Paper delivered at AMEE2013

1. Sentrum vir Gesondheidsberoepe Onderwys  Centre for Health Professions Education
Fakulteit Geneeskunde en Gesondheidswetenskappe  Faculty of Medicine and Health Sciences
International Classification of Functioning,
Disability and Health (ICF):
An Interprofessional Care/Collaboration Framework
for transformative interprofessional education.
Dr Stefanus Snyman
Stellenbosch University: Interprofessional Education and Practice
WHO: Functioning and Disability Reference Group & Education and Implementation Committee
Dr Klaus von Pressentin: Family Physician, Cape Winelands District
Prof Marina Clarke: Stellenbosch University: Emeritus Professor of Nursing
@MatiesIPE
#AMEE2013

2. Interprofessional Education and Practice
(IPEP):
@MatiesIPE
#AMEE2013

3. IPEP strategy took into consideration:
4 ground-breaking publications:
• Frenk, J., Chen, L., Bhutta, Z.A., Cohen, J., Crisp, N.,
Evans, T., Fineberg, H., et al. 2010. Health
Professionals for a new century: transforming
education to strengthen health systems in an
interdependent world. Lancet, 376:1923-1958.
• Institute of Medicine. 2011. The Future of Nursing:
Leading Change, Advancing Health. Washington, DC:
The National Academies Press.
• Interprofessional Education Collaborative Expert Panel.
2011. Core competencies for interprofessional
collaborative practice: Report of an expert panel.
Washington, D.C.: Interprofessional Education
Collaborative.
• World Health Organisation. 2010. Framework for action
on interprofessional and collaborative practice.
Geneva: World Health Organisation.

5. Adapted with the permission of CanMEDS © 2005

7. In search of an Interprofessional Care/Collaboration
Framework: a common language and approach
A statistical, research,
clinical, social policy
and educational tool to:
• Provide scientific basis
• Interprofessional
teamwork
• Common language
• Permit comparison
• Systematic coding
scheme

9. 2012: The ICF ride
• IPEP facilitators appointed to each site
• Clinical case presentation (Ukwanda Rural Clinical
School)
• Assessment: Students present to local interprofessional
team

10. The aim of this study
To establish how applying the ICF framework as
IPE strategy contributed to
1. instructional reform
2. institutional reform
3. interprofessional
practice, and
4. functioning of health
system

11. Design
• Associative group analysis
• Questionnaires were administered to 70
participants:
• 37 fourth year students,
• 18 facilitators of learning
• 15 patients.
• Free word associations were used to
reconstruct the internal world and subjective
meanings which were expressed by more
direct methods.

12. Results: Students
Students indicated that they adopted
a patient-centred interprofessional
approach which improved patient
outcomes and satisfaction.

13. Results: Health professionals
• Students’ response was confirmed
• Were indirectly challenged to practice patient-centred,
interprofessional care as a result of them assessing
students applying the ICF;
• Improved interprofessional collaboration and
interprofessional
practice;
• Bigger job satisfaction
as they started applying
the ICF in clinical
practice.

14. Results: Patients
• Patients appreciated the improved quality of
care.

15. Institutional reform:
Interdependence
• Appreciate for other professions
(incl. community care workers)
• Bottom up relationships: Commit
to teamwork
• Harmonisation between
education and health: Service
providers request capacity
building in ICF
Instructional reform:
Transformative learning
• Apply bio-psycho-social-
spiritual patient-centred
care, questioning
biomedical model in
tertiary hospitals
• Integrate “clinical
medicine” with “public
health”
• Integrate ethics and
human rights in patient
care
Health system strengthening
• Preceptors apply ICF in
teaching and practice
• Adopt ICF as approach to
patient care in PHC and district
hospital settings
• Influence patient outcomes
Discussion

16. The ICF ride continues…
Request by various sites/authorities for
IPEP/ICF training

Spontaneous change: clinical notes, discharge
notes

mICF mobile app project of WHO: Continuity of
care - Community Care Worker Specialist

17. To make a long story short…
• Assessment of student presentations using
the ICF framework drove interprofessional
practice among healthcare students and
professionals,
• Facilitated the bio-psycho-social-spiritual
interprofessional approach to patient-centred
care
• Resulted in improved patient outcomes
• Strengthened health systems.

18. Acknowledgements
Global forum for innovation in health professions education

19. Publish or perish is OLD SCHOOL
– Demo or die is NEW SCHOOL
Fake it or flunk is OUT
– Engage and cherish is IN
WE NEED PARTNERS:
JOINING IN?
Dr Stefanus Snyman
ssnyman@sun.ac.za
@MatiesIPE