Better Together: Transitioning an in-person, interprofessional event into the online space

In early March, the Indiana University Interprofessional Practice and Education Center (IU IPE) faculty and staff were deep into the planning and development stages for hosting a simulation learning event in its Team Education Advancing Collaboration in Healthcare (TEACH!) longitudinal IPE curriculum across nine-IU campuses, including a week-long event in Indianapolis. Meeting rooms were being reserved. Standardized patients (i.e. trained actors portraying patients) were being trained. Rosters of over 1,500 health profession students were being collected. Faculty members were attending facilitator development training preparing for the event. Canvas modules were being created and updated with content. The list goes on.

But like most, the learning environment drastically changed on March 10th when IU President Michael A. McRobbie sent a university wide-letter noting the suspension of in-person classroom teaching until April 6th. IU IPE was faced with a difficult decision, because the simulation learning events were to start on April 8th, two days after campus planned to re-open. With such a fluid situation, would IU IPE be ready to implement face-to-face events?

In anticipation of a University community call to action as an early response to the impending COVID-19 pandemic, IU IPE faculty and staff met on March 11 to discuss the next steps. The team was committed to developing a plan to ensure the health profession learners would be able to complete their interprofessional learning in a safe, secure, and protected environment. Many variables were uncertain – including the projected magnitude and length of IU’s COVID-19 response. With so many “ifs”, the team decided that the best course of action was to create a simulation in the online space in case face-to-face instruction did not resume. And sure enough, on March 15th, President McRobbie announced that face-to-face instruction was suspended for the rest of the Spring semester; further, it was to be extended over the summer.

In response to the uncertainty, the Executive Director of the IU IPE Center, Dr. Andrea Pfeifle stated,  “It was both invigorating and frightening to think about redesigning a curriculum built specifically to teach communication and best practices for interprofessional collaboration so that it could happen in a virtual, asynchronous environment. But IU faculty and staff were absolutely committed to delivering key elements on time and with high standards for our learners.”

And so, the countdown began.

Because simulation is grounded in experiential learning, IU IPE was faced with the challenge of how to create meaningful, interactive experiences for students online. Further, IU IPE had to be conscious that as part of IU’s early response, learners were given an extended Spring Break which shortened the time period to deliver instruction before the end of the school year; thus, the simulation learning event had to take place in a week and a half window in early April.

IU IPE had 12-working days to develop, create, and implement a simulation-based event online for 1,500 health profession students across the state of Indiana. Everyone hit the ground running with no time to waste.

Dr. Brittany Daulton, IU IPE’s Director of Curriculum Development and Research, gathered the team to identify what resources it did and did not have in order to make the best decision on how to move forward. Dr. Daulton led the curricular and implementation efforts for this event.

Dr. Daulton shared, “As a team, IU IPE is committed to providing valuable interprofessional learning experiences for students. Although COVID-19 threw many challenges our way, we were willing to accept and overcome those challenges. COVID-19 forced us to combine our collective expertise and experiences to create an effective learning space; further, students across Indiana were expecting to complete the last event of TEACH! curriculum in Spring of 2020. Thus, it was important to us that we created a comparable experience that met the same objectives as other face-to-face events as well as meet the same standards of quality standards.”

First, because this was a patient-based case simulation, IU IPE began refining the patient case used as the basis for the event. IU IPE included elements of COVID-19 into the patient case to reflect a realistic, yet challenging, situation for the health profession learners.

Next, the team brainstormed ways to ensure learners had the opportunity to work with one another in real-time. Do we create hundreds of breakout rooms in Zoom and have one live session? Do we have multiple live sessions to accommodate all learners? Do the learners take the initiative to set their own date and time to meet? What platform should the learners use? What assignment should the learners work on and discuss during their huddle? These were just some of the questions considered as to how the students might engage with one another.

IU IPE decided to let the students take the initiative to plan and set their own time to meet as a group via FaceTime, Zoom, WebEx, Google Hangouts, etc. Over the course of the event, about 300 groups of learners coordinated a time to meet.

