Latest / OT Potential Podcast | Occupational Therapy CEUs / #158 Interprofessional Education with Michael Sy

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#158 Interprofessional Education with Michael Sy · OT Potential Podcast | Occupational Therapy CEUs

0:00
SPEAKER_00: In the United States, therapy professionals are mostly educated in silos.
0:05
SPEAKER_00: So it is no wonder that when we get into the real world, we often struggle with interprofessional collaboration.
0:12
SPEAKER_00: If we want to collaborate better in practice, the fix starts upstream in how we learn.
0:18
SPEAKER_00: Medicine, nursing, and pharmacy have already embraced interprofessional education.
0:23
SPEAKER_00: But if interprofessional education is how we improve care delivery, why has therapy been so slow to adopt it?
0:31
SPEAKER_00: Will it make us lose our distinct value?
0:33
SPEAKER_00: Will it actually work?
0:34
SPEAKER_00: And if so, how do we measure it?
0:36
SPEAKER_00: And what does interprofessional education actually look like in practice?
0:41
SPEAKER_00: To answer these questions and more, I'm excited to welcome to the podcast Michael Sai, an OT researcher who writes and studies on this exact topic.
0:51
SPEAKER_00: I hope this conversation inspires you to think about how you collaborate across professions and to see that it can begin with learning together.
1:00
SPEAKER_00: We have a lot to cover today, so let's dive in.
1:05
SPEAKER_00: Welcome to the OT Potential Podcast.
1:08
SPEAKER_00: I'm your host, Sarah Lyon, OTRL, and I wanted to let you know that this podcast may qualify as continuing education for you.
1:16
SPEAKER_00: You are probably listening to this podcast on a free podcast platform, but to gain CEU credit, you will need to be a member of the OT Potential Club, our OT Continuing Education platform.
1:28
SPEAKER_00: You can go to OTpotential.com to learn more.
1:32
SPEAKER_00: Okay, here we go.
1:36
SPEAKER_00: As I mentioned at the top, joining us today is Michael Sai, PhD M H P E D O T R.
1:43
SPEAKER_00: Michael is a senior researcher and lecturer at Zurich University of Applied Sciences.
1:49
SPEAKER_00: His research spans occupational therapy, occupational science, health professions education, interprofessional education and practice, and the health social sciences.
2:00
SPEAKER_00: Through this role, Michael leads research projects, works with an interdisciplinary and international team, and co-develops educational and practical tools to advance occupational therapy in Switzerland, Europe, and beyond.
2:14
SPEAKER_00: Michael has more than 17 years of experience in occupational therapy, and he brings that together with his background in health professions education and international health.
2:25
SPEAKER_00: He also serves as adjunct faculty at the University of Southern Queensland, at Dalhousie University, and the University of the Philippines Open University.
2:35
SPEAKER_00: Beyond his university roles, Michael teaches students, professionals, and community members on topics related to his research, as well as health, well-being, and social justice.
2:45
SPEAKER_00: He consults with organizations, governments, and communities who want to support improving the work they do.
2:52
SPEAKER_00: So without further ado, we will patch Michael into our live studio.
2:56
SPEAKER_00: Mike, welcome to OT Potential.
2:58
SPEAKER_00: It's so great to have you.
3:00
SPEAKER_02: Hi, Sarah.
3:01
SPEAKER_02: Thank you for having me today.
3:03
SPEAKER_00: I am so thankful to be able to talk about this topic.
3:08
SPEAKER_00: When I think of healthcare, especially here in the United States, I tend to think about how just disjointed it is.
3:20
SPEAKER_00: For our patients, they tend to go from specialist to specialist.
3:25
SPEAKER_00: Lots of things fall through the cracks.
3:28
SPEAKER_00: That's a recurring thing we hear on our episodes.
3:32
SPEAKER_00: And as they're going from professional to professional, we tend to all be starting from scratch on our admin work.
3:39
SPEAKER_00: Like not so many things are not shared across encounters.
3:46
SPEAKER_00: And this is such a difficult, difficult thing to solve because there's so many systems at work.
3:52
SPEAKER_00: It's so complex.
3:54
SPEAKER_00: But I've really begun to believe that a big part of the solution is upstream in our education and moving more towards interprofessional education.
4:06
SPEAKER_00: So I'm so just thankful to be able to look at this topic today to dive into it and uh answer uh some of the questions about it.
4:17
SPEAKER_00: Before we get to those logistics, though, I just want to hear about your story.
4:22
SPEAKER_00: How did you become interested in OT and interprofessional education and then end up as a researcher and studying it?
4:32
SPEAKER_02: Thank you, Sarah.
4:33
SPEAKER_02: Um, well, I studied and uh and was trained as an OT uh in the Philippines 20 years ago.
4:41
SPEAKER_02: Uh and I actually went to OT by accident.
4:44
SPEAKER_02: It was not my first choice.
4:46
SPEAKER_02: I was actually encouraged to study nursing um earlier.
4:53
SPEAKER_02: But then again, um I mean nursing was very attractive because it's it makes you go abroad easier, you know, in our culture, it's it's how it is.
5:03
SPEAKER_02: But there's something in occupational therapy uh that made me go into it.
5:10
SPEAKER_02: Um it I think it's the flexibility and the how creative we can be as occupational therapists that made me more drawn into it and actually complete the the degree because I really wanted to work with people since I was in high school.
5:26
SPEAKER_02: So I I I thought that hey, um you could be a nurse, you can be a doctor, you can be a physio, but hey, OT uh made it.
5:34
SPEAKER_02: I I wanted just to be an OT.
5:36
SPEAKER_02: And then I fast forward I I went into pediatric practice.
5:41
SPEAKER_02: I worked in in pediatric care for six years.
5:45
SPEAKER_02: And then during that time, when I was working in clinical practice and also in school, in schools, I realized that people don't talk to each other.
5:56
SPEAKER_02: You know, they just go there, they make their notes, they go out, they go home and come back.
6:02
SPEAKER_02: And there is this confusion that made me really uncomfortable because we're dealing with people with lives, and I realized like, hey, we should collaborate more, we should talk more.
