Interprofessional Learning Afternoon
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Shelagh Brumfitt in Human Communication Sciences has organized an Interprofessional Learning afternoon on Communication Impairments for approximately 400 students in the Faculty of Medicine for the past 2 years. Students from different Schools and Departments all across the Faculty attend not only to learn more about a specific subject but also to learn more about working with each other.
We gathered the students together for one afternoon and educated them on the topic of communication impairments through presentations by academics, a patient and then having them role play in mixed group situations how they might deal with a patient who has a communication impairment. Based on our experience in doing this in 2006 we were keen to try and develop the student experience and so one member of staff suggested trying to find sponsors to support us. Having sponsors to pay for refreshments was undoubtedly an important part of the year 2 event, as this created a more comfortable atmosphere, enhancing opportunities for students to discuss their roles informally. Some charities also attended or sent materials to us and we created various stalls. One charity sent two representatives. Furthermore, having very concrete and transferable goals for the afternoons was seen to be essential:
- meet students from other medical disciplines,
- learn what the different types of communication impairments are,
- empathise from a patient’s point of view what it is like to try to communicate with an impairment,
- confront, in a small group setting the difficulties of trying to communicate critical information when you have limited speech (eg You are in Accident and Emergency and can only say 'yes'. How do you tell the nurse you are allergic to various medications?)
- learn some solutions when faced with a potential situation that involves a communication impairment,
- begin to think of themselves not only as “doctors” or “dentists” or as “speech and language therapists” but as part of the larger healthcare profession.
The afternoon came out of the Interprofessional Working Group in the Faculty of Medicine which was created because it was recognized that professionals in Healthcare and Medicine need to learn to work more closely together as part of their training (lead by Aiton Marr). Health care contexts often show that different professionals do not communicate well with each other. This is particularly important in healthcare when critical information about a patient may be known by one professional but not communicated to other members of a health team (and this has had serious results especially in the area of Childcare). Other Universities have taken this concept up with enthusiasm but it seems to have had more problems becoming truly embedded here at the University of Sheffield. This afternoon was one of the outcomes/solutions as was the Patient Safety Day (led by Nigel Bax and Michelle Marshall).
Who were the target audience (i.e. number of students, level, discipline)?
All first and second year students in the Faculty of Medicine. Some mix in large lectures that they may have or informally/socially but there is no formal/academic training where they get together and learn.
Apart from the Speech and Language Therapy professional training, there are very few healthcare courses where specific teaching on communication impairments is provided. Thus, many newly qualified health professionals such as doctors, nurses, and dentists may find themselves trying to talk to a person with a communication impairment in their clinical setting without the knowledge and skills to do this. So this afternoon seemed like a good way to begin addressing some of those issues.
What preparation did you need(please be as specific as possible)?
- Firstly I had to find enough willing staff in our department to join in with this session. This was not necessarily straightforward as not all staff would see this as an activity they needed to be involved in.
- We then needed a series of meetings to discuss our aims and outcomes and how we might implement this (at least 2 long meetings in the first year of doing this).
- Organisation of the video material. A lot of this was completed outside of the university with good will support.
- The event needed funding. We needed outside accommodation because of the size of the student group and because we wanted movable chairs so they could get into groups to do the tasks. The complete activity cost just under £1,000.
- The event needed secretarial/admin support because we needed to ensure that the date was suitable for five different departments and this involved some co-ordination. Then the booking of the outside accommodation/arrangements for the charity groups/arrangements for refeshments etc. We brought the patient speaker in by taxi. Admin: Secretarial support, approx. 15 hours. We also gave book tokens to two post graduate students who attended the session and acted as 'runners'.
- For the second year we were able to obtain sponsorship from a firm (specialising in materials for people with swallowing problems) to pay for the student refreshments and other costs were paid for via DLTD funding. The DLTD funding is not sustainable and thought will need to go into how this can be funded in future years.
- We held it at the Philadelphia Centre. We considered holding it at the Octagon Centre but there were all sorts of noise and space and issues there (and not able to move chairs etc. which was crucial to this afternoon’s activities). In addition, we found it strange that they were going to charge us for AV support (£400-500) so we simply decided to hold it off-campus.
- We spent a lot of time on the sponsor and the charities. This seemed important to us and they came through in the end but took a lot of time, energy and organization. Links that already had some sort of connection to the campus were much easier to set up (such as the Stroke Association who sent two representatives and provided bags with material about Stroke for all students). Using further staff time to contact new charities etc. simply didn’t make sense although this would have been a nice addition.
