional learning activities between educational institutions and the municipalities.
- the centre’s practice-based education program where students regularly participate in collaboration with the municipalities’ health services to apply current knowledge to patient care.
TVEPS has been in contact with Experts in Teams since 2013. The frame for the course is a real-life challenge presented by the patients in nursing homes or home-based health services. The students often improve patient care in innovative ways.
In the training students:
- establish interprofessional teams of 4-5 students from different programs.
- spend a day talking to and examining selected patients in nursing homes or in homebased health services. The health worker staff selects complicated patients for which they want an external and interprofessional view.
- write as a team an interprofessional treatment plan for each of the patients.
- discuss the treatment plan with the staff responsible for the patients. The staff decides which parts of the treatment plan may be implemented in actual patient care.
- write a self-evaluating reflection note of their learning experience.
Working on their treatment plans gives the students an object to develop through dialogue with each other and with the patient, thus training them in interprofessional co-work and preparing them for the assessment from the nursing home staff. The reflection note is meant as a means for self-assessing their input in the team and to secure a second wave of reflective learning.
The output is the students’ treatment plans with approximately 5 proposed actions for each patient. Many of these actions are implemented in actual care.
After the students have completed their training in TVEPS, together with their other studies, we expect them in a greater extent to:
- Know the competencies of other health care professionals and what they may contribute in patient care.
- Appreciate the impact of interprofessional collaboration.
- Understand the meaning of collaboration with patients and other users of the health care system.
- Know how to communicate their own thoughts and assessments to collaborating health care professionals.
- Be able to use own competencies in collaboration with other health care professionals for the benefit of the patients and other users of the health care system.
- Be able to actively participate in interprofessional examinations of a patient or user of the health care system.
- General competences:
- Know how to communicate professional opinions and conclusions to other health care professionals in a work place environment.
- Be able to appraise and reflect on the group dynamics within the team of which they are a member.
- Reflect on their own role in team and group processes.
Involvement of micro, small and medium-sized companies
TVEPS co-work on patient care with the municipalities’ health services, mainly in nursing homes and homebased health services.
We also co-work with municipality-based and private kindergartens. Interprofessional student teams create educational programs on public health issues for 4-5 years old children. They perform with children, debrief with staff and perform with other children. Students learn, staff learn and children learn.
We also offer interprofessional student teams to private general practice offices, to give an independent view on complex patients.
We further offer interprofessional student teams to initiate administrative innovations in the municipalities. Examples are the transition of a dementia home towards a dementia village in active interaction with the surrounding population, and maximising the administrative flux in an intermediate nursing home department.
Organisation and support structures
Apart from the facilitators, the TVEPS course involves the following support structures:
- Project coordination: TVEPS is located at the Department of Global health and primary health care, University of Bergen. TVEPS has a leader group consisting of the leader of TVEPS together with TVEPS assistant leaders from the participating educational institutions (University of Bergen and Western Norway University of Applied Sciences).
- The leader of TVEPS and a coordinator monitor all processes and provide infrastructure for the student teams.
- The coordinator has the day-to-day contact with students and staff at the workplace, and coordinates student teams at the workplace premises.
- Contact with the workplaces is carried out by leader and coordinator.
- National and international guest management: Assistant leaders and coordinator.
- Research: By the end of 2017 two manuscripts are submitted.
- TVEPS was in 2017 presented at three international conferences.
How do students improve interdisciplinary teamwork skills?
At TVEPS each student participate in these separate activities related to interdisciplinary teamwork skills:
- Assembling the team and getting to know each other. The students participate in a kick-off meeting organised by TVEPS and get a booklet describing the TVEPS learning methodology.
- At the workplace the student team works with two patients. Based on the current knowledge of the patient as noted in the different treatment and care documents, the students discuss which additional care may be profitable for the patient.
- Based on this they write an interprofessional treatment plan for each patient.
- The student team discusses the treatment plan in a dialogue meeting with the staff that is responsible for the care of that particular patient. Implementation of the proposals in actual patient care is discussed. The dialogue meeting is also a ‘natural exam’ for the students; a formative assessment integrated in the workplace.
- The students write a reflection note on own learning experience. The writing process is intended to foster a deeper understanding of own, mostly tacit, learning experiences. The reflection note is also the main source for our ongoing evaluation of the education we offer.
- The students also fill in the Interprofessional Collaborative Competency Attainment Survey (ICCAS).
How do students improve innovation skills?
Placing interprofessional student teams at the workplace foster innovation as often as the situated conditions allow for it. The political steering bodies of the health services in the municipalities explicitly invite TVEPS to be a part of their services, partly because of the learning possibilities which are offered for their employees, partly because of the innovative potential it represents.
How do students work with reflection?
Reflection occurs at every point in TVEPS based learning, either spontaneously or guided. Through interprofessional work with the patient we mainly rely on spontaneous reflections occurring at each point when the students experience unexpected arguments or situations. The guided reflection is the reflection note.
How do we work with facilitation?
The dialogue meeting between the interprofessional student teams and the workplace staff is facilitated, primarily by the academic staff in TVEPS. Facilitation aims mainly at monitoring the group processes and stimulate each participant to get involved in the process. Recently, we have engaged 3rd year medical students as facilitators. Our experiences so far are good. Student facilitators are subjected to a pedagogical course, they themselves participate in TVEPS in the same way as other interprofessional students and then they observe a dialogue meeting facilitated by academic staff before they themselves facilitate dialogue meetings.