Center for the Health Sciences Interprofessional Education

UW Health Sciences Objective Structured Clinical Examination

PROJECTS: Macy Interprofessional Bridges Program: Classroom and Clinical Linkages in the Health Sciences Curricula

The Macy Interprofessional Bridges Program: Classroom and Clinical Linkages in the Health Sciences Curricula is a three year project with the goal of sustaining and extending classroom and clinical interprofessional education into the required curricula of the six University of Washington Health Science Schools (Dentistry, Medicine, Nursing, Pharmacy, Public Health & Community Medicine, and Social Work) and the Information School (formerly the School of Library and Information Science). The project is developed and conducted through the Center for Health Sciences Interprofessional Education, created by the Deans of the Health Sciences Schools and housed in the School of Nursing.

Further development of such a program was a key recommendation of the July 2000 Josiah Macy Jr. invitational conference. [1] In addition, the Institute of Medicine Committee on the Quality of Health Care in America calls for a restructuring of professional education to incorporate exactly these approaches. [2] Through the Health Sciences Partnerships in Interdisciplinary Education (HSPICE), funded by the University of Washington Initiatives Fund, our team has nearly four years experience in developing elective interprofessional educational offerings. Thus we are in a position to extend these offerings in to the required curricula in the participating schools, to add the Information School to the active participants, and to incorporate into this project further research to measure the impact of interprofessional education on student competencies in collaborative practice and on patient care. This experience will be highly generalizable to other research-intensive universities with health science centers that encompass multiple professional schools.

Specific aims and activities to accomplish this goal are the following:

Increase the number of scheduled classroom interprofessional courses that satisfy curricular requirements in the participating schools.

We currently are offering classroom courses emphasizing interprofessional perspectives that span the spectrum from pre-professional to professional students. We have developed problem-based classroom courses in collaborative teams, case-based interprofessional grand rounds series, and have incorporated multiple professional programs in two required courses: Musculoskeletal and Hematology problem-based learning (medicine, physician assistants and nurse practitioner students) and Healthcare and Society (medicine, pharmacy, nursing and public health). To date, we have involved approximately 700 undergraduate and graduate health science and information school students in the various elective and seminar offerings. With the support of the Macy Foundation we can expand the number of students and health professions involved in required courses and identify and develop further joint offerings. Interprofessional offerings within required courses in each of the seven schools have the potential to reach over 350 students each year. Examples of topics for further development might include human behavior, physical assessment, ethics, information and evidence-based practice, cultural competence and clinical practice, and interprofessional clinical research. We will accomplish this aim by working with curricular bodies in each school to identify additional candidate courses, coordinate and solve scheduling and small group logistic issues, provide administrative and logistic support to these courses, and develop common web-based course supports regarding interprofessional team work. The trial and evaluation of these courses linkages will be conducted on the proposed Macy funding and then can be financed through University basic instructional funding with coordination from the Center for Health Sciences Interprofessional Education.

Expand our clinical settings for interprofessional clinical rotations.

We have currently identified a small number of inpatient, ambulatory and community sites with strong mentor teams from which we draw students for the interprofessional grand rounds. In the proposed Macy project we will identify a sufficient number of key well-functioning faculty/staff teams in clinical and community rotations to ensure that all health professions students have at least one rotation among these. At least three of the sites we have identified have newly developed interprofessional teams that will allow comparison of patient and staff outcome data with respect to the impact of the interprofessional activity on health outcomes. The faculty steering group in this Macy project will support the identified teams with evaluative and instructional material to help the rotating students appreciate the interprofessional team skills they are seeing in these model rotations.

Create faculty development series for faculty teaching in these courses and clinical/community rotations.

We have had small faculty development exercises within our Center steering group, and are planning an offering in the fall of 2001for the wider health science faculty to enhance interprofessional clinical teaching. The faculty development series envisioned for the Macy project will initially provide the materials and mentorship in interprofessional teaching for the faculty in the expanded coursework and clinical rotation sites in aims 1 and 2. We envision these offerings expanding into faculty training that we can offer to other schools embarking upon similar interprofessional endeavors. We have already responded to several calls for consultation about how to incorporate interprofessional training into academic health science centers. With Macy support we can develop a true faculty and administrative training component to help generalize this to other universities.

Evaluate the impact of these changes on student attitudes, faculty attitude toward interprofessional education, clinical team evaluation of how well prepared students are for team functioning, end of program evaluation changes and employer evaluation of interprofessional functioning.

In those clinical rotation sites that have recently developed interprofessional teams, we will also be able to measure impact on patient and care delivery system outcomes. Further, the case-based instructional supports will be adaptable to a standardized measurement of achievement of interprofessional competencies central to our work.

Although the University of Washington is funding the basic instructional components for each of the participating Health Science and Information Schools, additional funds are necessary for the interprofessional coordination and course development that will be required to tie these elements together in a sustainable fashion across the basic curricula. Our current experience with the extra costs of the interprofessional components has allowed us to estimate these costs as shown in attached budget.

Key personnel on this project include the director and steering team, comprised of lead faculty from each school who will lead course development, curricular liaison and faculty development with each school. In addition personnel will support the evaluation research, provide library and technology support, and budgetary administrative coordination. Basic staff support will be provided by the Center for Health Sciences Interprofessional Education.

References:

[1] Enhancing interactions between nursing and medicine: Opportunities in health professional education. (Chairman’s summary of the conference. September 2000, Josiah Macy Foundation).

2 Committee on Quality of Health Care in America (2001), Crossing the Quality Chasm: A New Health System for the 21st Century (Recommendation 12), Washington DC, Institute of Medicine.

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