As the complexity of caring for people with mental health needs increases, more and more consultants are working in interdisciplinary teams to respond to the acute and chronic needs of their clients. Many people with severe mental illness may also have concurrent physical disorders such as cardiovascular or nutritional / metabolic disorders (e.g. diabetes, obesity), as reviewed by Mark De Hert and colleagues in 2011. These individuals require increased medical care with the involvement of doctors, nurses, dietitians, and radiological and clinical laboratory specialists. Social work also coordinates care with mental health teams to support resources in the community and with vocational rehabilitation counselors to help with employment needs. Therefore, the consultants' understanding of the role and function of interprofessional collaboration in the delivery of care is critical to achieving high quality outcomes.
As a counselor educator, I strive to enable students to develop strong communication and leadership skills during their clinical training. When I invite alumni to speak with students about various aspects of career development, many are discussing their work on community mental health teams. They state that they need to learn to work with people outside of the counseling profession – nurses, psychiatrists, physical therapists, occupational therapists, speech therapists, social workers, pharmacists, police officers, and others. I began to understand that our students need to have better team-based mentoring skills. That's why I worked with our faculty to provide more opportunities to bring our students to a wider range of care providers and to do research on interprofessional education and practice (IPEP).
During this time I worked with faculties from physiotherapy and occupational therapy in our department for allied health sciences that were involved in IPEP. Through her, I learned more about IPEP in schools of medicine, nursing, and other health issues on campus. My personal contact with interdisciplinary care began in earnest when I was working part-time as a rehabilitation advisor in the inpatient acute rehabilitation unit of our hospital on campus as part of my duties at the clinical faculty. This put me in an interprofessional environment with providers from all health disciplines.
This required that I be part of a team of diverse professionals focused on providing high quality patient care, ranging from strong communication, an understanding of the roles of team members in providing care, and the use of best Practices in support of patient care depended on team. I've seen (and contributed to) the finest interprofessional practice that goes on every day. I was excited and worked with other allied health schools to find ways for our students to engage with one another. With the support of our dean, I became the IPEP coordinator for our department.
Two years ago, when our university management developed a campus-wide initiative to intentionally integrate IPEP and set up an official office for it, I was ready to represent our Department of Allied Health Sciences as director of IPEP. I work closely with fellow directors from all health disciplines, including public health, social work, business, and education, to intentionally build IPEP across curricula. The support from students and faculty was tremendous. I see the need to expand knowledge of IPEP to include counselor training as a whole and to build these efforts into our programs to ensure that future counselors can easily move into interprofessional care and become leaders in these teams.
Counseling educators should therefore be aware of current interprofessional teamwork practices and curriculum frameworks, which enable students to understand their roles in these teams, effectively describe and implement counseling services, and maintain the culture of interdisciplinary mentoring. Creating opportunities for advising students to participate in IPEP with stakeholders was a critical need identified by Kaprea Johnson and Krystal Freeman in 2014 in their work to integrate IPEP into mental health counselor training. This knowledge will help new consultants understand their role in a variety of environments and learn appropriate communication strategies for knowledge sharing in team settings. IPEP doctoral training courses also help dispel preconceived notions about the roles of other professional team members and underscore the importance of quality care.
Core competencies
In 2009, the Interprofessional Education Collaborative (IPEC) was founded by six national educational associations for health professionals dealing with nursing, osteopathic medicine, pharmacy, dentistry, medicine and public health. Her goal was to advance interprofessional learning strategies to improve team-based nursing skills and promote high quality health outcomes. The cooperation also established core competencies in the interdisciplinary supervision of clinical training programs for students. By 2016, IPEC had expanded its academic partnerships to include 21 health-related institutions. His vision is to promote interprofessional teamwork and collaborative practice that strengthens high quality, accessible, and person-centered care that improves the health of the population.
IPEC has four core competencies that guide curriculum content development:
Values / ethics for interprofessional practice to build and maintain mutual respect and shared values in patient care
Knowledge of roles / responsibilities in interdisciplinary teams for assessing and managing health needs
Interprofessional communication that supports and responds to team-based care as well as the treatment and prevention of diseases
Teams and teamwork that uphold high values and principles and recognize the roles of different team members in planning, delivering and evaluating patient care, programs and guidelines
The overall aim of the IPEP is that health workers learn from, with and from each other.
These competencies also promote the principles of the "quadruple goal" in health care. Three of the principles were originally developed by the Institute for Health Improvement in 2007 to promote health system reform to improve patient experience, reduce costs and achieve better outcomes. The fourth principle, which improves the clinical experience for providers, was added in 2015, primarily to address and manage doctor burnout.
Training opportunities for consultants that include these competencies help students understand their team roles, describe and implement their services effectively, learn appropriate methods of knowledge sharing in team settings, and maintain the culture of interdisciplinary teamwork. Overall, curriculum structures that promote opportunities to integrate IPEP competencies help develop graduates who are leaders in their fields. These graduates have the teamwork skills that can address challenges in providing quality health care, including counseling.
IPEP in relation to accreditation and licensing requirements
CACREP recognizes the need for counselor education programs to provide students with specific information and training about interprofessional care and their respective roles in these teams. On its website, CACREP claims to be a member of the Health Professions Accreditors Collaborative, which is committed to promoting learning opportunities that prepare students for interprofessional practice. The requirements for interprofessional educational opportunities are set out in the CACREP standards 2016 (19459002) in Section 2, Standard F.1.c. and Section 5, Standard D.2.b .
