Category Archives: Interprofessional Education

Chronic Pain Learnings

This is a blog post courtesy of Evan Zhou, MOT student (MOT 2025), who wrote this as part of a reflection piece (adapted by the OSOT Fieldwork Team).

This post highlights how much knowledge the MOT students often bring to placement, based on their prior experiences, as well as how much they learn during placement, which complements their classroom learning.

During a inclement weather day on my first placement (Level 1), I had the time to listen to a podcast titled “Tools to Reduce & Manage Pain” from the Huberman Lab Podcast and found it enthralling and transcendental. Below are my main takeaways and epiphanies.

Evan’s Pain Psychoeducation Philosophy:

  • Providing tools and building emotional resilience are paramount for our clients when managing their pain.
    • I am a big believer in cognitive reframing and emotional regulation.
    • The main message that I want to teach my clients is that if we can increase one’s emotional well-being and provide ways to regulate the nervous system, perhaps one’s pain can be managed, and decreased.
    • And over time, the client can build greater repetitions to build up their pain tolerance.
    • My goal is not to cure their pain or fully alleviate it. But rather, to provide them the cognitive scaffolding to be able to contextualize their thought patterns and perceptions of pain in an accepting and non-judgemental way.
    • This is the message that I would love my clients to work towards – “Here it is again, I recognize it, I honour it, it hurts like hell, but I know that it won’t be permanent and that it will go away. I know what I can do to manage it, and reduce some of the hurt, and make myself feel a little bit better again.” “It will pass.”
  • Pain is a subjective and complicated experience and is pre-programmed into our brains to protect us, to keep us safe from injury or harm.
    • However, its not only a physical experience, it also impacts us both at a sensory and emotional level too.
    • After hearing Dr. Mackey’s experience, and witnessing this in my own clients I do believe that the emotionality piece gets lost in people with chronic pain syndrome (CPS) during their recovery.
    • Based on client reports during sessions, I’ve noticed that clients with CPS often hyperfocus on their physical pain experienced within their bodies. There seems to be this assumption that if one can alleviate their physical pain, all their pain will recede thereby improving their QOL.
      • This is 100% valid, and understandable but I do fear that this cognitive belief may potentially limits one’s ability to recover.
      • In my opinion, one’s own physical pain may often be a manifestation of one’s emotional pain that they have bottled up and stored not allowing oneself to address it.
      • Something that I’ve learned is that when OT’s provide psychoeducation regarding pain, we should explain it through a holistic lens, teaching our clients that pain is a combination of physical, emotional, psychological, and spiritual elements.
  • One tool that my preceptors constantly use in their work is Pacing.
    • Pacing is defined as breaking down an everyday activity into smaller, more manageable components.
      • Its function is to help achieve a desired outcome while reducing the potential of a pain flareup. Pacing can help with finding that “just right fit” for a client in managing the activities that they need to do or want to do, while also being mindful of their fatigue and pain.
      • Pacing can help clients balance between over-doing and under-doing, which is pivotal as the challenge with CPS is thatit waxes and wains. When you finally feel good it’s common for folks to try and do everything that on their to do list (things they weren’t able to do when they were in bed all day yesterday) so you do everything that you haven’t been able to do, but then you regret the next day.
      • What happens is you go into this rollercoaster of no activity – activity- no activity. Which creates reinforcement of avoidance of activity X. And reinforces the notion of fear “that going to my job, doing my physio exercises, or going to the gym will cause me more pain. And I don’t want more pain so I’m not going to do this.”
      • Unintentionally, clients who follow this line of thinking create a  negative reinforcement model which disencentizes participating in meaningful activities that could provide physical, emotional, or psychological relief because they are scared that these things will make your pain worse.
      • Therefore, folks experience occupational deprivation and reduce engagement in activities, which may negatively compound leading to greater atrophy, mood challenges, and ultimately greater disability. This totally makes sense and was a huge epiphany for me
      • So how do we to tackle this? Pacing – set small goals. If you can comfortably walk a block, add an extra 25m each day.  If you are having a great day don’t do 50 blocks. You’re training for a marathon. Not a sprint.
      • You are going to have good days and bad days. On your good days don’t overexceed it, or push yourself. Set a time on your watch, have a threshold time/distance and don’t exceed it.
      • On the bad days, recognize that you have bad days. Everyone has bad days. Give yourself some grace and self-compassion and let yourself get the rest that your body and mind need. Then, the next day, restart to where you were previously and build from there..

Interventions for Pain Medicine & Management from Dr. Mackey:

6 Broad Categories: The idea is to not necessarily solve their pain using one modality but to slowly chip away at their pain experience using various interventions and tools.

