Printer Friendly

An interprofessional education initiative between students of Dental Hygiene and Bachelor of Science in Nursing.

ABSTRACT

Introduction: Interprofessional education Interprofessional education (also known as inter-professional education) refers to the teaching and learning of students from different professions together during all or part of their professional training in order to promote collaborative working in their professional practice.  (IPE IPE - Integrated Programming Environment ) is defined as occasions when two or more professions learn about, from, and with each other to improve collaboration and the quality of care. Nursing and dental hygiene dental hygiene
n.
The practice of keeping the mouth, teeth, and gums clean and healthy to prevent disease. Also called oral hygiene.
 students at George Brown College were brought together in an IPE initiative to learn about, from, and with each other in regards to the overlapping roles they share in oral health and blood pressure monitoring. The World Health Organization (WHO) has long advocated for "multiprofessional" education among undergraduate healthcare students to build "the skills necessary for solving the priority health problems of individuals and communities that are known to be particularly amenable to team-work". Discussion: The discussion will present developments the Ministry of Health and Long Term Care (MOHLTC) in Ontario, Health Force Ontario, the Registered Nurses Association of Ontario (RNAO RNAO Registered Nurses Association of Ontario (Canada) ) and the Office of the Chief Dental Officer The Chief Dental Officer is an official position created by the Government of Canada to improve the oral health status of Canadians and to increase awareness about the prevention of oral diseases.  (OCDO) are making to improve collaboration and quality of care within healthcare. The new National Competencies for Dental Hygiene also advocates such collaborative practices. Findings: There is evidence of the connection between oral health and systemic health, and the increased need for proper daily oral health assessment and care for populations within acute and long term care. At present, members of the nursing profession whose scope of practice includes providing oral assessment and daily oral care are the front line caregivers for these populations. The increase in high blood pressure within the general population is also a priority health problem. Dental hygienists are front line health professionals in oral assessment and oral care education whose scope of practice includes taking blood pressure and pulse. Conclusions: The results of the Canadian Health Measures Survey (CHMS CHMS Certified Home Marketing Specialist (real estate agent certification)
CHMS Church Management Software
CHMS Church Management System
CHMS Chapel Hill Middle School (Douglasville, Georgia) 
) show that approximately 70 per cent of the population sees an oral health practitioner on an annual basis. Dental hygienists are in an ideal position to monitor and screen for high blood pressure. This paper reports the lessons learned from the IPE initiative, rationales for continuing this initiative, and the future directions of this initiative in fulfilling aspects of the proposal by George Brown College (GBC GBC Game Boy Color
GBC Global Business Coalition
GBC Green Building Council
GBC George Brown College
GBC Great Basin College (Nevada)
GBC General Binding Corporation
GBC Greater Baltimore Committee
GBC Goldey-Beacom College
) to implement IPE initiatives.

RESUME

Contexte: La formation interprofessionnelle (FIP FIP

feline infectious peritonitis.
) se definit comme etant une source d'occasions pour deux professions et plus de s'instruire et de se former mutuellement afin d'ameliorer la collaboration et la qualite des soins. Les etudiantes en soins infirmiers et en hygiene dentaire du College George Brown ont ete reunies dans une initiative de FIP pour s'instruire et se former reciproquement sur le partage des roles qui se recoupent dans les soins buccaux et le monitorage de la pression arterielle. L'Organisation mondiale de la sante (OMS OMS - Opportunity Management System ) preconise depuis longtemps la formation * pluriprofessionnelle * des etudiantes en soins buccaux pour etablir * les competences necessaires visant a resoudre les problemes prioritaires de la sante des personnes et des collectivites qui se pretent particulierement au travail TRAVAIL. The act of child-bearing.
     2. A woman is said to be in her travail from the time the pains of child-bearing commence until her delivery. 5 Pick. 63; 6 Greenl. R. 460.
     3.
 d'equipe * Discussion: La discussion presente les echanges entre le Ministere de la sante et des soins de longue duree (MSSLDO) d'Ontario, ProfessionsSanteOntario, l'Association des infirmieres et infirmiers autorises de I'Ontario (AIIAO) et le Bureau du dentiste en chef (BDC (Backup Domain Controller) In a Windows NT server, a copy of the Primary Domain Controller (PDC). The BDC is periodically synchronized with the PDC. See PDC.

BDC - Backup Domain Controller
) visant a ameliorer la collaboration et la qualite des soins dans le cadre (company) CADRE - The US software engineering vendor which merged with Bachman Information Systems to form Cayenne Software in July 1996.  des soins de la sante. Les nouvelles Competences nationales en hygiene dentaire preconisent de telles pratiques de collaboration. Resultats: Les donnees temoignent du lien qu'il y a entre la sante buccale et la sante generate et du besoin de plus en plus grand d'evaluer correctement et quotidiennement la sante buccale des populations sous soins intensifs de longue duree. Actuellement, les membres de la profession des soins infirmiers dont le champ de pratique pra·tique  
n.
Clearance granted to a ship to proceed into port after compliance with health regulations or quarantine.



