WV RURAL HEALTH EDUCATION PARTNERSHIPS

FACULTY DEVELOPMENT COMMITTEE

 

Training Manual for Interdisciplinary Session Facilitators

 

Ways to Increase Student Participation in IDS sessions

 Michelle Kopf  RN, MS, C-FNP

Rivers & Bridges Consortium

Rt. 1, Box 615A

Scarbro, WV 25917

 

 

An IDS session is a unique setting that allows the interdisciplinary student team to teach each other while being guided by an IDS facilitator.  The goal of a successful IDS is full and lively participation by all students. It’s more about the process of uncovering history and physical findings and discussing possibilities of diagnosis, care and treatment of the patient with the inclusion of many disciplines – not just getting the “right answer to the diagnosis”. Without student participation, a facilitator will be tempted to teach or lecture in order to move things along and get to obvious conclusions.  This slippery slope can lead to a traditional classroom type setting that encourages students to watch/listen to the facilitator instead of listening/learning/sharing with fellow students. 

 

This chapter is divided into FIVE SECTIONS.  Each dealing with a different aspect of an IDS which can be used to effectively encourage student participation.  Remember that the specific suggestions reflect a larger paragon.  Some ideas will not be comfortable or feasible for all facilitators or consortia.  The variations are infinite and no doubt, as you grow into your IDS facilitator role, you will decide which suggestions work best for you, as well as discovering new approaches.

 

SECTION 1 -  THE SETTING

 

Make the setting as comfortable as possible:

1.  Good lighting

2.  Temperature controlled comfortably

3.  Provide a table or other writing surface

4.  Arrange the students facing each other

5.  Some consortia offer snacks or meals

6.  Use humor from the very beginning.  It will set a mood and take away some of the students’ anxiety.  HAVE FUN!

 

Introductions:

1.  Have an icebreaker ready for the group

2.  Each participant should introduce themselves by telling the group which discipline they represent, what year they are in,      where they are doing their clinical rotation, and their preceptor’s name.

3.  You may also ask them to share recent community service projects, interesting cases, etc.

 

Have everyone agree to the ground rules from the beginning:

1.  Every student is expected to participate

2.  There should be one speaker at a time

3.  The group should be respectful and non-judgmental.  Sometimes the wrong answers can stimulate the most discussion and learning.

4.  Cell phones and beepers should be turned off, or at least placed in vibrate mode

 

Think outside the traditional setting:

1.    Community pharmacy

2.    Exhibition Coal Mine

3.    Domestic Violence Shelter

4.    Black Lung Clinic

5.    School Based Health Center

6.    Mock rock-climbing accident in the New River Gorge

7.    Scavenger hunt for medical resources in a community

8.    Home visits to a patient

9.    Ambulance ride-a-long

10.  Focus group in a local church

11.  Visit a local compounding pharmacy

 

Props related to the case can help spark participation:

1.  A set of crutches, allow a PT student to demonstrate proper technique to the group.

2.  Dental molds and photographs, allow a dental student to explain unique techniques.

3.  A community resource binder, allows a social workers to explain case management.

4.  A scoliometer, allows a nursing student to demonstrate correct scoliosis screening.

 

 

 

SECTION 2 -  THE FACILITATOR

 

Understand adult learning principles.  Malcom Knowles identified the following characteristics of adult learners.

1.  Autonomy and self-direction are key to adult learning.  The facilitator must guide the adult learner to their own knowledge, not pummel them with facts.

2.  Life experiences and knowledge, already present, need to be connected to the IDS for the adult learner to recognize the value.

3.  Adults are goal-oriented.  Facilitators must explain how this IDS session is going to help the adult learner reach personal and school objectives.

4.  Adults are relevancy-oriented.  The facilitator should assure that the IDS topics and objectives are applicable to the adult learners.  Often, this is achieved by letting the adult learners choose topics and discussion paths that reflect their own interests.

5.  Adults are practical.  The facilitator should communicate how the IDS benefits the adult learners current situation, as well as their eventual entry into their profession. 

6.  Adults expect respect.  Facilitators should remind adult learners that they already possess great attributes, and encourage them to share their experiences with the other students.

 

Knowles, M. (1978), The Adult Learner: A Neglected Species (2nd ed.), Houston: Gulf publishing.

 

Facilitate, don’t lecture:

1.  If you provide all of the conversation, the students won’t share with each other.

2.  If the group seems to be relying on, or deferring to the facilitator, tell them you are going to the next room for ten minutes and when you return, they should have a plan to discuss this case and involve each other’s disciplines.

3.  The facilitator should not provide the group with a lecture, “PowerPoint” presentation (unless demonstrating clinical findings) or copies of past presentations. The group is responsible for developing and nurturing the IDS.