6:13
SPEAKER_02: Um, we should not only think about our own professions, we should also be cognizant and sensitive of what our physiocolleagues are also doing, our speech therapy colleagues.
6:25
SPEAKER_02: What are they doing?
6:26
SPEAKER_02: Um, how are they helping my patient?
6:28
SPEAKER_02: Because there's they are also my patient.
6:32
SPEAKER_02: So I was really reflecting on that while in clinical practice and thought that, hey, there should be something that we should do, and that's interprofessional work.
6:42
SPEAKER_02: And I discovered interprofessional education and practice when I was doing my master's in health professions education.
6:50
SPEAKER_02: And in 2011, I attended a conference in Japan about this topic, and I did not submit any abstract.
6:59
SPEAKER_02: I just wanted to learn.
7:00
SPEAKER_02: I was just, I just dove into that conference just like a sponge, where I wanted to learn about what is this all about.
7:10
SPEAKER_02: And to cut the long story short, that led me to doing my master's thesis about attitudes of Filipino occupational therapists, physios, and speech therapists on interprofessional collaboration.
7:23
SPEAKER_02: So uh just uh to make it short, that's how I ended up in this field.
7:30
SPEAKER_01: Yeah.
7:31
SPEAKER_00: Oh, that's so fun to hear.
7:34
SPEAKER_00: I am sure so many of us relate to just being really early in our education journey and looking at the different health professions and probably considering multiple avenues that we could go.
7:47
SPEAKER_00: Most people consider like once you narrow in a healthcare, then you're choosing a couple, um, or you're usually narrowing it in.
7:57
SPEAKER_00: And then we tend to choose to go into therapy, one, because we just love working closely with patients um and the time we get, but two, on some level, I would think that we're also drawn to this work because it's hypothetically a very team-oriented profession.
8:20
SPEAKER_00: All therapy professions, I say would say, are very team-oriented.
8:24
SPEAKER_00: So it is disappointing to get into practice and to feel so siloed.
8:31
SPEAKER_00: Um, not only is it like professionally disappointing, it's so frustrating to watch our patients fall through the cracks.
8:39
SPEAKER_00: Like it's, I don't, is it one of the big disappointments of our work?
8:45
SPEAKER_00: Maybe.
8:45
SPEAKER_00: Like it just is it hurts our hearts to see this.
8:49
SPEAKER_00: I'm curious as we begin this discussion to hear how you define interprofessional education and why it's important.
9:00
SPEAKER_00: I think it feels like fuzzy and good feelings, but how is it defined and why is it important?
9:09
SPEAKER_02: Okay, so I'm going to use the classical definition from the World Health Organization, which was um 20, 20 years old, 2010, no?
9:20
SPEAKER_02: Yeah, um, 20 plus years old.
9:22
SPEAKER_02: And I just want to define first interprofessional education, and then I'll define interprofessional practice.
9:29
SPEAKER_02: They are relate, they're different, but they're related.
9:32
SPEAKER_02: So interprofessional education is an occurrence where two or more members of the team coming from different professions learn with, from, and about each other.
9:45
SPEAKER_02: And the goal of this learning process is to support better health outcomes through team-based care.
9:52
SPEAKER_02: So the better health outcomes should be seen for the patients primarily, and health outcomes should also be part of how we provide quality work.
10:05
SPEAKER_02: This interprofessional education happens in the university or in training or when you're doing continuing professional development.
10:14
SPEAKER_02: And this competencies that you learn through this education must be translated as a competency in practice.
10:24
SPEAKER_02: And that's where you call uh that's where you have your interprofessional practice or interprofessional collaborative practice.
10:32
SPEAKER_02: This learning and practice should develop into a competence so that you can enact or actuate collaborative competencies, for example, teamwork, team communication, conflict management, and developing patient-centered care.
10:54
SPEAKER_02: These competencies need to be used or applied in practice so that your patients get better health outcomes.
11:02
SPEAKER_02: So the context or the setting where interprofessional practice is seen is in the practice itself.
11:10
SPEAKER_02: Whether it's a clinical, it's in clinical practice, where it maybe it's in community practice or mental health practice, that's where the IPE should go towards.
11:23
SPEAKER_02: So that's how the WHO defines it.
11:26
SPEAKER_02: I hope that's helpful, Sarah.
11:29
SPEAKER_00: Yeah, I wrote down it's with, from, and about each other.
11:34
SPEAKER_00: So it's not us sitting in our OT or PT classroom and seeing a PowerPoint about the other professions.
11:42
SPEAKER_00: It's literally getting in the same room, learning from different and maybe learning from another profession, learning alongside people, and also learning about our different roles.
11:53
SPEAKER_01: Yes.
11:54
SPEAKER_00: Um, so honestly, it's more complex than what I first think of.
11:58
SPEAKER_00: Like it's not just learning about each other, it's learning with each other.
12:02
SPEAKER_00: I have one quick follow-up about that, just about the backdrop around 2010.
12:07
SPEAKER_00: It just felt like uh like when I look at the different associations, they all started around that time.
12:12
SPEAKER_00: I think there was like concerns around patient safety in the backdrop.
12:17
SPEAKER_00: Like what was going on in 2010 where all of a sudden we were like, we need to revolutionize what we're doing and have more interprofessional education.
12:25
SPEAKER_00: Do you have any insight there?
12:27
SPEAKER_02: Yes.
12:28
SPEAKER_02: Yes, Sarah.
12:29
SPEAKER_02: Um, I don't have the numbers with me right now, but I guess one of the motivation as to why this framework for interprofessional education practice were developed and established at the time was because of clinical errors.
12:45
SPEAKER_02: That's one.
12:46
SPEAKER_02: And clinical errors are often documented, and there is an increase of that.
12:52
SPEAKER_02: And unfortunately, people get more injured or become more sick, or unfortunately, some die just because of miscommunication or not communicating at all, which is related to teamwork, you know.
13:13
SPEAKER_02: I mean, in in any hospital, I think it's not only the therapy professions who are team-oriented.
13:19
SPEAKER_02: All the healthcare and even the social care professions must be team-oriented.
13:24
SPEAKER_02: But this is not happening.