[French, from Old French practique, from Medieval Latin
 comprend l'evaluation buccale et les soins buccaux quotidiens sont en premiere ligne du personnel soignant de ces populations. L'augmentation de la tension arterielle de la population en general est aussi un probleme de sante prioritaire. Les hygienistes dentaires sont en premiere ligne des professionnelles de la sante concernant l'evaluation buccale et I'education des soins de sante dont le champ de pratique comprend la tension arterielle et le pouls. Conclusions: Les resultats de I'Enquete canadienne sur les mesures de la sante (ECMS ECMS Electronic Copyright Management Systems
ECMS Enterprise Content Management Solution
ECMS Extended Change Management System
ECMS Electronic Client Management System
ECMS Enhanced Crisis Management System
ECMS Environmental Corrosion Monitoring System
) montrent qu'approximativement 70 pour cent de la population consulte annuellement la praticienne en sante buccale. Les hygienistes dentaires sont ainsi dans une position ideale pour surveiller et depister la haute tension arterielle. L'etude fait etat des lecons de 1'initiative de FIP, les raisons de poursuivre l'initiative et les orientations a lui donner pour realiser la proposition du College George Brown (GBC) sous ses divers aspects et mener a bien les initiatives de FIP.

Key words: interprofessional education, oral health, blood pressure, Dental Hygiene, Nursing

Introduction

This paper describes an interprofessional education (IPE) initiative involving students of Dental Hygiene (DH) and Bachelor of Science in Nursing The Bachelor of Science in Nursing (BSN) is a four year academic degree in the science and principles of nursing, granted by a tertiary education university or similarly accredited school.  (BScN) at George Brown College (GBC) in Toronto, Ontario. It focuses on the development of an IPE initiative within the IPE curriculum at GBC. This initiative is comprised of two distinct components: i.) oral health assessment/daily oral care, and ii.) blood pressure/pulse. It utilizes the connection between oral and systemic health as an agent for an interprofessional collaboration between the dental hygiene and nursing professions. Summaries of the feedback given by the students from each of the components are provided as well as suggestions for expansion of this initiative.

The scientific community that informs both dental and non dental healthcare professions, recognizes an association between oral and systemic health. As well, healthcare experts have called for action for collaborative approaches to address the need for interventions to improve health outcomes and quality of life. As a result, educational institutions are focusing effort and attention on defining their role in preparing healthcare workers for collaborative practice.

Development of initiatives within the IPE curriculum at GBC

In 2005, proposals were requested by the Centre for Health Sciences at GBC to develop and implement interprofessional education (IPE) curriculum pilot initiatives that supported the College's new interprofessional education learning outcomes.' See also Figure 1.

[FIGURE 1 OMITTED]

1. Appraise appraise v. to professionally evaluate the value of property including real estate, jewelry, antique furniture, securities, or in certain cases the loss of value (or cost of replacement) due to damage.  the relationship between one's own profession and the background, roles and scopes of other healthcare professions.

2. Evaluate one's ability to work in a team.

3. Participate collaboratively as a health team member to support patients/clients' achievement of their expected health outcomes.

4. Assess the impact of the broader legislative and ethical framework on inter professional practice.

At that time, an initiative was proposed and developed between the collaborative BScN (George Brown site) and the Dental Hygiene (DH) programs. It reflected the Applied Interactive Activity involving two or more programs which was one of the six possibilities that were recommended in the call for proposals. This initiative included two interprofessional learning components:

The first utilized 2nd year DH students to guide 1st year BScN students in the practice of oral assessment and daily oral care appropriate for co operative long term care patients or clients.

The second involved 2nd and 3rd year students from the BScN program guiding 1st year DH students in the practice of taking a manual blood pressure and pulse.

Questionnaires were developed for students to complete anonymously at the end of each of the oral health and blood pressure sessions. The information gathered from the questionnaires has aided in the design and evaluation of both components of the IPE initiative for future iteration One repetition of a sequence of instructions or events. For example, in a program loop, one iteration is once through the instructions in the loop. See iterative development.

(programming) iteration - Repetition of a sequence of instructions.
.

Design of the IPE initiative

1. Oral health component

This component consisted of eight 2nd year DH students, two DH faculty mentors, two hundred 1st year BScN students, and four BScN supervising faculty mentors. Over the course of four days in the simulation lab setting, dental hygiene student "teachers" facilitated the nursing student "learners" practice of daily oral assessment and oral care appropriate for cooperative patients. Each day consisted of two, 2-hour sessions, which served approximately fifty BScN student "learners". DH student "teachers" presented a short demonstration session about oral assessment, daily oral healthcare procedures and care for various oral prostheses Prostheses
A synthetic object that resembles a missing anatomical part.

Mentioned in: Microphthalmia and Anophthalmia
 (e.g., dentures). Following the demonstrations, simulation exercises began with DH student "teachers" assigned to clinician-patient teams of BScN student "learners". Time was provided for each BScN student "learner" to switch roles in the practice session. See Figure 2. The DH faculty provided guidance to both student "learners" and student "teachers".

