Application and Student Perceptions of the PEEER© Model for Effective Healthcare Team Communications

Few interprofessional education (IPE) models include patients and caregivers. To address this, we developed a novel model for teaching IP communication which included patients and caregivers as team members. We describe the model and our use of it in several health professions education curricula. We report preliminary data from learners regarding their experiences learning and utilizing the model as part of their IPE. Overall the model was positively viewed by students, although the perceived value of learning activities involving the model varied by discipline. Physical therapy, nursing, and pharmacy students valued the IPE model most, whereas medical students valued it the least. Received: 05/04/2015 Accepted: 08/21/2015 Published: 10/01/2015 © 2015 Conigliaro et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Application and Student Perceptions of the PEEER© Model EDUCATIONAL STRATEGY 2(3):eP1079 | 2 Introduction In their report Crossing the Quality Chasm, the Institute of Medicine (Institute of Medicine Committee on Quality Health Care in America, 2001) identified the development of effective patient-centered teams as one of the re-design imperatives to achieve safe, effective, efficient, personalized, timely, and equitable care. The Core Competencies for Interprofessional Collaborative Practice sponsored by the Interprofessional Educational Collaborative (Interprofessional Education Collaborative Expert Panel, 2011) has refocused healthcare education’s attention on interprofessional education (IPE) and practice. As a result, many health professional training programs are developing curricula to improve the quantity and quality of interprofessional (IP) experiences (Aston et al., 2012; McNair, 2005), including training in IP communication and teamwork. Healthcare teams are complex, with multiple shared responsibilities in the provision of patient care, including creating team structure, ensuring professionalism, practicing flexibility, achieving conflict management, promoting trust and respect, and ensuring interand intra-team communication (Firth-Cozens, 2001; Hobgood et al., 2010). IP healthcare teams, which include members of different healthcare professions, must have shared goals focused on patients’ needs to provide effective health care. Accomplishing these goals may be particularly challenging when IP healthcare teams are composed of professionals with little prior experience working with team members from different disciplines (Barr, Hammick, Koppel & Reeves, 1999), as is often the case. Functioning effectively within an IP healthcare team may require individuals to develop skills beyond their traditional specialty training and education (Nembhard & Edmondson, 2006; Wanzer, Wojtaszczyk & Kelly, 2009). Effective communication among these IP team members is critical to the realization of team goals for safe, high-quality patient care. Our early experiences with IPE activities involving IP teams of students interacting with standardized patients revealed that students’ ability to form functional teams and communicate with each other was not intuitive. To address this and improve our educational process we identified existing models for communication among healthcare professionals (Apker, Propp, Zabava Ford, & Hofmeister, 2006; Boaro, Fancott, Baker, Velji & Andreoli, 2010; Ellingson, 2003; Wanzer et al., 2009), yet found little guidance for models of communication among IP healthcare teams which included patients as team members. Given the increasing emphasis on patient-centered care in many aspects of health care delivery, we believe that IPE should specifically address the inclusion of patients as part of the IP team. We therefore developed a schematic for IP team communication that stressed purposefully working together with each other as well as with the patient and their caregiver(s). In this context, “team” denotes the patient, caregiver, and all healthcare providers; caregiver is defined as anyone, family member or otherwise, who provides care and assistance, either personal or other care such as emotional or logistical support. Through literature review and iterative discussion, we identified five key skills essential for effective communication: 1) use of Plain Language understood by all team participants; 2) Engagement of all team members; 3) Empathy to convey an awareness of the experience of all team members; 4) Empowerment of each team member to actively participate; and 5) Respect for the experiences contributed by each team member. We named this the PEEER© model to allow easy recall of each skill and identified exemplar behaviors which demonstrate each skill (Conigliaro et al., 2013). The schematic representation of the PEEER© model (Figure 1, following page) includes all healthcare providers, patients, and caregivers and intentionally places all members as equal participants in the healthcare team communication process. It is built upon the foundational concept that all team members bring essential knowledge and skills to successful patient outcomes, stressing that effective team communication is both expressive and receptive. Of critical importance in the schematic is the non-hierarchical approach to valuing the contributions of each member of the team. Of additional importance is the flexibility of the model to be utilized with various pedagogical approaches. We present the PEEER© model’s use in health professions education, and report our preliminary results describing students experiences utilizing it.