13:25
SPEAKER_02: And I think it is because of the context where we work.
13:29
SPEAKER_02: It's a very busy clinic, clinical work.
13:33
SPEAKER_02: There's too many things that you need to think about apart from just treating and assessing patients and providing services.
13:41
SPEAKER_02: So this part of teamworking or communicating is often missed, which could lead to detrimental effects, such as clinical errors.
13:53
SPEAKER_02: And these clinical errors are recorded and it is worrisome for the healthcare organizations.
14:01
SPEAKER_02: That's why they decided to create a framework making sure that patient safety is at the core of why we need to do interprofessional education and practice.
14:13
SPEAKER_00: Yeah, that goes or connects to, to me, the phrase can just feel like a warm fuzzy, but in reality, it's very directly tied to patient care and error reduction.
14:28
SPEAKER_00: It definitely makes me think of the United States where we do not have the best outcomes in the world and we are highly siloed here.
14:36
SPEAKER_00: And there's just it's a weird reality where, like, we are documenting, we're writing a lot, but you can just feel the mis the miscommunication happen, or that we're not closely collaborating a lot of the times.
14:50
SPEAKER_00: You've researched interprofessional education and collaboration from multiple angles.
14:56
SPEAKER_00: I'm so curious what you've learned about it as you've dug into it.
15:01
SPEAKER_00: What has surprised you and what feels helpful?
15:04
SPEAKER_00: What would have helped you as you were practicing as that pediatric therapist back in the day?
15:10
SPEAKER_02: Yes, I've I've done several research, and one thing for sure that I uh how can I say reflected upon reading research or even producing our own results would be that people and healthcare professionals actually want, in theory, to collaborate.
15:36
SPEAKER_02: It's just that it's difficult to actually demonstrate that and match that with numbers in terms of patient outcomes because the system does not allow it.
15:48
SPEAKER_02: That's one.
15:50
SPEAKER_02: Um, another thing based on the research that I did several years ago when I was starting working on IPE and R is that interprofessional competencies, I just defined that earlier, uh, that interprofessional competencies can be developed definitely by any healthcare professional, but it is not a linear path.
16:14
SPEAKER_02: Because there we have this default thing when we say, Oh, we I want to be a competent occupational therapist or a physio or a speech therapist.
16:24
SPEAKER_02: I would start from being a novice and then I go into beginner mode, and then I go to intermediate and then advanced.
16:33
SPEAKER_02: Um, interprofessional education does from based on my research, it does not happen like that.
16:41
SPEAKER_02: It's nonlinear.
16:42
SPEAKER_02: You can be good in one competencies, and then you can fall back because of certain situations happening.
16:49
SPEAKER_02: You might not be as confident in confronting your colleague when you see some errors.
16:54
SPEAKER_02: And error errors should be seen as um a source of learning, error-based learning, you know, um, and not something that you feel like, oh, I'm not competent enough.
17:04
SPEAKER_02: It it should make you competent, you know, when you when you try out things, when you try to experiment, how you communicate with your colleagues, etc.
17:13
SPEAKER_02: And I just uh I say that it's nonlinear because of the perceptual dip.
17:20
SPEAKER_02: So, you know, I call it the perceptual dip, which connotes to the idea that our perception when we finish university or when we freshly finish school and start to work as an OT, we're so excited to work or to collaborate.
17:40
SPEAKER_02: So we have this very heightened perception of wow, it's so nice to work, teamwork, I just learned it in school.
17:48
SPEAKER_02: Now I'm ready to apply it.
17:50
SPEAKER_02: And then after the first three years of practicing, you will there there was this decrease in terms of how you perceive collaboration.
18:02
SPEAKER_02: And we found it in two of the studies.
18:04
SPEAKER_02: I'm not trying to generalize things, but this is what we found in the Philippines that it it decreases in the first three years and then it it goes a little bit up again when you pass the three years in practice, because that's where learning happens, not right after you finish, you know.
18:22
SPEAKER_02: So there is this dipping because I think the way we interpreted the dipping part of the perception, like, oh, collaboration is not working, or I don't want to collaborate anymore, is because they hit their heads on the system that does not allow or encourage collaboration.
18:40
SPEAKER_02: So that's where it happens.
18:42
SPEAKER_02: And so you have to relearn again, you need to fall back again.
18:45
SPEAKER_02: Okay, how do I do it again?
18:46
SPEAKER_02: And and again, these encounters in practice should allow us to develop our competencies and not discourage us.
18:55
SPEAKER_02: And also, discouragement is part of it, of course, as you know.
18:59
SPEAKER_02: And so, um, and I just one more thing based on the research, I'm just gonna add this.
19:05
SPEAKER_02: One thing that I have been reflecting on is that interprofessional competence is not just being nice at work or just being so, hey, I want to do teamwork.
19:17
SPEAKER_02: It's not just about that, it is also about being able to professionally manage conflicts and disagreements within colleagues in teams, especially when you are disagreeing and advocating for your patient.
19:33
SPEAKER_02: You're disagreeing because you wanted this to be done or not this.
19:39
SPEAKER_02: And and this can be very difficult for any professional, whether you're a fresh graduate or even if you're quite senior in your position.
19:51
SPEAKER_02: And hopefully, um this kind of competencies should be emphasized more in schools, how to to manage disagreements, how do you communicate better, um, especially when you communicate with medical doctors who who and because you know, as therapists, we see our patients more often, right?
20:14
SPEAKER_02: And we we also have this closer, I would say closer relationship with our patients because they sometimes trust us, you know, to tell us their story.
20:23
SPEAKER_02: So we we have more information as well.
20:26
SPEAKER_02: And so sometimes disagreement is for the betterment of the patient, but this is not very easy to to develop.
20:33
SPEAKER_02: So those are some of the things that I learned through the research that I've done, Sarah.
20:41
SPEAKER_00: Two things in what you just said really intrigued me.
20:45
SPEAKER_00: One, just the non-I'm really interested in nonlinear progress.
20:50
SPEAKER_00: I think we talk about that a lot in terms of just like a patient's healing journey, is typically nonlinear.