[FIGURE 2 OMITTED]

2. Blood pressure component

Approximately fifteen volunteer 2nd year BScN students and three of their faculty mentors met at the GBC Dental Clinic to work with DH students and their supervising faculty during one of the pre-clinical health assessment sessions. The session began with a BScN student "teacher" demonstrating the skills for taking a manual blood pressure and pulse to each of four pairs of DH student "learners". Once the demonstrations were completed, the BScN student "teacher" returned to each DH student "learner" pair and facilitated the practice of the skills as demonstrated. See Figure 3. The BScN faculty provided guidance to both the student "learners" and student "teachers".

[FIGURE 3 OMITTED]

Student feedback from both components of this IPE initiative

At the end of the blood pressure and oral health components of this IPE initiative, questionnaires were given to the student "learners" and the student "teachers" to answer anonymously for the purposes of program development. Table 1 shows the statements that both the student "learners" and student "teachers" were asked to evaluate. Students were asked to rate their answers on a five point Likert scale Likert scale A subjective scoring system that allows a person being surveyed to quantify likes and preferences on a 5-point scale, with 1 being the least important, relevant, interesting, most ho-hum, or other, and 5 being most excellent, yeehah important, etc , ranging from '1' (strongly disagree) to '5' (strongly agree). Students from GBC's Health Information Management Program, also a part of the Centre for Health Sciences, entered and analyzed the data from the questionnaires using SPSS A statistical package from SPSS, Inc., Chicago (www.spss.com) that runs on PCs, most mainframes and minis and is used extensively in marketing research. It provides over 50 statistical processes, including regression analysis, correlation and analysis of variance.  version 17.
Table 1. Statements from the student "learners" and student "teachers"
questionnaires.

   Statements for the student     Statements for the student "teachers"
    "learners" to evaluate                      to evaluate

1. The information demonstrated   1. I understood the information
   was accurate                      that I was to demonstrate

2. Explanation of the procedure   2. The students asked questions
   was easy to understand            that I was able to answer

3. The students who were          3. The student learners had an
   teaching were able to answer      adequate understanding of the
   questions appropriately           theory prior tothe demonstration

4. I now feel comfortable to      4. The student learners were better
   practice on my partner in the     able to practice once I had an
   pre-clinic lab                    opportunity to practice with them

5. I enjoyed working with         5. I enjoyed working with students in
   students in another               another profession
   profession


In both components of the initiative, the data revealed that students agreed or strongly agreed with the statements regarding accuracy of information presented, ease of understanding and knowledge level of the "student teachers". See Table 2. In addition, most, if not all, student "teachers" felt able to answer questions they were asked by the student "learners" (Box 7 and 17 in Table 2); and the student "learners" liked practising the skills with their student "teachers" (Box 9 and 19 in Table 2). Both student "learners" and student "teachers" reported that they enjoyed working with students from another profession (Box 5, 10, 15 and 20 in Table 2). The BScN student "teachers" all felt they understood the information that they were to demonstrate to the DH students about taking a manual blood pressure (Box 6 in Table 2).

[GRAPHIC OMITTED]

However, in two instances the data revealed that students disagreed or strongly disagreed. In the first instance, DH student "teachers" in the oral health component felt that the BScN students did not have adequate understanding of the theory of oral assessment or daily oral care prior to the demonstration (Box 18 in Table 2). In the second, DH student "learners" in the blood pressure component reported that they would not feel comfortable taking a manual blood pressure and pulse after this one teaching session (Box 4 in Table 2).

Analysis of the questionnaires has provided feedback that has been utilized to improve both the oral health and blood pressure components of this IPE initiative.

Discussion

Call for collaboration from the scientific and healthcare community

The scientific community has indicated a low to moderate association between periodontal disease Periodontal Disease Definition

Periodontal diseases are a group of diseases that affect the tissues that support and anchor the teeth. Left untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where
 and heart disease, and a moderate association between periodontal disease and stroke. (2) Additionally, there is mounting evidence of a probable two way association between periodontal disease and diabetes. (2) Research is emerging regarding improved oral hygiene and the reduction in respiratory infections in long term care settings. (3) There is also growing recognition of the importance of oral health to quality of life. (3)

The World Health Organization's (WHO) 1948 definition of health (4) states, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Flaw, defect, or weakness.