In true collaboration, IU IPE worked hand-in-hand with the IU Health Simulation Center to provide interactive video elements with a standardized patient, and the IU Bloomington’s Center for Innovative Teaching and Learning (CITL) to build a user-friendly Canvas site to host all content, instructions, and assignments for the learners. Further, all IU IPE staff and faculty were involved in some capacity, whether it was sending communications, hosting virtual office hours via Zoom, and responding to learners’ questions via email.

The event was live from April 1st through April 10th. The students had to complete pre-work activities via Canvas, meet virtually as a team to discuss the patient and develop a care plan, and turn in a written assignment as a group.

A rising third-year IU Occupational Therapy learner, Cara Bloom, shared, “I felt thankful to have a smooth experience with Anchor 4 being online rather than in-person. I was lucky to have committed group members who were very responsive to setting up a time to meet and remaining positive about completing the Anchor over Zoom instead of face to face. It was helpful to be able to meet with our group at a time convenient for us all, and each group member was respectful of others’ time.”

Another student, a rising third-year IU medical student, shared, “As a rising MS3, I completed IPE Anchor 4 online this year. I found the Canvas page to be well organized and easy to follow; I understood the goals and expected deliverables. My group used Zoom to meet and collaborated on worksheets through Google Drive. These are resources that many of us have utilized since undergraduate, and therefore we were comfortable coordinating our meeting without explicit directions from the IPE staff. I liked that Anchor 4 was online because it gave groups more freedom to choose when to meet. Additionally, our group kept our online meeting just as engaging as an in-person meeting by turning on our video and audio for the whole time. In past IPEs, we were often on a tight 2 – 3-hour schedule and conversations were cut short as we moved through the programming. However, because the online IPE was strictly student-driven, we were able to discuss one topic for as long as we wanted in order to cover the material. In summary, I enjoyed completing the IPE online for both the convenience of meeting online and for the ability to pace ourselves when working through the worksheets.”

The student-portion of the event was closed; however, it was time to get the health profession faculty members involved. In the in-person event, faculty members would function as facilitators; so, to continue with the same model, they would be included in the online space in the same capacity.

As others worked on the learner-facing module, Dr. Laura Romito, the IU IPE Associate Dean for Faculty Development, was busy developing a process and building content to train facilitators on their responsibilities and duties. Content was added to a facilitator development Canvas page, a podcast was created, and virtual office hours were hosted. Dr. Romito and IU IPE wanted to make the facilitation process as valuable as possible.

The facilitators’ role was to review students’ work together and provide them with feedback that would be useful to them going forward as interprofessional collaborators in their future work.

A facilitator, Dr. Jeanne Johnson, a Clinical Associate Professor of Gerontology Education at IU Bloomington, stated, “I enjoyed being part of the team that developed this online IPE event. It was a valuable experience for both faculty and students. Students were able to apply the teamwork, communication, and collaboration skills they learned through participation in IPE events in a timely and relevant situation that clearly demonstrated the value of each profession in tackling the pandemic.”

The event successfully concluded on April 22nd.

Even though the event did not take place in its ideal form, Dr. Daulton saw significant value of this activity in the online space. Dr. Daulton stated, “In the end, we were able to provide a quality and collaborative learning experience, even in the online environment. We took this opportunity to re-design our learning management system site and focus on COVID-19 restriction and telehealth. The changes we implemented had a positive effect on students’ reactions and learning; further, we plan to integrate these changes in future events. Our data provides evidence that students were satisfied with their learning experience online and that the learning outcomes did not change from the live to online environment. Our team is very proud of the outcome, and how we banded together to meet the challenges of COVID-19.”

To highlight the success of the event as well as the design process, Drs. Pfeifle, Daulton, Weber, and Romito were invited to host a webinar with The National Center for Interprofessional Practice and Education in its “Connecting at the Nexus: COVID-19” web series. The webinar was held on April 23rd at 2:30PM EST, and the recording can be found by CLICKING HERE.

Though COVID-19 threw some wrenches into the original event plans, IU IPE has found ways to overcome them and to keep the work moving forward. Now, more than ever, we need to work together in interprofessional teams to address the ever-changing challenges and ultimately to overcome this pandemic.