University of Bergen

Overall Frame

The centre’s overall goal is to train tomorrow’s health workers in interprofessional collaboration, to increase patient safety and care, and to contribute to the municipal quality assurance systems for health and social care services. We focus on:

1. developing the students’ interprofessional competencies and innovation potential.
2. the alignment of interprofessional learning activities between educational institutions and the municipalities.
3. the centre’s practice-based education program where student groups participate in dialogue with the municipalities’ health and social care services to apply current knowledge to patient care, life mastery, and sustainability.

Course Setup

TVEPS has been in contact with Experts in Teams since 2013. The frame for the course is a real-life challenge presented along three different models: 1) tailoring careplans for patients in nursing homes, home-based health service or in a number of other workplaces; 2) preparing and performing an interactive pedagogic session for children in kindergartens/schools about health and life mastery; 3) tailoring sustainability plans for how a workplace may obtain the Sustainable Development Goals (SDGs) as outlined by the United Nations (UN). The students’ work often result in innovative plans and results.

In the training students:

1. establish interprofessional teams of 4-5 students from different education programs (almost twenty different education programs send their students to TVEPS, most of which are health and social care education programs).
2. spend a day talking to and examining selected patients in a workplace within the municipal health and social care services, or prepare an interactive pedagogic session for children about health and life mastery, or examine a workplace with the UN sustainability development goals in mind.
3. write as a team an interprofessional care plan for each of the patients, or a pedagogical session for the children, or a sustainability plan for the workplace.
4. discuss the care plan / pedagogical session / sustainability plan with the staff at the workplace. Afther the discussion, the students revise the plan / session to have an optimal product which the staff in turn gets to keep and implement as they see fit.
5. write a self-evaluating reflection note of their learning experience.

Working on their treatment plans / pedagogical sessions / sustainability plans gives the students an object to develop through dialogue with each other and with the patient / children / workplace, thus training them in interprofessional co-work. Interprofessional skills are further developed and consolidated in the dialogue meethings with the workplace staff.  The reflection note after TVEPS-practice is finished is a tool for self-assessing their input in the team and to secure a second wave of reflective learning.

Output

The output from TVEPS is one of three, depending on the TVEPS model un use: 1) the students’ care plans with proposed actions for how each patient may increase his/her quality of life and sense of everyday mastery; 2) the interactive pedagogic session about health and life mastery that the students create for children in kindergartens or schools; 3) the sustainability plans with proposed actions for how the workplace may obtain the UN sustainable development goals. The output is available for the workplaces to be implemented as they seem fit.

Learning Outcomes

After the students have completed their training in  we expect them in a greater extent to:

• Knowledge:
• Know the competencies of other health care professionals and what they may contribute with in later worklife.
• Appreciate the importance and impact of interprofessional collaboration.
• Understand the meaning of collaboration with patients and other users of the health and social care services.
• Skills:
• 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 patients and other users of health and social care services.
• Be able to actively participate in interprofessional examination of a patient or interprofessional investigation of a topic.
• Improve communication skills with patients/users of health and social care services within an interprofessional context.
• General competencies:
• Know how to communicate professional opinions and conclusions to other health care professionals in a workplace environment.
• Be able to appraise and reflect on 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 collaborate on patient care with the municipalities’ health and social care services – in nursing homes, homebased health services and a number of other healthcare arenas. In addition, public and private workplaces (mainly health-related but also others) can commission an interprofessional student group to tailor a sustainability plan to help them obtain the UN sustainable development goals.

We also collaborate with municipality-based and private kindergartens and schools. Interprofessional student teams create interactive pedagogic sessions related to health and life mastery issues for 4-5 years old children. The students perform with children, encounter the staff in a dialogue meeting and perform with a new group of children.

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 Public Health and Primary Care, University of Bergen. TVEPS has a leader group responsible for the day-to-day management consisting of the head of TVEPS together with TVEPS coordinators and TVEPS deputy head and scientific staff from participating educational institutions (University of Bergen and Western Norway University of Applied Sciences).
• The head of TVEPS and two coordinators monitor all processes and provide infrastructure for the student teams.
• The coordinators have the day-to-day contact with students and staff at the workplaces, and coordinate student teams at the workplace premises.
• Contact with the workplaces is carried out by head, deputy head and coordinators.
• Research: TVEPS is in the process of constructing a research unit, and has an increasing production of scientific papers in peer-reviewed international journals, as well as presentations on national and international conferences.

At TVEPS each student participates in the following activities related to interdisciplinary teamwork skills:

1. Assembling the team and getting to know each other. The students participate in a kick-off meeting organised by TVEPS where they are informed about the TVEPS learning methodology and where they spend time within their team – mapping backgrounds, getting to know each other, and planning their upcoming TVEPS practice.
2. Spending a practice day at the workplace arena in accordance with one of the three TVEPS models: 1) The students have an interprofessional in-depth conversation with two patients selected by the workplace. Based on the current knowledge of the patient as noted in the different treatment and care documents and as communicated by the patients themselves, the students discuss which additional care may be profitable for them. 2) The students perform an interprofessional pedagogic session about health and life mastery for children at an kindergarten or school. They have prepared the session through interprofessional collaboration within the group before the practice day. 3) The students have an interprofessional in-depth conversation with the workplace personnel regarding sustainability challenges at the workplace. Based on the information from the staff and a guided tour around the workplace, the students discuss which actions may be taken for the workplace to obtain the UN sustainable development goals.
3. Based on the experiences from the practice day the students write an interprofessional care plan for each patient /sustainability plan for the workplace, or – in the kindergarten/school TVEPS model – the students write out the pedagogical session about health and life mastery for children.
4. The student team discusses the care plan /sustainability plan in a dialogue meeting with the staff that is responsible for the care of the particular patients / responsible for the workplace. Implementation of the proposals is discussed. In the kindergarten/school TVEPS model, the pedagogic session is discussed with the staff in a dialogue meeting in a similar manner. The dialogue meeting is also a ‘natural exam’ for the students; a formative assessment integrated within the workplace.
5. 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 TVEPS education program.
6. In addition, the students fill in the internationally acknowledged Interprofessional Collaborative Competency Attainment Survey (ICCAS), retrospectively scoring their interprofessional competencies as they were perceived both before and after TVEPS.

Placing interprofessional student teams at the workplace stimulate to innovation. The political steering bodies of the health and social care services in the municipalities explicitly invite TVEPS to be a part of their services, partly because of the innovative potential it represents. Innovative skills are developed and innovation can occur when interprofessional student groups tailor care plans for patients, when they prepare interactive pedagogical sessions for kindergarten/school children, and when they tailor sustainability plans for how workplaces can obtain the UN sustainable development goals.

Reflection occurs at every point in TVEPS based learning, either spontaneously or guided. Through interprofessional work with the patient spontaneous reflections occur when the students experience unexpected arguments or situations. In the dialogue meetings, the students reflect upon interprofessional collaboration together, and also in conversation with the workplace personnel and the facilitator from TVEPS. After TVEPS-practice the students in addition fill in a reflection note with room for individual reflections about their recent interprofessional learning experience.

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 and reflect upon the importance, advantages and challenges of interprofessional collaboration. We also engage students as facilitators with good results. Student facilitators are subjected to a pedagogical course, after which 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.