In a legal sense, the term infirmity is used to mean any imperfection that renders a particular transaction void or incomplete. For example, if a deed drawn up to transfer ownership of land contains an erroneous description of it, an
." With an ever increasing awareness of the connection between the health of the oral cavity and the health of the whole body, the American Surgeon General's (ASG ASG Assign
ASG Allen Systems Group (Naples, FL)
ASG Abu Sayyaf Group (terrorist group)
ASG Associated Student Government
ASG Area Support Group
ASG Adaptive Services Grid
ASG Assistant Secretary General
) report (5), in 2000, focused on the relationship between oral health and overall good health throughout life. The report described the mouth as a "mirror for general health and well-being and the association between oral health problems and other health problems." (5) Lawrence and Leake (6) in their article Canadian Perspective of the US Surgeon General's report on Oral Health state that one of the calls to action within the report was to "educate non-dental health professionals about oral health and disease and their role in ensuring that patients receive good oral healthcare". They also indicate that more research is needed as in the US, and that Canada should apply interventions that demonstrate effectiveness in eliminating oral health disparities

Main article: Race and health


Health disparities (also called health inequalities in some countries) refer to gaps in the quality of health and health care across racial, ethnic, and socioeconomic groups.
. (6) The philosophies of both the ASG and the WHO are increasingly recognized by governments, scientific communities, and members of the public. Additionally, in 2004, the Canadian government established the Office of the Chief Dental Officer (OCDO) to provide strategies to support the oral health of Canadians focused on increasing access to oral healthcare, and using a collaborative approach to health promotion. (7)

Oral health data from the Canadian Health Measures Survey (CHMS) were released in 2010. (8) The CHMS, supported by both Health Canada Health Canada (French: Santé Canada) is the department of the government of Canada with responsibility for national public health.

Health Canada's goal is to improve Canadian life by improving Canadian longevity, lifestyle and use of public healthcare.
 and Statistics Canada, was undertaken to collect key information relevant to the health of Canadians. It provides a national baseline level of the oral health of Canadians including decayed, missing, filled teeth scores (DMFT DMFT Decayed/Missing/Filled Teeth (dentistry)
DMFT Doctorate of Marriage and Family Therapy
) for Canadians from 6 to 79 years of age. The 2010 results show that only 6% of adult Canadians are edentulous edentulous /eden·tu·lous/ (-tu-lus) without teeth.

e·den·tu·lous
adj.
Having no teeth; toothless.
. While, in 1972 data indicated the edentulous rate was 24%. This represents a vast improvement in the number of people who retain their teeth. (8)

The Chief Dental Officer of Canada also reports findings of the CHMS that demonstrate oral health disparities exist for a number of population groups. Key to addressing these disparities is research that asks why and how disparities occur, who are the most vulnerable, and what can be done to improve oral health for all". (8) The Canadian Institutes of Health Research Canadian Institutes of Health Research (CIHR) is the major federal agency responsible for funding health research in Canada. It is the successor to the Medical Research Council of Canada.  (CIHR CIHR Canadian Institutes of Health Research
CIHR Cambodian Institute of Human Rights
) is currently investigating these issues. "This research is focused on finding ways to influence health and economic policies, education and dental services for the benefit of Canadians who have difficulty accessing oral healthcare". (8)

There is evidence from Statistics Canada that the number of seniors in the Canadian population is rising--7.7% (1966) to 13.7% (2006). (9) In the next twenty-five years it is projected that the population of seniors could nearly double. (10) Also, life expectancy Life Expectancy

1. The age until which a person is expected to live.

2. The remaining number of years an individual is expected to live, based on IRS issued life expectancy tables.
 of Canadians stands at 82.5 years for women and 77.7 years for men. (10) Eighty-seven per cent of older women and 92.7% of older men say they have one or more chronic health problems. (11)

Since Canadians are living longer and retaining their teeth there is a demonstrated need for health professionals to be experienced in oral assessment and daily oral care, particularly when working with vulnerable populations such as those in either acute or long term care. There is a growing consensus that health professionals working as partners, in a team approach, will produce better health outcomes, improved access to services, improved use of resources, and greater satisfaction for both patients and providers. Such teams are better positioned to focus on health promotion and to improve the management of chronic diseases. (12)

Health Force Ontario is a provincial government body that addresses Ontario's health human resource needs to ensure that Ontarians have access to the right number and mix of qualified healthcare providers, now and in the future. (13) Health Force Ontario has been engaging partners in education and healthcare to develop skilled, knowledgeable providers, and to create interprofessional healthcare delivery teams. The implementation of interprofessional care is to provide comprehensive health services health services Managed care The benefits covered under a health contract  to patients or clients by multiple health care givers, who work collaboratively to deliver quality care within and across healthcare settings. (14) Interprofessional care has the potential to provide the needed services to Ontarians. The education system needs to prepare current and future health professionals to work in multidisciplinary, collaborative, team based models. The BScN-DH initiative provides a partnership and collaboration to enhance the outcomes of improved oral assessment and daily oral care for the public.

Additionally, changing guidelines from the Ministry of Health and Long-Term Care regarding oral assessment and daily oral care for residents within long term care are becoming more precisely defined. Nurses are the front line delivery health professionals responsible for assessing oral health status and implementing daily oral care within acute or long term care settings. Dental hygienists can provide knowledge and expertise to nurses for outcomes required by government and nursing regulatory bodies. Dental hygienists are well positioned to work as integrated members of healthcare teams addressing oral health issues across a continuum of care in conjunction with physicians, radiation therapists, dentists, social workers, occupational therapists, registered dieticians and most importantly Adv. 1. most importantly - above and beyond all other consideration; "above all, you must be independent"
above all, most especially
, patients or clients.