20:56
SPEAKER_00: To me, nonlinear progress just means, oh, you're doing something really hard.
21:01
SPEAKER_00: Like if you're doing something hard, there's naturally going to be setbacks.
21:04
SPEAKER_00: And I would definitely put interprofessional collaboration in that bucket.
21:09
SPEAKER_00: I'm really intrigued by the three-year window that you said.
21:14
SPEAKER_00: Um, I always tell people with no data to back it, I'm just like, it takes three months to when you're starting a new job.
21:21
SPEAKER_00: The first three months are your like find the bathroom phase, like you're just like learning the logistics.
21:27
SPEAKER_00: But it really takes three years to feel adapted to a new setting.
21:34
SPEAKER_00: I wonder if that's how long it takes to build professional relationships.
21:39
SPEAKER_00: Like if you're doing interprofessional collaboration, I don't know.
21:43
SPEAKER_00: Does it just take three years to feel confident in your setting and build relationships to where you're finally at the point you can collaborate more?
21:54
SPEAKER_00: Yeah, the three year window is really interesting.
21:58
SPEAKER_02: In our inner research, we Put a range of one to three years.
22:02
SPEAKER_02: So it can be between one to three years.
22:04
SPEAKER_02: So yeah.
22:05
SPEAKER_02: We did not generalize anything that it takes three years to adjust in your workplace.
22:12
SPEAKER_02: But depends on the workplace.
22:15
SPEAKER_02: I believe there could be workplaces that are easier to adjust in.
22:22
SPEAKER_02: It really depends on the complexity of the system.
22:28
SPEAKER_02: Especially when you are, for example, you live here and then you move to another state or another region to work.
22:38
SPEAKER_02: So that can add up to the time you need to adjust and adapt in a certain workplace.
22:47
SPEAKER_02: So yeah, but I yeah.
22:50
SPEAKER_02: I don't know if if if that's still true, but yeah, I think it can take up to three years to adjust.
22:56
SPEAKER_02: Yeah.
22:57
SPEAKER_00: Yeah.
22:58
SPEAKER_02: Yeah.
23:00
SPEAKER_00: We've we're talking about interprofessional education and interprofessional um collaboration or practice kind of hand in hand.
23:09
SPEAKER_00: And I want to zoom in a little bit on the logistics of this interprofessional education.
23:15
SPEAKER_00: I want to ask why this year in 2026, why is it so important in this moment in time?
23:24
SPEAKER_00: It's been around since like 2010.
23:26
SPEAKER_00: There's been a push for it, but I just have this sense that it feels more important than ever.
23:34
SPEAKER_00: Why is it important today?
23:37
SPEAKER_00: And is there a renewed focus around it?
23:41
SPEAKER_00: Or is that just me just feeling that myself?
23:45
SPEAKER_02: Well, that's quite a challenging question, actually, because before I answer, if it's relevant, there have been newer things that universities and the higher education institutions are busy with.
24:02
SPEAKER_02: AI, you have simulation-based learning, you have different kinds of technologies that the students need to learn, which are important, I would say.
24:15
SPEAKER_02: But uh interprofessional education is not a new concept.
24:20
SPEAKER_02: It has been around the idea, the principles behind it, has been around in this in the 70s and the 80s.
24:29
SPEAKER_02: It's just that you know it it became more formal, the name, it becomes more, it became more standardized the name of interprofessional work.
24:39
SPEAKER_02: But I think it has become more relevant right now, or maybe more heard right now, because of the complexity of our healthcare assistance, because of the many conditions now that are being diagnosed, and so people's health becomes more complex.
24:59
SPEAKER_02: Services also become more complex.
25:02
SPEAKER_02: We have more professionals, we have professionals also working as assistants, we need to coordinate with different kinds of people and not only healthcare workers, we also need now to collaborate with social care.
25:18
SPEAKER_02: We have patients who have health issues, but also legal and social issues.
25:24
SPEAKER_02: Hence, this need to coordinate and collaborate becomes more relevant, I would say.
25:32
SPEAKER_02: But it does not just become relevant now, it has always been.
25:37
SPEAKER_02: Maybe it's just more magnified or right now because it's people talk more about it.
25:44
SPEAKER_02: Um, because when I started thinking about interprofessional education and sharing it with my colleagues in 2011, people have no idea what I'm talking about.
25:56
SPEAKER_02: That was years ago.
25:57
SPEAKER_02: But now when you say interprofessional, people have an idea what I'm what it is.
26:03
SPEAKER_02: So yeah, but I think the value has been magnified, but it has always been important, I would say.
26:13
SPEAKER_00: Yeah, and as we're when I think of like the new technologies and AI tools entering into our workforce, I see two things happening.
26:23
SPEAKER_00: One, a lot of us are just seeing new technologies at our point of service.
26:27
SPEAKER_00: I just saw an EMR, um, it was in um home health like six months ago, where you saw the OTPT SLP goals just side by side.
26:38
SPEAKER_00: And I was like, just little things like that are so helpful in understanding what each profession is doing.
26:46
SPEAKER_00: And I had never seen that before.
26:47
SPEAKER_00: Like, so as we get to see new tools, there's new opportunities to see professions side by side.
26:55
SPEAKER_00: And also, I also feel like the AI push, to me, it's been making me think a lot about the healthcare professional to patient, like that human connection.
27:05
SPEAKER_00: And this topic now is making me think about the professional to professional human connection too, and how valuable that is, and how it's something to be really protected in this new AI era.
27:18
SPEAKER_00: Um, it does feel really relevant.
27:22
SPEAKER_00: We've alluded to that there since 2010, we've had like frameworks coming out about what interprofessional education um entails, can look like.
27:36
SPEAKER_00: Can you orient me a little bit to what's out there and what the basic components overall of some of the frameworks are for interprofessional education?
27:48
SPEAKER_02: Yes, I can share one of the I would say more known frameworks in interprofessional education in practice from Canada, from the Canadian Interprofessional Health Collaborative, which was um revised in 2024.
28:07
SPEAKER_02: So it's quite uh up to date.
28:10
SPEAKER_02: And I'm not gonna go through that, we can share them later.
28:14
SPEAKER_02: Uh the link into the PDF.
