Center for Interprofessional Practice and Education
at Washington University Medical Campus

Fall 2018 Newsletter

The Center for Interprofessional Practice and Education at Washington University Medical Campus publishes a quarterly newsletter to share updates and professional development opportunities. For questions or to join our mailing list, contact the center!

In This Issue

Select a story below to expand each section.

Pharmacy and Dental Students Team Up for First IPE Experience!
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St. Louis College of Pharmacy and the Missouri School of Dentistry & Oral Health recently joined forces to bring students together for a meaningful interprofessional experience. A total of 24 students – 12 third year dental students and 12 fourth professional year pharmacy students – participated in the pilot program. On two separate dates, six dental and six pharmacy students were partnered to see patients in the St. Louis Dental Center intake clinic.

We started each morning with introductions and a brief orientation. We shared the objectives of the session, and provided students with instructions for the morning.

Students double-teamed patients for the interview: dental students asked about the health history and pharmacy students collected a thorough medication history.  Pharmacy students then watched the dental exam (specific things were noted to pharmacy students by dental students).  Both students provided education: medication-related by pharmacy students and dental care-related by dental students.  Both students worked on documentation of the visit together.

Students were also given a list of conversation questions to discuss in the event of a patient no-show or down time between patients.  These included:

  1. Discuss the role of your profession in opioid abuse. What do you see?  How can you prevent it?
  2. Discuss the role of your profession in tobacco cessation. What do you see?  How do you support/facilitate?
  3. Discuss antibiotic use for common oral infections. What do the latest guidelines and literature suggest for optimal management?
  4. Discuss optimal pain relief options for oral pain. What does the evidence support?
  5. Describe your schooling/education. What are the different types of post-graduate training you can do?  What different types of careers can you pursue with your doctorate degree?

Following each morning session, students and supervising faculty debriefed while sharing pizza for lunch. Students were also asked to complete a written reflection on what they had learned or observed.  One reflection question was: What did you learn about the other profession’s role and responsibilities?  Dental students commented that they learned that “Pharmacists are educating patients about their health and possible medication interactions, not just dispensing meds”, and “they have a much more thorough understanding of classes of medications.”  A pharmacy student noted “the dental student did an extensive initial exam, assessing blood pressure and medical history before even beginning to look in the mouth of the patient.”

When asked about lessons learned, students mentioned the importance of communicating across disciplines. They discussed benefits to team-based care, for the patients and the professionals caring for them. Simple steps, such as introducing themselves to their local dentist/pharmacist or participating in each other’s study clubs would encourage basic communication and collaboration. Dental and pharmacy students all felt they would be more likely to reach out to the other profession after this experience.  As one student noted, “I think the main barrier to collaboration is simply not understanding the importance. After today, I feel more confident about reaching out to my local pharmacist.”

We plan to repeat this interprofessional experience and are discussing other opportunities to encourage meaningful interactions and learning opportunities for the students.  

Written by

Gloria Grice, PharmD, BCPS, Professor, Pharmacy Practice & Director, Experiential Education, Office of Experiential Education

Patricia Inks, RDH, MS Assistant Professor

The Community Action Poverty Simulation

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The cycle of poverty is complex and interconnected. The daily struggles of life for several million people in the United States of America are difficult to truly comprehend without stepping into those shoes. It is critical for health providers who are serving vulnerable patients to understand the care and physical needs of these populations.

The Community Action Poverty Simulation for health care students engages future health providers to think about the harsh realities of poverty and cultivates discussion among peers. This unique tool allows students to e­­xperience and see the direct impacts poverty has on individuals, families, and communities. To find more information about the simulation, click here.

In this particular session, 40 nursing students participated in a 60-minute simulation at Missouri Baptist Hospital. Participants role-played the lives of low-income families, all facing a variety of challenging circumstances. During four 15-minute “weeks,” students lived a month in poverty, interacting with different stations that acted as resource providers in the community. After the four “weeks,” students came together for an hour debrief session led by their class instructor.

I had the opportunity to participate in the simulation, which included a role-play scenario for students. My job was as the Community Action Staff. It was my responsibility to make appropriate referrals for services such as emergency food, utility vouchers and transportation passes. During the debriefing, we learned how there are a lot of resources and programs available to help people. Unfortunately, many are not even aware of them or if they are, there are barriers to access (such as transportation).

Occupational therapy student Stephanie Kibby had the opportunity to participate in a second poverty simulation at the St. Louis College of Pharmacy. This simulation brought together nursing and pharmacy student to shed light on the harsh realities of poverty. Students explored how both professions can work together to assist their patients, who may be concurrently dealing with limited resources, time, and energy, in navigating the complex world of health care.

The simulation made the need for interprofessional work evident. The learners realized the crucial role they can play in helping patients access resources in the community. “Helping each other (across professions) is not a bad thing. It is important to realize limitations as a health care provider and know when to ask questions/help to other professionals to provide the best possible care.”