The recent Long Term Care Home Act (15) in Ontario places the care of the mouth for residents in long term care [LTC LTC
abbr.
lieutenant colonel
] under the skin and wound care program for LTC facilities. The Standards and Criteria for Resident Care and Services (16) implemented in 2006 by the Ontario Ministry of Health and Long Term Care (MOHLTC) indicated that each LTC home operator shall develop and follow policies on the management of skin care, including care of the skin, nails, feet and mouth. An interdisciplinary team interdisciplinary team,
n a group that consists of specialists from several fields combining skills and resources to present guidance and information.
 shall coordinate the LTC home operator's program of skin care and wound management. This interdisciplinary team shall include a skin care coordinator and a regulated health professional who will coordinate the required expertise to educate and support the team on skin care and wound management, and knowledge of current "best practices". (16) In addition, the Registered Nurses Association of Ontario (RNAO) released Nursing Best Practice Guidelines practice guidelines Medical practice A set of recommendations for Pt management that identifies a specific or range of range of management strategies. See Peer review organization, Practice standards. Cf 'Cookbook' medicine.  on Oral Health: Nursing Assessment and Interventions. (17) The target users of the guidelines are nurses in various practice settings who work with vulnerable populations of those who need assistance to meet their oral hygiene needs. Nursing faculty in the collaborative Bachelor of Science in Nursing (BScN) program at the George Brown College site recognized the opportunity for improved education for nursing students related to oral health assessments and daily oral healthcare in acute and chronic care facilities.

Dental hygienists work with their clients to establish a dental hygiene treatment plan that includes disease prevention, therapeutic interventions, and appropriate referrals. Recent amendments to the Dental Hygiene Act (18) in Ontario allow the public increased access to dental hygiene services. This access creates the potential for more Ontarians to be assessed for oral health problems that may impact their overall health. Moreover, it provides an opportunity for dental hygienists to work with other health professionals in multiple practice settings to ensure that the oral health needs of Ontarians are addressed safely, effectively, and efficiently. (18) As a result, dental hygienists are now even better positioned to be part of the interdisciplinary team identified by the LTCHA required to educate and support staff on skin care and wound management, and knowledge of current best practices.

New National Dental Hygiene Competencies for Entry-to-Practice were developed and released in 2008. (19) One of the domains calls for dental hygienists to be communicators and collaborators. This is supported by competencies from the Public Health Agency of Canada The Public Health Agency of Canada (French: Agence de la santé publique du Canada) is an agency of Health Canada a department of the Government of Canada that is responsible for public health, emergency preparedness, and response and infectious and chronic disease control  (20) which states
  "Communication involves an interchange of ideas opinions and
  information. This category addresses numerous dimensions of
  communication including internal and external exchanges; written
  verbal, non-verbal and listening skills; computer literacy; providing
  appropriate information to different audiences; working with the
  media and social marketing techniques. Collaboration captures the
  abilities required to influence and work with others to improve the
  health and well-being of the public through the pursuit of a common
  goal. Partnership and collaboration optimize performance through
  shared resources and responsibilities."


During the oral health component of the IPE initiative, both students and faculty had an opportunity to experience each other's professional language, and learned that this is a necessary step for improved communication between health professionals. By way of example the term calibration was used by nursing and dental hygiene faculty during the blood pressure component to mean distinctly different things. BScN faculty defined the term "calibration" as a "measurement for the blood pressure instrument", while the DH faculty use the term to refer to "consistency of knowledge and skill among clinical teaching faculty". It demonstrated the confusion that can result and the need for good communication skills when working in an interprofessional team.

Both components of this IPE initiative provided the opportunity for all participating students to observe and better understand the importance of communication professionals within the healthcare community. An improved understanding puts students closer to being "workplace ready"; a concern which is high on the list of priorities for employers. (21)

Findings

Lessons learned from this IPE initiative

There have been many lessons learned by both students and faculty over the multiple iterations of this initiative. The lessons students learned are summarized below.

1. Students report recognizing how much they have learned when given the opportunity to teach others outside their profession.

2. Students learned there are shared skill sets across the dental hygiene and nursing professions.

3. BScN student "learners" discovered that dental hygienists need to take a manual blood pressure and pulse.

4. DH student "learners" discovered that nurses are responsible for providing daily oral healthcare for clients in acute and LTC settings.

5. BScN student "learners" recognized that there are differences in the roles of a DH and a Dental Assistant dental assistant
n.
A person trained to assist a dentist with clinical and administrative procedures.
 (DA).

6. DH student "learners" gained insight into the various types of nursing professionals such as a BScN, a Registered Practical Nurse (RPN See reverse Polish notation.

RPN - postfix notation
) and a Personal Support Worker (PSW (Program Status Word) A hardware register that maintains the status of the program being executed. ).

7. BScN faculty recognized the need for additional Personal Protective Equipment (PPE PPE (Brit) n abbr (Univ) (= philosophy, politics, and economics) → Studiengang bestehend aus Philosophie, Politologie und Volkswirtschaft

PPE n abbr (BRIT ) (SCOL
) when providing oral care to patients (i.e., eye protection, masks and gloves).

