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Interprofessional education opportunities blossom

Posted: Thursday, April 05, 2012 · Volume: XLV · Issue: 7

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Estela Bavugirje, a refugee from Burundi, has her blood sugar tested by fourth-semester nursing student Jasmine Smart in the San Antonio Refugee Health Clinic. Nursing, medical, dental and physician assistant students are involved at the clinic to provide care for the refugee population that lives near the campus.
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Estela Bavugirje, a refugee from Burundi, has her blood sugar tested by fourth-semester nursing student Jasmine Smart in the San Antonio Refugee Health Clinic. Nursing, medical, dental and physician assistant students are involved at the clinic to provide care for the refugee population that lives near the campus. clear graphic

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When the Interprofessional Education Council was initiated at The University of Texas Health Science Center at San Antonio in fall 2009, there were few educational or clinical programs that brought together students from more than one discipline to learn from each other or work together.

However, that is rapidly changing. In keeping with the national trend of educating medical and health professionals to have a broader understanding of the teamwork involved in delivering health care services, the Health Science Center now has 11 interprofessional courses and a growing number of classes and activities including clinical education experiences, community service learning projects and conferences.

“The goal of interprofessional education at the UT Health Science Center San Antonio is to promote and support the process by which students, residents, fellows and faculty with different health disciplinary backgrounds learn and interact with each other with the focus on improving care for patients,” explained President William L. Henrich, M.D., MACP, who fully supports the effort.

Jan Patterson, M.D., M.S., chair of the Health Science Center’s Interprofessional Education Council, added, “Interprofessional education is the key to improving communication among health care providers that will lead to health care that is safer, and more timely, effective and patient-centered. Because we have so many health care disciplines on campus, our Health Science Center has great potential to lead in areas of interprofessional education. There are increasing venues for this in both the standard and elective curricula, and through special activities,” she said.

Dr. Patterson also is associate dean for quality and lifelong learning in the School of Medicine, and a professor in the school’s Division of Infectious Diseases and in the Department of Pathology. She also directs the Center for Patient Safety and Health Policy (CPSHP), which received the 2011 Outstanding Educational Program award from the Association of Prevention Teaching and Research.

Coordinating interprofessional education efforts
Under Dr. Patterson’s leadership, an Interprofessional Education website was developed. Less than two years later in spring 2011, the Health Science Center hosted The University of Texas System’s Seventh Annual Innovations in Health Science Education Conference, with the theme of “Interprofessional Health Science Education: The Innovation Imperative.” The conference was coordinated by Janet Williams, M.D., FAAP. She is associate dean for faculty and diversity, and Distinguished Teaching Professor of pediatrics in the School of Medicine, and the immediate past president of The University of Texas' systemwide UT Academy of Health Science Education.

Curriculum development
Curricula in the Health Science Center schools are being adjusted and better synchronized to create opportunities for student interaction.

For example, more than 445 medical students, 520 nursing students and six students from the UT Austin School of Pharmacy have taken an interprofessional course in quality improvement and safety begun in fall 2009. The course, now part of the standard curriculum for medical and nursing students, received a national award from the Institute for Healthcare Improvement (IHI) Open School and the Josiah Macy Jr. Foundation at the IHI National Forum in December 2010.

Earlier this week, Dr. Patterson, who is principal investigator of the course, and Suzanne Yarbrough, Ph.D., RN, FAAN, co-principal investigator and associate dean for undergraduate nursing programs in the School of Nursing, presented outcomes from the course at the Josiah Macy Jr. Foundation Conference on Interprofessional Education.

There are additional interdisciplinary courses and projects that include the Dental School and School of Health Professions, such as RESPECT (short for Realizing Enhanced Student Interprofessional Education through Clinical Teamwork). This project involves four-person teams involving each discipline that include teambuilding activities and working together to design tailored, comprehensive health promotion plans for families living at the SAMM Transitional Living and Learning Center.

In addition, the UT Health Science Center recently entered into an agreement with UT San Antonio, UT Austin College of Pharmacy and the UT School of Public Health’s San Antonio Regional Campus to establish a joint Ph.D. degree program in translational science beginning in fall 2012.

Simulated learning
Interprofessional clinical education for medical interns and nursing students is taking place in the School of Nursing’s Clinical Learning Laboratory and Simulation Center, where students practice realistic responses to cardiac and respiratory arrest with simulation manikins in a medical surgical care unit environment. Also, surgery and internal medicine interns practice cardiac and respiratory arrest simulations as interdisciplinary teams in the H-E-B Clinical Skills Center.