 

Ask, don’t tell:

1.  It will be tempting to tell students the correct answer, especially if they seem to be struggling.  It is more beneficial to ask questions that spark their critical thinking skills and eventually lead them to developing an answer.

2.  Ask discipline specific questions to encourage participation.  For example, “Why would dental visits be important for a patient taking Dilantin?” This question addresses the dental, pharmacy, nursing and medical disciplines.

 

Introduce non-discipline specific questions to stimulate participation:

1.  Ask a question that covers ethical, moral, or professional issues.

2.  Ask questions specific to rural health issues, using local data if ppossible.

3.  Ask questions related to prevention issues/Healthy People 2010. (if you are unfamiliar with HP 2010, please refer to the appendix of this manual).

 

Encouragement and praise:

1.  Traditionally, there is a hierarchy in the health fields.  Verbally praising a student in the presence of their peers and colleagues demonstrates interdisciplinary respect and a feeling of trust.  Both these properties can lead to increased participation and risk taking.

Acknowledge deficits:

1.  If you are unfamiliar with the area of discussion, let the students know; it’s an excellent example of why the disciplines must rely on each other to complete a task.

2.  If the discussion steers into an area that cannot be addressed by a group member, it should be added to the list of learning issues (see SECTION 5) to be explored later.

 

 

SECTION 3 -  THE STUDENTS

 

Provide clear expectations:

1.  The student presenting the IDS case should call the facilitator a week before the presentation to make sure they are proceeding in the right direction and will meet IDS objectives.

2.  Remind the students to talk to each other during the IDS, not just give the report to the facilitator.  The students are responsible for the IDS and it’s outcome.

3.  Anecdotal comments are encouraged, have FUN!

4.  Everyone is expected to participate in active learning.

5.  Everyone will be responsible for researching a learning issue (see SECTION 5).

 

 

SECTION 4 -  THE CASE

 

Involve all disciplines:

1. Participation will increase if each of the students appreciate that their discipline is being acknowledged and valued.

2.  If a particular discipline is not represented at an IDS, the facilitator should address the issue.  For example, a facilitator should prompt medical and nursing students to discuss the role of physical therapists or dentists in the case, if students from those disciplines are not present.

 

Keep it simple:

1.  The case chosen should not be a zebra. In other words, the case should reflect situations that will be commonly seen in rural settings, not a specialist’s office.  Students are more likely to participate if they are not made to feel out of place or over their head.

2.  The student presenting the case should be familiar with the patient/problem, but it is not necessary for them to supply the rest of the group with a written report.  The most interesting cases usually start with one or two sentences representing the chief complaint.  It’s the responsibility of the group to flush out the case by asking questions, applying theories and using critical thinking.

 

Current patient:

1.  Every attempt should be made to have the student present a real case.  The case should be someone the student has encountered on their current rotation.  A canned case will feel like busy work to the IDS participants and lends itself to predetermined conclusions and outcomes.

 

Healthy People 2010:

1.  The student should be able to identify and share specific Healthy People 2010 objectives related to their case presentation. This activity defines a relationship between the patient, the community, the state, and our nation.  Expanding the scope of health in this way encourages further participation and discussion.

 

 

SECTION 5 -  THE LEARNING ISSUES

 

Student driven:

1.  The facilitator may want to keep a list of questions that went unanswered during the IDS.  This list can be read at the end of the IDS to help remind students what learning issues were raised, but the students should choose their learning issues based on their interest and resources.

 

Should be relevant, but not limited:

1.  The case should be a starting point for choosing learning issues, but it should not define specific categories.  For example, a breast cancer case may generate learning issues such as preventive health measures in middle age woman, osteoporosis risk during menopause, dental problems and chronic disease, nutrition and rehab requirements after surgery, self esteem and intimacy issues after diagnosis, etc.

 

Concise:

1.  The learning issue assignment should not involve a full written report.  As with the IDS, this activity should be a discussion among the students, with an emphasis on shared knowledge that can be applied to their patients/clients.

2.  In some instances, it may be helpful for the student to prepare a short handout for the rest of the IDS team.  For example, someone researching antibiotic prophylaxis prior to a dental procedure, may want to provide a written list of current recommendations. 

 

 

 

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CONCLUSION

 

Remember, the success of an IDS hinges on full student participation.  These FIVE SECTIONS are basic recommendations to encourage interaction, but the IDS facilitators are encouraged to customize the approach to match their setting and further enhance the experience.  Guiding the students in a manner that encourages session ownership and interdisciplinary teamwork will lead to success.

 

Michelle Kopf  RN, MS, C-FNP

Rivers & Bridges Consortium

Rt. 1, Box 615A

Scarbro, WV 25917

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