8. DH faculty recognized the need for improved bedside ergonomics for providers of oral care to patients or clients.

The challenges and lessons learned by faculty members related to both components of this initiative are reported in the list below.

1. The first and most persistent challenge in this type of endeavor is scheduling:

i. There is a complexity about time tabling across two programs and two campuses that requires specific focused attention to lab availability, supplies, and time to coordinate the initiative.

ii. Scheduling issues create logistical challenges on other involved faculty members not directly involved in both programs related to pre-existing class times and clinics.

iii. Students who participated and then had to make up any missed regularly scheduled clinics or labs were also affected by this inititative's scheduling. Both programs continue to review strategies in future planning to consider ways in which more seamless scheduling can minimize or eliminate missed classes or clinic time.

2. Flexibility and a willingness to work together are essential to make a project of this nature work.

3. An overview of the principles and benefits of IPE for students and faculty is critical to the success of the project.

4. The feedback from the student "teachers" questionnaire regarding the need for better understanding of theory prior to the demonstration of the skill has resulted in provision of additional up to date resources related to the theory of oral assessment and daily oral care to the BScN faculty. (22) These up to date resources will now be available for nursing student "learners" by the nursing faculty in future iterations of this IPE initiative.

5. Feedback from DH student "learners" blood pressure and pulse questionnaires informed faculty of the need to implement additional practice sessions for DH students in the health promotion centre. Nursing students are onsite weekly to provide assistance to all health sciences students who are practising the skill of taking a manual blood pressure and pulse. This provided students with another interprofessional opportunity. It was determined that 3rd year BScN students were better suited to be student "teachers" due to the extra year of gained experience in their learning regarding vital signs.

6. This initiative allowed us to think more broadly about partnerships. Accordingly we connected with students from the Health Services Management program who entered and analyzed the data from the questionnaires. While they contributed to the project outcomes, they were not a part of the IPE education dynamic, as they did not learn about, from and with the BScN and DH students. Attention to this will be necessary in future endeavours to ensure that the most is made of the partnership.

7. The initiative allowed faculty who normally do not have an opportunity to work together to collaborate, and to realize that the IPE benefits extend beyond students and patients or clients to the faculty members themselves.

Recommendations for future IPE initiatives

Faculties are now focused on better defining learning outcomes specific to this initiative. In addition, work continues on how best to evaluate interprofessional experiential learning as a sustainable aspect of the curricula of both programs. Currently, all 1st year students in the BScN program participate in the oral health initiative. It is felt that students in the Registered Practical Nurse (RPN) and Personal Support Worker (PSW) programs should participate in an oral health IPE initiative as they are the health professionals most likely to be providing this care. It is suggested that all DH students would benefit from participation in this type of initiative to enhance communication and interprofessional collaboration as outlined in the new National Dental Hygiene Competencies for Entry-to-Practice. (18) As well, it is believed that all BScN students would benefit from participating in a manual blood pressure and pulse IPE initiative with other health science students who are in need of learning this skill. Furthermore, there is a need to establish academic credit for students participating in IPE initiatives to embed effectively interprofessional education within curriculums.

Efforts are underway to expand the oral health aspect of this project into settings where both DH and BScN students have clinical experiences within common long term care and rehabilitation rehabilitation: see physical therapy.  centres. It is believed that collaborative problem solving Collaborative Problem Solving (CPS) is a behavior management approach developed for children with social, emotional, and behavioral challenges. The CPS approach views behavioral challenges as a form of learning disability and seeks to correct behavior through cognitive intervention.  between the two professional groups "in the field", regarding the oral care needs and challenges of selected clients, could result in improved quality of oral care for clients and expanded and improved skills amongst the students.

In addition to the lessons learned, we offer the following thoughts and recommendations for those considering an initiative of this nature:

1. Choose a primary skill or competency from your health profession that is also a skill or competency that can or is required to be performed by another health professional.

2. Be flexible in making arrangements and willing to think "outside the box".

3. Implement a pilot version first. Include an evaluation component to survey the student participants for their feedback from both the pilot and newly implemented activities.

4. Plan joint debriefing de·brief·ing  
n.
1. The act or process of debriefing or of being debriefed.

2. The information imparted during the process of being debriefed.

Noun 1.
 sessions for the faculty involved.

5. Plan debriefing sessions for the student "teachers" involved.

6. Schedule adequate planning time for each academic year.

7. Schedule voluntary focus groups for student "learners" for further feedback.

Conclusion

The scientific and healthcare communities indicate the need for collaborative interprofessional approaches to care that are initiated in the education of health professionals. Furthermore, evidence is clear that there is an association between the health of the oral cavity and the health of the whole body. (2), (3) Heart disease, strokes, diabetes, and respiratory disease Noun 1. respiratory disease - a disease affecting the respiratory system
respiratory disorder, respiratory illness

adult respiratory distress syndrome, ARDS, wet lung, white lung - acute lung injury characterized by coughing and rales; inflammation of the
 are among the top chronic diseases afflicting af·flict  
tr.v. af·flict·ed, af·flict·ing, af·flicts
To inflict grievous physical or mental suffering on.