Community Service Learning Conference April 5
An upcoming activity this week that illustrates the progress in interprofessional education is the Fifth Annual Community Service Learning (CSL) Conference on Thursday, April 5, with the theme of “Meeting the Social Mission: Health Science Education Through Community Collaborations.” Sponsored by the Center for Medical Humanities & Ethics (CMHE), which is directed by Ruth Berggren, M.D., professor of medicine, the free conference features keynote speaker Fitzhugh Mullen, M.D., professor at George Washington University, speaking on “Social Accountability in Medical Education: A Goal for the 21st Century.”

Also at the conference are a variety of oral and poster presentations from students of nursing, medicine, dentistry, pharmacy and other health professions, as well as free continuing education. “We are featuring more than 30 CSL projects that are funded through mini and midi grants offered by the Center for Medical Humanities & Ethics,” Dr. Berggren said. “Each project proposal is vetted by an interprofessional review committee before funding is awarded. This signature program is available to every student at our Health Science Center, regardless of discipline, and is a major catalyst for interprofessional learning through community-campus partnerships.” The CMHE also offers an online CSL course directed by Dr. Berggren and Melanie Stone, M.P.H., M.Ed., which is available for elective credit to medical and pharmacy students.

Second-year medical student Chad Schmidal (right) checks the mouth of  Deu Biswa, a Bhutan refugee, while paid interpreter Tika Biswa (no relation to Deu Biswa) looks on. The San Antonio Refugee Health Clinic is one of many examples where Health Science Center interprofessional projects are taking place.
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Second-year medical student Chad Schmidal (right) checks the mouth of Deu Biswa, a Bhutan refugee, while paid interpreter Tika Biswa (no relation to Deu Biswa) looks on. The San Antonio Refugee Health Clinic is one of many examples where Health Science Center interprofessional projects are taking place. clear graphic

 

San Antonio Refugee Health Clinic
One of the oral presentations at the CLS Conference focuses on interprofessional work at one of the Health Science Center’s newest student-run free clinics. At the San Antonio Refugee Health Clinic, initiated by Roseann Vivanco, M.S.N., RN, clinical instructor in the School of Nursing, nursing, medical and dental students learn clinical skills while serving the refugee community. Physician assistant students from the School of Health Professions also have been involved by creating a website for the refugee community on how to access health care services. Faculty adviser for the student-run free clinics is Richard Usatine, M.D., professor of family and community medicine and of dermatology, and assistant director of humanities education.

Interuniversity activities
In addition, the IHI Open School San Antonio (IHIOSSA) student chapter is now working at the refugee clinic to develop possible process improvement plans. “The IHIOSSA is a health care interprofessional student organization focused on ensuring patient safety and improving quality of care,” explained Veronica Madlangbayan, a Health Science Center nursing student and vice president of the organization. “We're serious about achieving safe, effective, patient-centered, timely, efficient and equitable care for our patients and the community.”

IHIOSSA is composed of students and faculty advisers from the Health Science Center and Trinity University, which offers a master’s degree in health care administration. “Another of our goals is to expand our organization into other schools in San Antonio and other disciplines at the Health Science Center,” Madlangbayan said. “We are also looking for more faculty mentors to help us with quality-improvement projects.”

TeamSTEPPS™
Another major interprofessional effort is the implementation of TeamSTEPPS™ throughout the Health Science Center, UT System components and the San Antonio community. TeamSTEPPS™ is a powerful evidence-based training program designed to improve patient safety through effective communication and care team performance skills among health care professionals. Training is offered through two-day Master Trainer Workshops held locally on the Health Science Campus and through half-day evaluation Fundamentals Workshops at the Summer Institutes on Evidence-Based Quality Improvement offered by the Academic Center for Evidence-Based Practice (ACE), directed by Kathleen Stevens, Ed.D., R.N., ANEF, FAAN, professor in the School of Nursing. The TeamSTEPPS™ program is supported through funding from the UT Healthcare Safety and Effectiveness Grants program awarded to Dr. Stevens and Michael Corneille, M.D., associate professor of surgery. Since 2009, 110 clinicians, educators, researchers, administrators and students have been Master Trained through this UT Systems-supported program.

With many interprofessional programs under way and others being developed for the future, Dr. Patterson said, “There are so many opportunities to collaborate and learn from each other. We just have to learn the best way to do this to continually improve our care of patients,” Dr. Patterson said.

 
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