28:17
SPEAKER_02: But there are six domains in there in the framework from CIHC.
28:22
SPEAKER_02: And the the first one uh would be on relationship-focused care, relationship-focused services.
28:31
SPEAKER_02: So that's one which um means that professionals should ensure that while they're there that they're not just delivering services, there has to be a trust between the patient, the family, and the professionals while providing the care services.
28:53
SPEAKER_02: So that's um one of the domains.
28:56
SPEAKER_02: You have your team communication, you have role clarification and negotiation, which is important.
29:03
SPEAKER_02: Sometimes the people think that negotiating is a waste of time, but actually, when you negotiate and clarify things, then efficiency becomes more uh relevant rather than the time.
29:16
SPEAKER_02: The fourth one is team functioning.
29:20
SPEAKER_02: Um, we have to remember that each team is different, there are no same team.
29:27
SPEAKER_02: There could be a team between OTPT speech, you can have a team between social worker, medical doctor, and an OT.
29:35
SPEAKER_02: You can have an OT or diatrist team.
29:38
SPEAKER_02: You can have different kinds of teams.
29:40
SPEAKER_02: So you every team should know why we are a team?
29:45
SPEAKER_02: How do we function as a team?
29:47
SPEAKER_02: That's very, very important.
29:49
SPEAKER_02: The fifth one is on uh disagreements processing, or what I said a while ago, conflict management competence.
29:57
SPEAKER_02: That's another domain.
29:59
SPEAKER_02: And the sixth one is on collaborative leadership.
30:04
SPEAKER_02: And this involves not only the healthcare professionals who are working uh with the patient directly, but also the admin, also the the people who you know make decisions upon about discharge.
30:21
SPEAKER_02: I mean, it's not just our team, but also within the institution.
30:25
SPEAKER_02: Are they facilitating or promoting collaboration or or not?
30:29
SPEAKER_02: So I think these are the six domains.
30:32
SPEAKER_02: They can you can look deeper into that.
30:35
SPEAKER_02: And this is just the framework that I'm the most familiar with.
30:39
SPEAKER_02: That's why I'm sharing it.
30:40
SPEAKER_02: There are also other others, but um, yeah, just to share one example.
30:46
SPEAKER_00: So let me try to restate this back.
30:50
SPEAKER_00: Interprofessional education is by with and for the team.
30:56
SPEAKER_00: So we're alongside each other, we're learning maybe from someone, it's planned by at least two professions.
31:05
SPEAKER_00: You're learning alongside other professionals, and then what you're learning can be these communication-based skills.
31:14
SPEAKER_00: You're learning about roles and responsibilities of others.
31:19
SPEAKER_00: You said like leadership was one of them.
31:23
SPEAKER_00: What other pillar am I missing?
31:25
SPEAKER_02: And relationship-focused care, relationship-focused care, team communication, yes, and yeah, you mentioned all the others.
31:35
SPEAKER_00: Okay, yes, yep.
31:37
SPEAKER_00: And relationship-focused care is just is about the relationship with the patient.
31:44
SPEAKER_02: Yes, and and also, yes, yes, and also the when you work with a colleague, you know, from another profession, you have to establish good relationships with them as well to provide the care that you want, the quality care that you want.
31:58
SPEAKER_02: That's very, very important.
32:00
SPEAKER_00: Yeah.
32:01
SPEAKER_00: Yeah.
32:01
SPEAKER_00: The relationship-focused care was the one that you said that surprised me the most because it feels personal.
32:06
SPEAKER_00: When you first said it feels personal between you and the patient.
32:10
SPEAKER_00: But when you think of the relationship with the other professions, uh, that's a component of it too.
32:17
SPEAKER_00: I think anecdotally too.
32:18
SPEAKER_00: I do think when I've had a strong relationship with the other people on the team, that actually really helps the relationship with the patient.
32:26
SPEAKER_00: Like it feels indirect, but it's so connected.
32:30
SPEAKER_00: I had never thought about that before.
32:32
SPEAKER_00: But as you say, I'm like, that's totally true.
32:36
SPEAKER_03: Yes, that's that is very important.
32:39
SPEAKER_03: Yes.
32:41
SPEAKER_00: I'll link to these frameworks in our show notes for people to reference.
32:47
SPEAKER_00: Uh, there's a lot of nice visuals in them that uh help kind of sync it together.
32:53
SPEAKER_00: And one of the papers you wrote, I have it, I have it uh on my desk somewhere.
33:00
SPEAKER_00: I just uh was looking at it again this morning.
33:03
SPEAKER_00: Um, you talk about sociomateriality and how it relates to interprofessional education and collaboration.
33:14
SPEAKER_00: Can you tell me what that long word means and then how does it relate to this topic?
33:21
SPEAKER_02: Okay, thank you.
33:22
SPEAKER_02: Thank you for bringing that up.
33:24
SPEAKER_02: Um, it's also not uh a new concept, but for many of our listeners, I would say, or even therapists that we know uh might find it new.
33:33
SPEAKER_02: Social materiality is a concept that proposes that organizations composed of people, the social part and the technology or the material part, the material part, are not separate entities, but are entangled together and they're fused together.
33:54
SPEAKER_02: That's how Orlikovsky and Scott define that.
33:58
SPEAKER_02: And they're actually from the US, from MIT, who were studying about organizational um psychology and organizational technologies and how technology shapes organization.
34:11
SPEAKER_02: So that's where it originated from.
34:14
SPEAKER_02: But having this kind of perspective, or what we call social material perspective, aims to place due attention to the non-human elements and its complex interactions with the human elements.
34:27
SPEAKER_02: In our practice, in healthcare, it means that non-human elements are equally important as the human elements that create the practice.
34:37
SPEAKER_02: So to make it simpler, it's quite theoretical, but when you make it simpler, we have uh a social material perspective on things is how we see both the value of the things we use in therapy as well as our colleagues.
34:54
SPEAKER_02: We we see the material and the social, the people, as you cannot separate them.
35:01
SPEAKER_02: We can only provide a practice or or create a practice when we use our tools in occupational therapy, when we use our if if you work in pediatric practice, you have your toys with you, you have your when you work in in physical rehabilitation, you have all these assistive technologies with you that we use.