  1. Medications
  2. Nerve blockers, spinal cord stimulators, drug deliver pumps
  3. Psychological and behavioural therapies
  4. Physical and occupational therapy approaches to pain (ex. Pacing, diaphragmatic breathing, MSBR, MBCT, AROM)
  5. Complimentary/alternative medicines (ex. Chiropractor, Acupuncture, Trauma-informed Yoga, TCM, Qi-Gong, Tai Chi, Breathwork)
  6. Self-empowerment – reading stories, books, blog posts, evidence based podcasts, learning coping skills.

Feel free to share examples of topics you’ve learned about from your students, that have been enhanced while on placement…

Interprofessional Opportunities During OT Placements: Some Suggestions

Please consider these activities below when you host your next student.

Why Interprofessional Education?

There is a growing need to change the way health care is delivered to ensure timely access to health and human service professionals who provide comprehensive care.  Interprofessional collaboration is increasingly acknowledged as the best means of accomplishing this.

Interprofessional Collaboration “is designed to promote the active participation of each discipline in patient care. It enhances patient and family centred goals and values, provides mechanisms for continuous communication among care givers, optimizes staff participation in clinical decision making within and across disciplines and fosters respect for disciplinary contributions of all professionals” (Health Canada, 2003).

 

In order to have the skills and knowledge to practice interprofessionally, health care providers need to be trained interprofessionally.

Interprofessional Education occurs on “occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (CAIPE, 2002).

Ideally, interprofessional education should be integrated throughout the continuum of learning, which starts with pre-licensure, university-based education; includes practice-based education that occurs during placements; and is maintained through continuing professional development.  Most learners spend at least 40% of their training in clinical settings that range from acute care settings to community-based offices and clinics throughout the province, making this an ideal space for them to learn with, from and about other professions.

Here are 3 suggestions for when the OT students are on placement:

1. Reflection on an Interprofessional Education Session: This activity will enable learners to:

  • Develop a different understanding of issues of common concern for a range of health care providers &
  • Understand the roles of other health care providers and the contributions they make to the health care team

Before the session, learners should reflect on:

What is the purpose of the education session?

What do I  hope to learn through participating in the education session:

    • About the topic?
    • About the team/other team members?

After the session questions to consider include:

    • Who was involved? (e.g. team members, other health care staff, community members)
    • What was the value in learning with other professionals? What were the benefits of and challenges to learning together in this experience?
    • What did I learn about your professional role and the role of others in the context of the session?
    • What could have been different during this session to enable additional interprofessional learning about, from and with each other?
    • How will I apply what I learned today in the future?

2. Shadowing a client through their appointments

The activity will enable learners to:

  • Describe their own roles, responsibilities, values and scope of practice effectively to  team members
  • Explain how other professions’ goals are related to and different from their own role
  • Relate their learning to patient/client goals
  • Describe why or why not interprofessional collaboration is required for patient/client care
  • Explain the concept of a team
  • Demonstrate effective team skills by:
    • Sharing information effectively
    • Listening attentively
    • Using understandable communications
    • Responding to feedback from others

Points to consider after the shadowing:

  • What did I learn about the roles on this team that I did not know previously?
  • What are the similarities and differences between the roles (including yours)?
  • What else do I want to learn about the team and its members? What new learning objectives have now emerged for me?
  • How will this experience influence my role as a professional and team member?

This opportunity is so rich in learning, much more so than just having the student “meet” with other team members.

3. Participation in a Team Meeting

The activity will enable learners to:

  • Identify factors that contribute to or hinder team collaboration
  • Recognize the dynamic nature of teams
  • Consider conditions that promote collaboration
  • Analyze team dynamics  and stages of team development

Before the meeting, Learners should think about:

  • What supports will you need to perform as an effective interprofessional team member and how should you prepare for collaborating in team meetings?
  • What do you expect will happen through collaborating?  E.g. what type of information do you expect you will receive?  What information will they expect from you?
  • What do you expect will happen when you participate in and observe the team meetings? E.g. How will the team function?  What will support the team to reach its goals?

Reflective Questions to consider after the meeting:

  • Briefly describe the purpose of the meeting and your role and your profession’s role in it.
  • Who was involved? (e.g. patient/client, team members, other health care staff, community members) Who wasn’t there and how was information from that person/profession shared? (e.g. how was the patient’s voice expressed?)
  • What ‘group roles’ were evident such as chair, facilitator, mediator, clarifier?
  • Describe the group process or how the team interacted (e.g. consider how team members behaved, communicated, solved problems, made decisions, provided and responded to feedback, addressed conflict).
  • What did the team do well?  What could have been done differently?
  • What did you learn that you can apply to your own practice in your role?  What learning will you take as a team member in the future?