[Middle English afflighten, from afflight,
 the general population (11) which could potentially relate to increased costs to the healthcare system. Added to that are the ever increasing numbers of the population moving into their senior years who are expected to live longer and retain their dentitions. This IPE initiative is an effective vehicle to enable all BScN, RPN, PSW, and DH students to learn about, from and with each other, and this initiative lends itself to the development of interprofessional teams of students. Our hope is that TPE TPE Thermoplastic Elastomer
TPE Terminal de Paiement Electronique (French)
TPE Total Power Exchange
TPE Twisted Pair Ethernet
TPE Tampines Expressway (Singapore)
TPE Therapeutic Plasma Exchange
 initiatives such as those we have described and experienced will be a model for others in establishing IPE learning opportunities for their students.

In closing, it is critically important to state that while it was beyond the scope of this initiative, it is recognized that properly designed research is required to better test the outcomes from an IPE initiative of this nature. Any future research should also include following graduates into their practice settings to determine the extent that these interprofessional learning experiences have informed their professional practice.

Acknowledgement

The authors would like to acknowledge the contributions made by the students, Gary Kapelus, Coordinator for Interprofessional Education; Connie Barbour, Nursing Professor, the accompanying part time nursing faculty, all faculty members in the dental hygiene program who have supported this initiative, and all from George Brown College's Centre for Health Sciences, Faculty of Community Services and Health Sciences.

References

(1.) George Brown College. Interprofessional Education (IPE) in Action -What we are up to. IPE experiences. [Cited 29 Aug. 2009] Available from: http://www.georgebrown.ca/healthsciences/interprofessional-education/documents/IPE_Experiences_Map_Base.pdf

(2.) Lux J. Review of the Oral Disease-Systemic Disease Link. Part I: Heart Disease, Diabetes. CJDH. 2006;40(6):288-342. Available from: http://www.cdha.ca/pdfs/Profession/Publications/Journal_December_2006.pdf

(3.) Lux J. Review of the Oral disease-Systemic Disease Link. Part II: Preterm preterm /pre·term/ (-term´) before completion of the full term; said of pregnancy or of an infant.

pre·term
adj.
 low birth weight babies, respiratory disease. CJDH. 2007;41(1):8-21. Available from: http://www.cdha.ca/pdfs/Profession/Publications/Journal_January_2007.pdf

(4.) WHO. Preamble to the Constitution of the World Health Organization. Official Records of the World Health Organization. 1946;(2):100 [Cited 14 Aug. 2010] Available from: http://www.who.int/suggestions/faq/en/

(5.) Office of the Surgeon General The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease . Oral health in America: A report of the surgeon general. [Cited 14 Aug. 2010] Available from: http://www.surgeongeneral.gov/library/oralhealth/

(6.) Lawrence HP and Leake JL. The US Surgeon General's Report on Oral Health in America: A Canadian Perspective. JCDA JCDA Journal of the Canadian Dental Association
JCDA James Carpenter Design Associates
JCDA Johnson City Development Authority (Johnson City, TN)
JCDA Japan Craft Design Association
JCDA Junior Catholic Daughters of America
. 2001;67(10):587. Available from: http://www.cda-adc.ca/jcda/vol-67/issue-10/587.pdf

(7.) Office of the Chief Dental Officer of Health for Canada. [Cited 14 Aug. 2010] Available from: http://www.hc-sc.gc.ca/ahc-asc/branch-dirgen/fnihb-dgspni/ocdo-bdc/index-eng.php

(8.) Health Canada Office of the Chief Dental Officer Projects. Summary Report. Canadian Health Measures Survey. 2010. [Cited 14 Aug. 2010] Available from: http://www.fptdwg.ca/assets/PDF/CHMS/CHMS-E-summ.pdf

(9.) Statistics Canada. Population and Demography demography (dĭmŏg`rəfē), science of human population. Demography represents a fundamental approach to the understanding of human society. . Population estimates and projections. Summary Tables. 2010. [Cited 14 Aug. 2010] Available from: http://www40.statcan.gc.ca/l01/cst01/demo08a-eng.htm

(10.) Statistics Canada. 2006 Census: Portrait of the Canadian Population in 2006, by Age and Sex: National portrait. [Cited 5 Jan. 2011] Available from: http://www12.statcan.ca/census-recense-ment/2006/as-sa/97-551/p3-eng.cfm

(11.) Novak M and Campbell L. Personal Health and Illness. In Veitch, Yarzab, DeRuiter, Kohmeier & Koch (eds.) Aging and society. p. 87. 2006. Toronto: Thomson-Nelson.

