On-The-Job Cross Pollination Part 3

Learning Has No Boundries

I have often joked, or maybe bragged, that I must be the most well-versed SLP in the world on rehabilitation topics such as amputations, upper-extremity robotics or bladder management following spinal cord injury. But in all seriousness, as a rehab director, I need this knowledge to lead my team.

Members of the rehab team need to appreciate one another’s contributions to the clinical and professional work provided at our institution. To this end, my director colleagues and I have built a CE model at Frazier Rehab Institute that offers onsite courses as an employee benefit. We also encourage staff to collaborate as faculty on our internally produced courses.

Many of our courses are relevant to the interprofessional team. For example, in early 2013 we brought in Joe Giacino, a leading authority on disorders of consciousness, to train our brain injury team on best practices. Attendees included SLPs, occupational and physical therapists, psychologists, neuropsychologists, nurses, admission liaisons, and physiatrists. Based on this training, all our team members now use a battery of evidence-based assessments for differentially diagnosing state of consciousness. Additionally, the interprofessional team administers the Confusion Assessment Protocol on all patients admitted to our brain injury program.

We’ve also added a cross-disciplinary bent to our CE on student development, tapping instructors from the American Physical Therapy Association’s Credentialed Clinical Instructor Program. APTA originally designed the course for physical therapy professionals, but we’ve seen this learning gap across professions, and the course has bridged it. APTA’s course covers such concepts as parallels between being a practitioner and a clinical educator; identifying student learning needs; designing quality learning experiences; and using effective teaching, supervisory and evaluation techniques. Participating SLPs and OTs are not credentialed by APTA, but they report feeling more qualified to teach students, better prepared, and more satisfied with their experiences.

In fact, since introducing interprofessional CE, we’ve seen overall improved recruitment and retention among staff. Of course, interprofessional teaming can also have its challenges, including concerns about encroachment, territoriality, scope of practice and the like. So some of the interprofessional education instructors clearly indicate whose role it is to conduct a specific clinical function—for example, it is the physician’s responsibility to conduct the brain stem reflex assessment on the Coma Recovery Scale. In cases in which delineations are not as clear, the team discusses which professionals are most qualified to perform specific tasks. Such open discussions tend to keep territorial issues at bay.

In these days of short stays for severely impaired patients, it is more important than ever that we co-treat patients effectively, clearly sharing our understanding of the clinical issues with one another, as well as with patients and their families. This collaboration reaps mutual respect that naturally evolves and strengthens the team.

Kathy Panther, MS, CCC-SLP, director, inpatient therapies (brain injury and stroke rehab programs), Frazier Rehab Institute, Louisville, Ky.

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