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Interdisciplinary Education and Training


You're a song, a wished-for song. Go through the ear to the center where sky is, where wind, where silent knowing. Put seeds and cover them blades will sprout where you do your work. —Rumi

This chapter delves into interdisciplinary education and training in pediatric palliative care, both its basis in the underlying principles of adult education and its creative initiatives specific to the field. The chapter explores:

  • Principles of adult education,

  • Principles of interdisciplinary education as a framework for pediatric palliative care,

  • The unique pedagogy of pediatric palliative care, including suggestions for creative initiatives in training.

In order to optimally tailor the teaching approach, the following factors must be considered: the background, perspective, and experience of the intended audience; the skills they bring; and the most likely and/or most significant gaps in their knowledge.

Principles of Adult Education

Learners seeking increased competency in pediatric palliative care are generally those with a large amount of experience, so the assumptions of andragogy (adult learning) are an integral part of curriculum development. These assumptions as defined by Malcolm Knowles include:

  • Adults have a self -concept of being responsible for their learning,

  • Adults become ready to learn what they need to know.

These attributes lead to highly pragmatic learners who are likely to be motivated when the material is relevant. They are able to be critical about the value of what they learn. When adult learners feel respected by the teachers, they can actively test what they learn in the real world, integrating new learning into their professional roles ( Box 11-1 ).

BOX 11-1
Necessary Ingredients of Adult Learning

  • Choice

  • Customization

  • Authenticity

  • Interaction

  • Team reflection

  • Educators trained in interdisciplinary facilitation

  • Mentoring by expert clinicians

  • Time for formal and informal learning

  • A comfortable environment

  • Access to food, drink, and washrooms

  • Experiential and practical hands-on learning

  • Reflection on personal and professional interdisciplinary educational experiences

  • Social activities within the interdisciplinary learning format

Principles of Interdisciplinary Education

The World Health Organization (WHO) says “Interaction is the important goal, to collaborate in providing preventive, curative, rehabilitative, and other health-related services” regarding interdisciplinary education. Other goals include “enhancing” or “improving” both collaboration and quality of care ( Table 11-1 ).

TABLE 11-1
Core Competencies for Every Clinician
Institute of Medicine—IOM Interprofessional Education Consortium—IPEC
Provide patient-centered care Family-centered practice
Work in interdisciplinary teams Employ evidence-based practice Apply quality improvement Use informatics Integrated services through collaboration and/or group process
Assessment and outcome
Social policy issues
Communication
Leadership

There is a mantra in palliative care circles that interdisciplinary teamwork and learning are beneficial. However, the supporting research and literature is limited, and where available, remains controversial. A review of the general and academic literature on interdisciplinary education identifies some of the salient qualities, benefits, and challenges ( Table 11-2 ).

TABLE 11-2
Interdisciplinary Education: Benefits and Challenges
Benefits Challenges and/or disadvantages

  • Generally well received

  • Variation by individual teacher and learner, compounds the challenge of also being from different disciplines

  • Enables learning the necessary knowledge/skills for collaborative work

  • Attitudes and perceptions remain less impacted than knowledge and/or skills

  • Every learner embodies values reflective of themselves and others

  • Faculty development is necessary for effective education and can be a challenge to deliver

  • All participants access core content components at the same time

  • Discipline-specific content requires additional allocation of time, space, and educators

  • Teaching that genuinely reflects practice is effective

  • There can be a disconnect between what is taught and what is practiced

  • Education can be a quality improvement measure, resulting in practice/service enhancement

  • The physical and temporal hurdles involving space and coordination of varied schedules

  • Participant quotes:

    • “I cannot imagine working again without the interdisciplinary team.”

    • “I will feel naked without the team members.”

  • The necessary component of involving participants to learn from one another in social as well as academic situations can present a challenge

The Pedagogy of Pediatric Palliative Care

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