35:24
SPEAKER_02: And these non-human elements are equally important as the human elements.
35:33
SPEAKER_02: So they try to kind of make every uh make this idea that humans are better or are have more value than the material things.
35:43
SPEAKER_02: And material things are not only the tools that we use, it's also the policies where we navigate our practice, the documents that we write, the EMRs, all these are part of it.
35:56
SPEAKER_02: And it is related to social materiality because it it tries to break down the hierarchies, which we which is the one of the main challenges why collaboration does not happen, because hierarchies are are quite evident in our practice.
36:21
SPEAKER_02: Who's who, who who makes the final yes, who decides.
36:27
SPEAKER_02: And it kind of um social materiality perspective provides this idea that every everyone has equal share, equal voice into our practice.
36:41
SPEAKER_02: The social materiality perspective, based on our scoping review that we published in 2023, also allows us to understand the complexity of our healthcare practices, um, including power relations.
36:55
SPEAKER_02: When we use this perspective, it allows us to see the intricacies of how materials, non-human entities, actually oppress certain professions from others.
37:10
SPEAKER_02: Through this perspective, we we recommend also we recommended the inclusion of non-health professionals as part of creating effective interprofessional teams.
37:22
SPEAKER_02: Because you know, traditionally, when you say interprofessional work, oh, it should be the doctor, the nurse, the pharmacist, the dentist, the OT, the PT, the speech, etc.
37:33
SPEAKER_02: But we forget that when you work in hospitals, when you work in clinics, you also actually work with people from the custodian staff, the people who actually make sure that the therapy room that you're using is clean, sanitized.
37:50
SPEAKER_02: Um, we forget to include the people who are in the IT department, the people who actually make sure that we are able to use the EMRs that we are actually using to provide the service that we want.
38:03
SPEAKER_02: And also, another thing, another result, important result that we found is that when we look at things from a social material perspective, it allows us to practice professional humility.
38:22
SPEAKER_02: You know, and professional humility is also hard to develop because some professions, I think all professions are socialized that we are the best.
38:31
SPEAKER_02: Each profession is the best.
38:33
SPEAKER_02: And when you're socialized or trained like this, and then you go into practice where there are different professions with you, you you know, they will kind of fight for that um podium.
38:48
SPEAKER_02: Who's the best now?
38:50
SPEAKER_02: But I guess when you look at that, um it it allows you to to kind of look at cultural humility and professional humility, that at the end of the day, the most important team member in your team is your patient and their families.
39:04
SPEAKER_02: That's what I wanted to to kind of share from that perspective.
39:10
SPEAKER_02: I hope I'm making sense, Sarah.
39:13
SPEAKER_00: It's actually making a lot of sense to me because partially because I just read this book, it's called Situated by Angela Duckworth.
39:26
SPEAKER_00: Have you read this book yet?
39:28
SPEAKER_00: Not yet, but I know you'll have to read it because I think it's there's a part of it that has a really clear example of what you're talking about.
39:38
SPEAKER_00: I wasn't expecting to share this anecdote, so hopefully I do it with some accuracy.
39:43
SPEAKER_00: But she has a segment in the book about a CEO in a health system who uh really transformed the health system.
39:51
SPEAKER_00: And he did, and the steps that he took, now knowing your framework, I would say were from a sociomaterial perspective.
39:59
SPEAKER_00: Like he really looked at the space of the hospital and fostering collaboration.
40:07
SPEAKER_00: For example, anecdotes were like, we put patients first at our hospital.
40:12
SPEAKER_00: That means we're going to give them the front parking spots, like very concrete, like that.
40:17
SPEAKER_00: But then also instituted like company-wide in-service days where everyone who was on staff at any level uh would come to these in-services.
40:28
SPEAKER_00: So you would have the custodian sitting by a heart surgeon uh did that.
40:32
SPEAKER_00: And then I remember the other thing she said was I think she regrouped just like offices.
40:38
SPEAKER_00: So like OTs weren't together.
40:40
SPEAKER_00: They were together based on what they were working on.
40:43
SPEAKER_00: So there was like interprofessional, prioritized interprofessional workspaces over being in your asilo.
40:50
SPEAKER_00: So that like totally syncs just hearing that anecdote in that book of what that focus can look like in practice, like really synced it up for me.
41:01
SPEAKER_00: And it transformed our outcomes.
41:02
SPEAKER_00: Yes.
41:03
SPEAKER_00: Like it feels so indirect to be like, what if we move in the parking spot of the patients that could transform our outcomes?
41:09
SPEAKER_00: Like it doesn't even really make sense unless you're thinking through this lens that you describe.
41:16
SPEAKER_00: Does that sound like an accurate uh it's a good example?
41:19
SPEAKER_00: Okay.
41:20
SPEAKER_02: It's a good example, Sarah.
41:22
SPEAKER_02: And I just it it just reminded me of one thing that we were looking at um using this perspective when when uh a team oh a healthcare team um wears the same color scrubs or uniform without having to identify who's the doctor, who's this, who's the senior, who's that.
41:44
SPEAKER_02: Because I come from a culture and a society where uniforms indicate your social status or your professional status.
41:53
SPEAKER_02: And when you try to make sure that uniforms are the same for all, it also uh it's it's an indication or a visual sign that we are all equal and everyone can speak in the table when we discuss the patient.
42:09
SPEAKER_02: And there's there's no hierarchy because we are all visually equal compared to sitting on a table where you see one has a longer gown, which indicates higher position.
42:21
SPEAKER_02: And you know what I mean?
42:23
SPEAKER_02: And the therapists are in scrubs.
42:25
SPEAKER_02: Why are we wearing scrubs where the others are not?
42:27
SPEAKER_02: And what is this?
42:29
SPEAKER_02: I mean, for the nurses, it used to be the the cap indicates their their status.
42:36
SPEAKER_02: And so looking at materials, we we always think that oh, material, oh, they're they're just material things.
42:42
SPEAKER_02: What's important are the humans.