How your development of this approach impact on your time (please be as specific as possible)?
- Even though I had excellent support from a secretary and the support of three other experienced colleagues, I would say that it took up a considerable amount of time; just at a point in the semester when standard teaching was at a peak.
Advice to others trying a similar approach?
- At this kind of event, whomever is presenting really needs to think about the “TV Approach” and needs to adapt the core knowledge of whatever discipline they are presenting at the most consumable and accessible level.
- BE absolutely certain that you have a commitment from other people in the Department or Faculty who will work with you or it could become easily overwhelming.
- You need a working group, working towards a set date: need an overview, make sure that everyone knows what is involved.
- 400 students is very daunting to lecture if your presenters are not experienced or comfortable with this so you need to keep this in mind when choosing who will speak.
- The number of students also made the preparation of the task more stressful as were knew that if we did not provide a good quality experience we would 'lose' the students as the afternoon progressed.
- Remember (we didn't the first time!) to get the students from the different departments/schools to raise their hands and identify themselves at the start of the session. This created quite a good atmosphere, with people cheering each other on etc.
- Make sure that there are refreshments (we didn’t do this the first year and learned our lesson)!!!
What did you need to adapt when using this approach?
- Video materials were difficult to organize so needed to get help and technological support in transferring them into an appropriate format.
What is an aspect that will need to be adjusted in the future?
- Funding and sustainability as above.
- Certainly does not represent the core interests of everyone in the Department so so if key people leave or are on Sabbatical this may cause problems.
- Expertises are built up (now that this has been running for 2 years it is something that we can build upon and would be a shame to lose these expertises) but it is a very difficult to contemplate this activity with such a large group of students to manage, without a core group of staff.
What is a main strength of this approach?/How does it make things better?
- We believe this provided interprofessional opportunities and increased knowledge and understanding about communication impairments.
- For the Department, a major benefit was that it raised the profile of what we do, our approach and concerns but also just generally increased understanding of who we are in the University.
- The good feedback has been an extremely positive thing for our Department on a series of levels.
- Word has gotten around with charities and companies/firms that have something to do with speech impairments and now we have these links set up with the Department.
- Allows different groups of students to see each other and to get to know each other a little better which may have some impact in the future.
- The Department of Health wants evidence of Interprofessional learning and this provides one example at this University which can be quoted in the future.
Trying IPL activities in this University has been a very worthwhile activity but issues of sustainabilitiy (at other Universities for example they have IPL centres which support these kinds of endeavours) question whether or not this activity will continue. Even if this was accommodated on the university campus there would still need to be a budget of some sort to support it.
Given the length of time available to run the session and the amount of material we needed to provide as core understanding on communication impairment it does make the guidelines for interprofessional learning difficult to adapt.
Is there anything else you wish to add?
I think that, when organizing this kind of event, the issue of Student Loading becomes a serious one. Getting the appropriate credit for the Department (especially when you consider all the time, energy and staff resource that goes into this type of thing) might encourage more of these kinds of events.
Do you have any quotations from staff or students that you can cite?
- 'It was good to think about key strategies for how to communicate with people with impairments'
- 'Good to see extremes of communication impairment and was able to appreciate how they would affect me in my career as a dentist'
- 'I think every element was well balanced and about the correct length of time'
- 'Fantastic insight into what it is like to have a communication difficulty'
- 'It made me aware of possible things I might come across throughout my career and how to deal with different situations'
- 'I thought it was very informative and varied'
- ' The chance to see how people adapted what they said, to be able to obtain the information they needed'
- ' The videos gave a really clear impression of how difficult communication can be'
Where are you now? Update us on changes, recent successes, evolutions…
Not really sure where to go from here as this is so dependent on funding and the will of staff to be involved in this activity. This really highlights the need for the University to decide whether it will develop opportunities for IPL or not.
One possibility is to apply for a Learning and Teaching Grant and make this material available through a DVD for relevant staff to use or for students to watch individually.
Update from the Human Communication Sciences News Bulletin, December 2007:
"Jasvinder Khosa gave a moving account of his personal experiences as a dysphasic speaker. In addition, all students took part in a role play task requiring them to communicate personal details in an accident and emergency unit, such as stating whether they had any allergies. The person who played the patient only had the use of the word ‘yes’".
Further relevant articles/references and websites to read if interested in this subject: http://www.cuilu.group.shef.ac.uk/
Supporting evidence (photos, multimedia files, relevant documents, links):
To discuss this Case Study/Contact Details: Shelagh Brumfitt
Copyright University of Sheffield 2007-2008.