The 2014 ACA Code of Ethics, Section D, Relationships with Other Professionals, clearly states the importance of being part of interdisciplinary teamwork (Standard D.1.c.) and the professional and ethical obligations as a team member to understand (Standard D.1.d.). In 2017, the Code of Professional Ethics for Rehabilitation Counselors included guidelines for certified rehabilitation counselors who work as members of interdisciplinary teams and provide complex and comprehensive services for people with disabilities. Section E, Relationships with Other Professionals and Employers, describes these ethical responsibilities in standards E.1., E.2.a. and E.2.b.
Therefore, consultant training programs are called upon to build relationships among all stakeholders (administration, faculty, students and community partners for clinical education) who are critical to successful IPEP development and implementation, like Daniel Kinnair and colleagues (2012) and Kaprea Johnson and Krystal Freeman (2014).
IPEP experience for the training and development of consultants
Innovative ideas for incorporating IPEP experiences into counselor training include collaborative learning experiences with other professions, problem-based learning events, and simulation activities. One of the best approaches to starting IPEP development in counseling programs is to work with other departments on campus for opportunities that may offer similar graduate introductory courses that cover disability rights and current health issues such as quality indicators of care and differences in health Health care included nursing, implicit bias, and leadership development. These topics are useful for developing interdisciplinary journal clubs, case-based problem solving events, and opportunities for students to talk about their various professions or why they chose their career path in graduate school. Most importantly, these activities help students understand and clarify their roles and how they fit into interprofessional teams. Your professional thinking can be challenged by understanding different points of view, reducing the use of jargon, and building trust and leadership for future teamwork.
IPEP events that are more intentional with certain learning outcomes require more planning. However, working with other health professionals on campus or on-site internships to develop opportunities prevents reinvention of the wheel and models interprofessional collaboration for students. Examples of IPEP activities aimed at specific learning objectives for students include case-based learning experiences, seminars with discussions and debriefings in small groups, and clinical simulations where videos or actors are used to play patients and depict various health problems and patient ages. Service learning opportunities, particularly focused on rural health care, can bring together students from many disciplines, including business, education, justice, and faith-based organizations. These opportunities serve as excellent ways to learn from, with, and about each other in order to serve the community.
Field internships for clinical work offer integrated opportunities for IPEP in clinical agencies in which interdisciplinary teamwork is offered. These teachers have practical knowledge of their teamwork and examples of interprofessional care that works and doesn't work. They may also provide counseling opportunities for students to incorporate counseling theory into IPEP practice and to reflect possible ethical dilemmas for counselors in providing team-based mentoring. These environments can help all students, not just counseling students, learn to deal with complex problems and bridge theory to practice difficulties in delivering clinical care as new professionals. In addition, these experimental learning opportunities are very important to IPEP as they provide environments in which professionals and students can interact and reflect on practices for improved care.
It is important to note that the four IPEC core competencies discussed earlier should always guide IPEP initiatives and the curriculum of a program. Students and faculty should be able to explain how the activity fulfills the competencies. Participant assessment for each event is critical to ensure that the goals of the training are being achieved and that this is a valuable learning opportunity. The development of the Faculty of Counseling Educators and Other Health Disciplines, as well as IPEP Partners, is critical to the design, development, implementation and evaluation of successful learning opportunities.
When planning IPEP events, it is important to involve students from the start. You may have friends or contacts in other departments or community agencies who have resources or programs that can help plan and run events. Encouraging students to take leadership roles in working with the faculty to develop IPEP on campus is an excellent way to develop their leadership skills and get involved in interprofessional learning.
Value in the consultant development
The inclusion of IPEP in counselor training programs can improve opportunities for clinical participation in other related disciplines in a way that helps counselors develop strong professional identities. Well-planned IPEP activities build on knowledge learned in the classroom and improve critical thinking skills by assessing complex care needs from multiple perspectives. Additionally, students will see faculties and professionals from other disciplines collaborate during IPEP activities, modeling effective interprofessional teamwork that may not be experienced during training.
IPEP training provides students with the opportunity to better understand aspects of patient-centered care, holistic treatment, and shared decision-making practices that support teams in their goals for achieving outcomes. Most of all, however, the students enjoy IPEP events. They will of course form their own interdisciplinary groups for further discussion after participating in IPEP opportunities and develop friendships that may lead to building a better workforce in the future.
Our students have their own campus-wide student executive committee with representatives from all schools participating in the IPEP. They plan formal and informal events that promote IPEP and act as links between the IPEP office and student groups across campus to raise awareness of interprofessional learning and collaboration as part of their academic experience. These students are leaders on campus and will also develop into our future leaders in counseling and team-based community care. Because of this, we have a deep commitment to IPEP on our campus. And they are worth it.
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Judy Schmidt is Director of Interprofessional Education and Practice (IPEP) in the Department of Allied Health Sciences at the University of North Carolina at Chapel Hill. She is a member of the university's IPEP office leadership team dedicated to working together to transform health education and prepare professionals from different disciplines to better work together to deliver quality patient care. She is a clinical assistant professor in the department and a certified rehabilitation advisor. Contact her at [email protected].
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