42:44
SPEAKER_02: But actually, uh we also need to redesign and and and put some architecture in in our environment, in how we use these materials, because they can actually somehow I would say oppress or it would, you know, um it can control or put hierarchies further uh without even saying it.
43:08
SPEAKER_02: So so so we need to be very critical about how these materials affect how we practice.
43:14
SPEAKER_02: So that's a good example, and I just wanted to add that.
43:18
SPEAKER_00: Yeah.
43:19
SPEAKER_00: Yeah, this whole topic today just is making me feel like the things that feel indirect actually have a really direct impact on our patient care.
43:31
SPEAKER_00: I want to ask what to me feels like one of the trickiest questions I've had about this, um, which is how do we know if interprofessional education is working?
43:44
SPEAKER_00: Like it already feels like a fluffy, nebulous concept.
43:48
SPEAKER_00: And we've talked about like the logistics, but how do we measure or know if the efforts that we're putting into interprofessional education are working?
44:01
SPEAKER_02: Well, that's a tough question.
44:02
SPEAKER_02: And I'm just sharing my thoughts as a professional myself and as a person who is not only a researcher in IPE but also an advocate of it, we can see that interprofessionalism is working when you put the hierarchies and power differentials aside and put forth patient care in front of your agenda, of your daily agenda in practice.
44:32
SPEAKER_02: And if your goal continues to be about improving the health of the patients that you you work with, the groups or even the communities that you work with.
44:42
SPEAKER_02: So sometimes, again, because of the busy clinical setting, sometimes it's not easy to reflect and and go deeper into to do some introspective reflection about the hierarchies and the power differentials, because it has become a default as society dictates.
45:03
SPEAKER_02: Another thing that we should aim for to see if interprofessional education practice works is when the central focus of our work is providing the best possible care at the perfect place in time and not about how good you are as a professional.
45:23
SPEAKER_02: And I know we need to uh professionals need to be the best in their work because of how can I say because you're being um being checked, you're being monitored, you're being um, you need to earn certain credits and all that.
45:40
SPEAKER_02: That's fine.
45:41
SPEAKER_02: That we we have to do that, that's very important.
45:44
SPEAKER_02: Um again, let's focus on are we providing the best possible care?
45:50
SPEAKER_02: And it's and and and we can put the idea of we need to be the best because uh I think we can only do so much, right?
46:04
SPEAKER_02: When whenever we're practicing.
46:07
SPEAKER_02: And I'm saying this because there's this concept called the heroic individualism attitude, where you see your knowledge and skills as a private capital rather than something that you do for your patient.
46:22
SPEAKER_02: And this kind of attitude is actually prevalent amongst healthcare workers.
46:28
SPEAKER_02: Um, when we kind of think that we're heroes and we we will try to save all of you.
46:38
SPEAKER_02: And so there is this focus of the self.
46:41
SPEAKER_02: Yes, you wanted to help, but the focus actually is on yourself when you try to think that you're gonna do everything.
46:50
SPEAKER_02: But again, let's go back to making sure that the patient is getting the best quality of life at that point in time, uh, because you know each patient has their different concerns, and and when I say patients, it involves it includes the families who we are working with as well.
47:13
SPEAKER_02: So those things, and I wanted to add one more IPE is working when we do interprofessional collaboration and practice because we are intentional in improving health outcomes and not just because it's the fashionable thing today, it's the trend.
47:40
SPEAKER_02: Um, oh, we need to be collaborative because the institution says so.
47:45
SPEAKER_02: You know, I've heard and I've observed certain groups doing this because it's a thing, and because oh it's in the accreditation, that's why we have to do it.
47:58
SPEAKER_02: Um, I hope it's not like that.
48:01
SPEAKER_02: The danger of that is it becomes we reproduce this competitive competitive, it's good to be competent, but when you compete between IPE groups, which I call collaborative silos, so you want to collaborate because you want to break the silos, not to create new silos, you know what I mean?
48:25
SPEAKER_02: So that is the danger when we when we don't do it based on how it was defined and how it was conceptualized.
48:36
SPEAKER_02: We want to do IPE because we want to decrease clinical errors, we want to make sure that we provide better outcomes, we want to make sure that the patient is able to participate in their daily occupations as occupational therapists.
48:50
SPEAKER_02: That is the goal.
48:51
SPEAKER_02: And not, I mean, the others could be secondary, but it's not about it's not about us.
49:00
SPEAKER_02: That's what I wanted to say, um, Sarah.
49:04
SPEAKER_00: Yeah, I'm taking it all that you're saying as someone who's an educator myself and am hit with the challenge on the regular, where I'm like the strongest research that we cover on the podcast tends to have like an interprofessional flair to it.
49:29
SPEAKER_00: Like it's around helping patients sleep better, like something that's like simple and clear.
49:35
SPEAKER_00: And it's almost like we don't do, we don't focus on it enough in our healthcare system, I think, because it doesn't help one profession like put itself forward or it's not like the cool thing to focus on.
49:51
SPEAKER_00: Like it's really tempting to talk about like new technologies that are really specific to PTROT when the reality is those don't work as well as getting a good night's sleep.
50:02
SPEAKER_00: So I totally resonate with what you're saying that that's the overall indicator is are we putting our like professional egos aside and really looking at what's best for the patient?
50:15
SPEAKER_00: Because it's very hard to do, even though we totally know what's best for the patient.
50:20
SPEAKER_00: Usually it's usually sleeping, eating, social connection, sense of purpose.
50:24
SPEAKER_00: Like it's the cores and they are shared across professions.
50:28
SPEAKER_00: No, they are not specific to OT.
50:30
SPEAKER_00: No, OT does not own one of those.
50:33
SPEAKER_01: Yes.
50:34
SPEAKER_00: Um, we have to put that ego aside and work collaboratively on these core things.
50:40
SPEAKER_00: That's our North Star.
50:42
SPEAKER_00: Uh, I know from like looking into continuing education, interprofessional education, there are a bunch of like scales out there to measure the different competencies around interprofessional education.
50:56
SPEAKER_00: What's out there as far as like self-assessment tools, or where could we look if we wanted to see other ways of measuring interprofessional education?