(12.) Health Canada. Chronic Disease and Prevention Management. [Cited 5 Jan. 2011] Available from: http://www.hc-sc.gc.ca/hcs-sss/pubs/prim/2006-synth-chronic-chroniques/index-eng.php

(13.) Health Force Ontario. Interprofessional Care. [Cited 14 Aug. 2010] Available from: http://www.healthforceontario.ca/Glossary.aspx

(14.) Health-Force-Ontario. Implementing Interprofessional Care in Ontario: Final report of the Interprofessional care strategic Implementation committee. [Cited 3 Jan. 2011] Available from: http://www.healthforceontario.ca/upload/en/whatishfo/ipcproject/hfo%20ipcsic%20final%20reportengfinal.pdf

(15.) Government of Ontario The Government of Ontario refers to the provincial government of the province of Ontario. Its powers and structure are set out in the Constitution Act, 1867.

In modern Canadian use, the term "government" refers broadly to the cabinet of the day, elected from the Legislative
. Service Ontario e-Laws. Long-Term Care Homes Act 2007. S.O. 2007, CHAPTER 8. [Cited 14 Aug. 2010] Available from http://www.e-laws.gov.on.ca/html/statutes/eng-Iish/elaws_statutes_07108_e.htm

(16.) Ontario Ministry of Health and Long-Term Care. Homes Program Manual. Resident Care and Services Standards and Criteria. [Cited 14 Aug. 2010] Available from: http://www.health.gov.on.ca/english/providers/pub/manuals/ltc_homes/sub_secs/09_03.pdf

(17.) Registered Nurses of Ontario. Nursing Best Practice Guideline. Oral Health: Nursing Assessment and Interventions. [Cited 14 Aug. 2010] Available from: http://www.rnao.org/Storage/50/4488_Oral_Health-Jan9.09-web.pdf

(18.) Government of Ontario. Service Ontario e-Laws. Dental Hygiene Act 1991. S.O. 1991, Chapter 22. [Cited 14 Aug. 2010] Available from: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91d22_e.htm

(19.) College of Dental Hygienists of Ontario. National Dental Hygiene Competencies for Entry-to-Practice [monograph on Internet]. 2008. [Cited 14 Aug. 2010] Available from: http://www.cdho.org/Home/EntryToPractice.pdf

(20.) Public Health Agency of Canada. Core Competency A core competency is something that a firm can do well and that meets the following three conditions specified by Hamel and Prahalad (1990):
  1. It provides customer benefits
  2. It is hard for competitors to imitate
  3. It can be leveraged widely to many products and markets.
 Statements. [monograph on Internet]. [Cited 30 Dec. 2010] Available from: http://www.phac-aspc.gc.ca/ccph-cesp/stmts-enon-eng.php#4

(21.) Conference Board of Canada The Conference Board of Canada is a not-for-profit Canadian organization dedicated to researching and analyzing economic trends, as well as organizational performance and public policy issues. . Employability Skills, [monograph on Internet]. [Cited 5 Jan. 2011] Available from: http://calsca. com/conf erence_board.htm

(22.) University of Manitoba Location
The main Fort Garry campus is a complex on the Red River in south Winnipeg. It has an area of 2.74 square kilometres. More than 60 major buildings support the teaching and research programs of the university.
. Oral Health Promotion Fact Sheets & Video Clips for Mouth Care in Long Term Care [monograph on Internet]. [Cited 5 Jan. 2011] Available from: http://umanitoba.ca/faculties/dentistry/ccoh/ccoh_longTermCare.html

THIS IS A PEER REVIEWED MANUSCRIPT. Submitted 27 Aug. 2010; Revised 6 Jan. 2011; Accepted 10 Jan. 2011

[section] Faculty of Nursing, Community Services and Health Sciences, George Brown College

[DELTA]Faculty of Dental Hygiene, Community Services and Health Sciences, George Brown College

Correspondence to: Lynne Grant, Professor; lgrant@georgebrown.ca

Centre for Health Sciences, School of Dental Health, George Brown College, Toronto, Ontario

Lynne Grant[DELTA], RDH RDH
abbr.
Registered Dental Hygienist


RDH,
n an abbreviation for registered dental hygienist.
; Linda K, McKay[DELTA], RDH, BScD; Lisa G. Rogers[DELTA], RDH, BEd; Sandy Wiesenthal[section], RN, MN; Shari L. Cherneys [section], RN, MHSc; Lorraine A. Betts[section], RN, BSc, BScN
COPYRIGHT 2011 The Canadian Dental Hygienists Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2011 Gale, Cengage Learning. All rights reserved.

 Reader Opinion

Title:

Comment:



 

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:EVIDENCE FOR PRACTICE
Author:Grant, Lynne; McKay, Linda K.; Rogers, Lisa G.; Wiesenthal, Sandy; Cherneys, Shari L.; Betts, Lorrai
Publication:Canadian Journal of Dental Hygiene
Article Type:Report
Geographic Code:1CANA
Date:Feb 1, 2011
Words:5710
Previous Article:Book for the lay public on oral health and hygiene: Keep Smiling! A practical guide to lifelong dental health.
Next Article:Canadian journal of Dental Hygiene--student submissions.
Topics:

Terms of use | Copyright © 2014 Farlex, Inc. | Feedback | For webmasters