These activities were generously shared by © Centre for Interprofessional Education, University of Toronto, 2010 and adapted with permission  by UBC Health

Shared Spaces: Fostering Interprofessional Interactions for Students

This post comes courtesy of Hina Mahmood, 2016 MOT GraduateRetrieved from: https://www.emaze.com/@AOWCFOII/Interprofessional-Practice

Environments such as hospitals, rehabilitation facilities and community health centers are a hub of activity involving people from multiple health care professions working together to promote health and well being. While these health care providers have implemented collaborative environments with respect to clinical care, the physical work spaces of many health care organizations are more segregated and hierarchical. Doctors have their single offices and nurses congregate around the nursing stations. Even within the rehabilitation department, occupational and physical therapists have their own designated work areas. While this separation makes sense from an administrative and organizational perspective, it hampers potential for interprofessional collaboration which can prove to be an invaluable opportunity, especially for students.

Fieldwork educators can foster a collaborative environment by creating shared spaces for their students.

  • Encourage them to do chart review, documentation and research at a computer terminal located in a common space. This allows them to interact with nurses, case managers, social workers and even doctors.
  • Urge students to take initiative and actively seek out other members of a client’s health care team to explore and discuss care plans and possible interventions.
  • Shadowing other professionals that work in different health care disciplines (i.e. nurses or social work) can provide students with a broader perspective into how they form their clinical reasoning.
  • Students should attend and take active part in team meetings and/or grand rounds. On occasion fieldwork educators can also organizestudent-led, interprofessional meetings.
  • Invite students to have lunch in the staff room – you will be surprised by how often they feel as if they do not belong or aren’t welcome to join.
  • Pair up your student with students from other disciplines that might also be doing their fieldwork placements (eg. physiotherapy, nursing, or social work)

As fieldwork educators, students are looking to you to not only learn and grow as occupational therapists but also as competent health care professionals. You are providing them with the foundational knowledge on how to work effectively and collaborate in a team environment while ensuring that clients receive the best care possible. This creates a trusting and safe learning environment and promotes reflective practice and lifelong learning.

Image retrieved form www.emaze.com/@AOWCFOII/Interprofessional-Practice

Patient as Educator Program at UBC Prepares Students for Placements

The UBC  Interprofessional Health Mentors program helps to prepare students for their fieldwork experiences.

The interprofessional Health Mentors program is an initiative at UBC where teams of students from different disciplines learn together, from and with a mentor (patient/client) with a chronic condition or disability (an expert in their life). Over the course of the program (16 months) student teams (4 per team) meet with their mentor twice a semester, each meeting focusing on specific curricular goals and interprofessional competencies.

The lived experience of disease or disability is unique experiential knowledge not possessed by health professionals. The patient’s voice can enrich health professional education in a variety of ways, broadening out curricula from the traditional biomedical model.
Health Mentors are ‘experts by experience’ in living with and managing chronic disease or disability. Students learn directly from the Health Mentors through an authentic patient-centred model of education in which the locus of learning is between the student and the mentor.

What do students learn?
• How important it is for each individual to be at the centre of their own care
• How to work well on a team with other health professionals
• How healthcare providers can support people with chronic conditions/caregivers and what changes would make things better

Topics  Discussed Include But Not Limited To:

Session 1: Words and meanings – and why they matter
Session 2: Living with chronic disease / disability and its management
Session 3: Managing every day life with a chronic condition
Session 4: Experiences with the health care system
Session 5: Finding, managing and sharing health information
Session 6: Partnerships, collaboration, shared decision making and the future

The program culminates in a symposium where groups share their most biggest “aha” moment in the form of a “tweet” and a creative pictorial representation of their experiences. client centred care for blog

In the words of a past student-This porgram helped me to realize that every profession has a unique and important perspective of health care and everyone [including the patient ]needs to be included to create wholistic health care [solutions]. Devon Cochrane

Getting to know the team: Helpful hints for facilitating shadow experiences

This post is brought to you courtesy of Aja Hann, MOTII student, class of 2016. Edited by Donna Drynan

What thoughts run through your mind when a student you are supervising asks about shadowing other health professionals? UBC occupational therapy (OT) students are extremely lucky in t that they come from a program that promotes interdisciplinary learning. According to a document from the World Health Organization (2010), only 8.9 percent of OTs worldwide receive interprofessional training. This is in sharp contrast to UBC, where 100% of the OT students receive training. Preceptors and students alike should consider having interdisciplinary collaborations and shadowing experiences reflected  in the placement learning  objectives. It is the only chance we will really get to shadow other professions. ***Check out what the WHO thinks of interdisciplinary care http://www.who.int/hrh/resources/framework_action/en/index.html]***