51:06
SPEAKER_02: Yes, there is this website called the Nexus IPE website.
51:11
SPEAKER_02: Nexus is N-E-X-U-S IPE.
51:14
SPEAKER_02: Our website is, I think, hosted by the American Interprofessional Collaborative, and they have a database of different kinds of interprofessional education and practice-related skills that you can use in your practice or with patients or from patients.
51:34
SPEAKER_02: It can be a patient report, it can be therapist reports or professional reports.
51:40
SPEAKER_02: And there you they also provide information on how it can be used or where should it be used, what setting.
51:48
SPEAKER_02: In some cases, there are psychometric properties like the validity and the reliability of the tool are also stated there.
51:58
SPEAKER_02: One thing that I used is a self-report instrument called the Attitudes Towards Healthcare Team Skills.
52:06
SPEAKER_02: And this is used to evaluate healthcare students, healthcare professionals about how they work as a team, which is something that I use myself in my research.
52:17
SPEAKER_02: But there are new ones right now, shorter ones, because this one is a 14 or 21 item, depends on what which type you're using.
52:26
SPEAKER_02: But there are shorter versions that you can use, especially when you are um dealing with complex cases.
52:34
SPEAKER_02: I think it's very important to kind of use this as a part of debriefing within the team.
52:40
SPEAKER_02: So, and I think you can use it again and compare and contrast um different periods of time when you use this tool.
52:49
SPEAKER_00: That Nexus website is super helpful for people who are members of OT Potential.
52:55
SPEAKER_00: We've actually, when you're doing the post-course survey, I took one of those scales that's on there, and it's now we have an interprofessional education uh question at the end of all of our courses.
53:08
SPEAKER_00: As I've been learning more about this, I've been trying to incorporate the pillars of interprofessional education into our coursework at OT Potential.
53:16
SPEAKER_00: And part of that is measuring how we're doing.
53:18
SPEAKER_00: So heads up to everyone that you will see that extra question, and I'll link to that website to that Nexus website, because there's a lot of different surveys out there.
53:29
SPEAKER_00: We're getting down to our last three minutes.
53:32
SPEAKER_00: I have two short things to ask you.
53:36
SPEAKER_00: What's the most important thing we need to do for this future of interprofessional education?
53:41
SPEAKER_00: Or what's the what's your hope for the future?
53:44
SPEAKER_02: My hope is that um interprofessional education and practice or learning about it should not be an option or an additional course.
53:56
SPEAKER_02: It should be a mandatory course for all healthcare professionals.
54:01
SPEAKER_02: Hopefully, before you even get your license or before you finish your schooling, you have an idea, not just an idea, but how to actually practice it in actual practice.
54:14
SPEAKER_02: Why?
54:14
SPEAKER_02: Because I believe that the future is going to offer us more complex needs of humans and groups and communities.
54:23
SPEAKER_02: And so I think that team-based care will be so important more than ever.
54:28
SPEAKER_02: Team-based care means um the care that we provide is not only um through one person, it has to be provided by several healthcare professionals who actually talk with with or with and learn about with and each other.
54:46
SPEAKER_02: So I also hope that interprofessional education practice is something that is learned not only during undergraduate, but also in continuing professional development.
55:04
SPEAKER_02: Um, even if you're a senior therapist in in a and you have positions, uh head positions or director positions, I think this should be included in in future continuing professional development programs.
55:19
SPEAKER_02: That's my hope.
55:20
SPEAKER_02: Absolutely.
55:21
SPEAKER_00: I am totally with you on that.
55:23
SPEAKER_00: We've talked about so many things today that have really stretched my thinking.
55:30
SPEAKER_00: I think I came in with a really narrow understanding of interprofessional education, and this really broadened it.
55:38
SPEAKER_00: What's the final thought that you want to leave us on today?
55:44
SPEAKER_02: One of the things that I might want to leave our listeners in this podcast is to understand that that being part of the healthcare profession is something that we should be grateful for because we are able to provide impact, and they also provide impact in our lives.
56:04
SPEAKER_02: And we we also support people to improve their their not only their health, but their overall quality of life.
56:13
SPEAKER_02: Um, it's privileged to be in this position, and so let's not take it for granted or take it easily.
56:21
SPEAKER_02: Um, and so it is important for us to learn how to work better through interprofessional work, teamwork, learning about these concepts that seems to be like, oh, it's not um, it's just an attitude thing that I need to change.
56:37
SPEAKER_02: But these competencies um make a difference when we actually apply it in our practice.
56:44
SPEAKER_02: So I just want to um hopefully people who are in this podcast um could share about what we talked about today, about how important it is to work together with other healthcare professionals, the families, and the patients themselves, so that they can get the best care at the best place, the best time.
57:03
SPEAKER_03: Yeah.
57:04
SPEAKER_00: Oh, Mike, we entered this work in therapy because we wanted to build those relationships with our patients, but also be members of a team.
57:14
SPEAKER_00: And this discussion has made me feel hopeful that we can not only improve, continue to improve our patient care, but also continue to improve what our membership on the team looks like.
57:25
SPEAKER_00: And interprofessional education is such a powerful tool there.
57:28
SPEAKER_00: Thank you so much for this conversation.
57:31
SPEAKER_00: It's been so fun, so eye-opening.
57:33
SPEAKER_00: I so appreciate all the work that you've done.
57:36
SPEAKER_00: And I look forward to continue to follow the continued research that you're doing in this area.
57:42
SPEAKER_00: Thank you so much for this discussion today.
57:45
SPEAKER_02: Welcome, Sarah, and thank you for having me once again.
57:52
SPEAKER_00: Thank you for joining us on the OT Potential podcast.
57:55
SPEAKER_00: To earn one hour of AOTA approved continuing education for your time today, you will need to sign in or sign up at OTPotential.com.
58:05
SPEAKER_00: Once you're in the OT Potential Club, you will find a five-question post-course quiz connected to this episode.
58:12
SPEAKER_00: When you pass the quiz with a score of 75% or higher, you will be able to download a PDF certificate that certifies your completion of this course.
58:21
SPEAKER_00: Okay, I want to thank you for joining us today, and we'll see you next time.