Addressing the Gap: Expanding IPE to Graduate Trainees

Dr. Keri Hager shares the focus of some of her work from her spring 2017 semester leave.

Why IPE?

It is essential for students in health professional programs to learn the skills necessary to work effectively in a team-based, patient-centered, interprofessional setting. This goal has been clearly articulated in the IHI’s Triple Aim.

What is 1Health?

Through its 1Health initiative, the University of Minnesota is preparing students in allied health, dentistry, medicine, nursing, pharmacy, public health, veterinary medicine and other related programs, such as social work, to develop the skills needed for success in interprofessional collaborative practice. Since the first 1Health course, Foundations of Interprofessional Communication and Collaboration (FIPCC), started in 2010, the 1Health curriculum has involved more than 7600 unique students and the number of professions involved has grown from 9 to 16! The 1Health learning process currently consists of three phases.

Phase IV Fills The Gap

“While we recognize the importance of introducing our foundational learners to the concepts of interprofessional collaboration, we also recognize that we need to increase our focus on the learners that are responsible for the delivery of care and for educating our foundational learners – the graduate learners (residents, fellows, advance practice nursing students) and practitioners.” ~Brian Sick, MD, Interprofessional Academic Deputy, University of Minnesota AHC

The 1Health curriculum provides foundational health professional training (Phases I-III) but leaves an interprofessional education gap for graduate trainees (i.e. those post-professional degree, but prior to autonomous practice including pharmacy and medical residency and doctor of nursing practice training). Graduate trainees are practicing, but also learning, and teaching and role-modeling for other learners. This presents an important window of opportunity for providing additional necessary interprofessional collaborative patient-centered care team skills and precepting training to support clinician success in evolving collaborative practice and learning environments.

Utilizing Local Resources– IMPACT

In 2013, The University of Minnesota’s residency programs in Internal Medicine, Pediatrics, Family Medicine, as well as the combined program in Internal Medicine and Pediatrics, in collaboration with the School of Nursing and the College of Pharmacy developed the Minnesota Primary Care Transformation Collaborative (MPCTC), now the Interprofessional Minnesota PrimAry Care Team (IMPACT), as a result of a separate national project, the Primary Care Faculty Development Initiative. The mission of IMPACT is to promote and strengthen an interprofessional patient-centered primary care workforce for the state of Minnesota. Initial efforts of the group have been focused on piloting faculty development around teaching and assessing residents and Doctor of Nursing practice students in patient-centered interviewing, and on the development of an interprofessional and interdisciplinary curriculum on the fundamentals of Patient-Centered Medical Homes.

As the pharmacist and College of Pharmacy faculty lead, I have played a key role with IMPACT in developing and implementing the “Essentials of Ambulatory Care (EAC),” a day-long workshop focused on: 1) team (roles, responsibilities, communication), 2) patient-centered medical home principles, 3) systems thinking, and 4) patient-centered communication. The EAC workshop has now been offered nine times (between October 2014 and March 2017) and has been continually refined and reworked by IMPACT faculty to improve cohesiveness and learner engagement, based on faculty experience and learner input.

IMPACT Aligns with 1Health to Include Graduate Learners

The 1Health curriculum and the work of IMPACT have been functioning in parallel, but we saw a great opportunity to combine the efforts to align, expand, and support IPE across the spectrum of learners (from foundation to graduate) and into practice. This was the focus of my spring 2017 semester leave. As the newly elected lead for IMPACT, I am working with IMPACT and 1Health leadership with a goal of expanding the work of IMPACT to other University of Minnesota graduate trainees, such as other residencies and social work.  We are seeking to further develop the program (e.g. add a longitudinal experience, incorporate practice site observations), develop a robust program evaluation plan, and broadly disseminate what we are learning from our work.

Developing health professionals who are ready to work in an interprofessional collaborative practice requires an understanding of the basic concepts (Phase I), development of interprofessional skills (Phase II), and interactions in experiential settings (Phase III). In most higher education settings, the majority of interprofessional education takes place in the early foundational stages, and too little emphasis is placed on later stage learners (IOM REPORT).  Efforts to reach these graduate learners, such as those of IMPACT, are important and should be embraced and encouraged.  Expansion of the 1Health curriculum to include these learners is an important step in the right direction at the University of Minnesota.

This post was guest authored by Dr. Keri Hager, Associate Professor for the Department of Pharmacy Practice and Pharmaceutical Sciences at the UMN-COP. Contact Dr. Hager to learn more at khager@umn.edu.

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