Sometimes, as students, we are so wrapped up in our skill development and evaluations that we miss opportunities for interdisciplinary learning during fieldwork. As a student on placement, I was very nervous about expressing interest in shadowing other professionals in the hospital because I was unsure how this request would be perceived. Luckily, I had great preceptors who went out of their way to find me opportunities when I did get the nerve to bring it up, and I think that I will be a better health professional because of it! Through these experiences I  learned what some of the professions in the hospital do (for example – I had no idea what a psychometrist did before my second placement), and I also gained a deeper understanding of what individuals undergo when they are in the hospital. Further, interdisciplinary training creates opportunities in rural or remote settings for Occupational Therapists to explain our role on the team to an alternative profession we are shadowing. I would recommend that  preceptors, allow such collaboration to occur by organizing shadow opportunities. Do you know any outstanding health care professionals beyond OT who would make great teachers for your student? If you do, think about asking them if they would be open to having an OT student shadow them! For students – the future of the healthcare system – these fundamental skills need to be made available to support our training, future practice, and consequently, improved service we can provide to our clients.

New Online Interprofessional Resource Available

 ipcontherun
Have you ever… wished there was a quick resource available  to explore what all the buzz is about interprofessional education? or  wished your team could be more collaborative? or wished you could have provided more interprofessional collaborative placement activities for your students?Well, wish no more! We are pleased to announce the launch of IPC on the Run – an online learning  series.  After being piloted with over 500 participants, the following modules are now available for broad use:

  • Introduction to Interprofessional Collaboration
  • Interprofessional Communication
  • Patient-Centred Care
  • Role Clarification
  • Team Functioning
  • Conflict Management
  • Collaborative Leadership

WHAT IS IPC ON THE RUN?

IPC on the Run is a series of online modules designed to provide flexible interprofessional education (IPE) for interprofessional collaborative practice (IPC). It is based on the National Interprofessional Competency Framework developed by the Canadian Interprofessional Health Collaborative and integrates online and face-to-face learning

WHY DO I NEED IPC ON THE RUN?

–  focuses on the competencies for collaborative practice

– engages learners in a way that will help them improve their practice

– enables effective collaborative practice, which in turn optimizes health-services, strengthens health systems and improves health outcomes.

– modules  provide a comprehensive program that integratde online and face-to-face learning focused on the competencies required for collaborative practice.

– modules use adult learning principles, consider context of learning and practice, and set clear learning objectives.

 WHO SHOULD USE IPC ON THE RUN?

– designed for learners from any health care discipline interested in enhancing their ability to practice collaboratively.

– designed to meet the needs of learners across the continuum of learning including:  pre-licensure, university-based education; practice-based education that occurs during placements; and for  continuing professional development.

 WHEN SHOULD I USE THE IPC ON THE RUN MODULES?

–  modules are flexible and user-friendly, so they can meet the needs of learners with busy schedules. –  each module can be delivered in something as short as a lunch hour session.

 WHERE DO I USE THE IPC ON THE RUN MODULES?

They are designed to meet the unique needs of different learners in different settings. Some examples might include:
– at work-  individually or with some of my team mates or when I have a student

– at home

– a wide range of contexts (waiting for the bus, at the airport, at Starbucks… 🙂

 HOW DO I USE THE IPC ON THE RUN MODULES?

The IPC on the Run program uses a modular approach that integrates online and face-to-face learning as a way of facilitating the structural integration of interprofessional education into a wide range of learning environments. The online components of the program provide quality content, while helping users reduce some of the scheduling and logistical problems that come with training busy practitioners and learners from different professions. The program integrates face-to-face activities as a means of engaging learners, promoting reflection, and strategically planning ways to improve practice. The program starts with an introductory module that should be completed before learners can access the other modules in the program. This module can be completed independently. Subsequent modules each focus on a different interprofessional competency domain and integrate online and face-to-face learning. Learners need to complete the interactive, face-to-face components of these modules as part of a group, ideally with participants from two or more professions.

Here is a sample of one of interactive activities that you could have a discussion with a student about:

ipc on the run sample

For more information on IPE, IPC and the Interprofessional Competencies, please click here-  IPC on the Run Summary

I trust you will enjoy the modules, find them informative and entertaining and provide you with some new and innovative activities for use in your practice setting.

Visit www.ipcontherun.ca to access the modules and a number of resources that support their delivery.