A key takeaway: in order to help patients, we must work in teams. Not one health care provider can address the social factors that greatly influence the health of patients. As future health care professionals, we witnessed how poverty and poor health are intertwined to form a complex and dynamic web. When one is faced with the decision to buy food for family or insulin for diabetes, many learners chose to support their family with food—sacrificing their own health concerns. The inequalities in the circumstances of many living in poverty lives (e.g., access to health care and conditions of their households) affect one’s ability to maintain health. As health care providers, students experienced the importance of asking questions and inquiring about needs of patients. The needs are not limited to why the patient is seeking health care. These student nurses learned to investigate what the condition of the patient’s home and social environments are. “Just because someone may not ask for help or appear to need help, doesn’t mean they are not struggling.”

 

Upcoming Poverty Simulation—Fall 2018:

Monday, October 22nd at Missouri Baptist Hospital

Contact for more information:

Susan Fliesher, DNP, CPNP, RN

susan.fliesher@barnesjewishcollege.edu

 

Team CIPE Inspired at National Meeting for Interprofesional Education

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I’m new to the Washington University faculty and to the world of interprofessional education (IPE). Thanks to the CIPE, I attended the annual NEXUS meeting for IPE at the end of July in Minneapolis, Minnesota. The conference’s mission is to bring together health professionals and educators who are committed to a future in health care where interprofessional teams improve the health of individuals and communities.  It was exciting and inspirational to meet with experienced interprofessional educators and hear their stories. All were at different stages of the process and it made me realize what amazing things were possible. It was also comforting to know that we are all struggling with the same issues around organization, assessment and buy-in.

One session from Jefferson University gave me a look at a well-developed IPE program that had created a unique and robust assessment tool.  The tool they used was called the Jefferson Teamwork Observation Guide (JTOG) and it was developed around the IPE competencies outlined by the Interprofessional Education Collaborative: Communication, Values/Ethics, Teamwork and Roles/Responsibilities.  The JTOG tool was further refined with surveys of staff and most importantly patients. Many of the questions centered around crucial aspects of team care: was the team member prepared, did team members listen to each other and show respect and trust with one another.  The two best parts of the tool were that for each type of evaluator (team member, team leader and patient) there was a unique survey created just for their perspective and the JTOG tool could also be downloaded as an app. 

The sessions I attended also stressed that although it is extremely important to evaluate what our learners learn, the true goal of any health professional education is to affect behavior so that we provide better care to our patients. This idea of centering our assessments and curriculum around the patients was further emphasized in the opening plenary where the Associate Vice President of the National Center for Interprofessional Practice and Education (NCIPE), Dr. Barbara Brandt advocated for having patients and patient advocates be part of IPE curriculum planning.

My colleague Nancy Mueller, MPH, Assistant Dean and Director of the Brown School Evaluation Center, attended a session from Case Western Reserve where participants described their experience in creating meaningful IPE clinical experiences at clinic-based practice sites that mirrored some of the ideas we are currently working on here at the CIPE. Another session emphasized the need to push our evaluation of IPE beyond “does it work” for all learners to which specific learners benefit and why.

Said Kelly Hantack, MSN, RN, CPN at Goldfarb School of Nursing, who attended the conference: “My takeaways for this enlightening conference were big. Each program within each center needs a director of IPE or at minimum a designated faculty champion to ensure success and engagement. CIPE needs a community health clinic on campus ran by our students. We also need a CIPE dedicated simulation center where students can learn together throughout their programs. We need to look at the mission/vision of all programs involved. IPE involvement should be included in promotion guidelines at each of the programs as well.”

NEXUS was a wonderful conference that showcased amazing work going on across the country in the world of IPE and inspired us to continue this challenging but rewarding work. 

Dennis Chang, MD

CIPE Curriculum & Assessment Committee member

IPE Thread Leader for the WU MD program

A Day in the Life of an Occupational Therapy Student

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My name is Rich and I just completed my second year of the occupational therapy program at Washington University in St. Louis. I am currently on Level II Fieldwork, free from didactic coursework and immersed in the clinic experience.

Here’s a bit more about me. I am originally from Long Island, N.Y., and I graduated in 2011 from Binghamton University with a Bachelor of Science degree in human development. My first job was at an ophthalmology practice. There I learned that my passion for health care and research were strong enough for me to move to St. Louis and start graduate school!

7:00 am: Arrive at Milliken Hand Rehabilitation Center. I review my schedule, progress on established patients and check for new referrals. For all patients, I check for any communication from other members of the health-care team. I discuss plans for treatment with my instructors.

7:30 am: Our first patient arrives, an individual with a near amputation of the dominant hand. She had severed arteries, nerves and tendons, and she has multiple fractures in the hand and wrist, all repaired surgically prior to her visit with us. Her primary concerns are how to care for her child and when she can return to work. We discuss her injury, precautions and a home exercise program to help her regain function. We also discuss her goals, her hopes and her values. Together, we decide on a therapy plan. She leaves empowered with a better understanding of her condition and treatment plan.

8:30 am: My clinical educator, Rhonda Powell, OTD, OTR/L, CHT, and I work with our next patient, referred with an order for a more complex orthosis and a delicate zone two flexor tendon repair. During our session, we teach her about tendon anatomy, what the typical healing times are, how to self-manage her health care at home to reduce edema and scar tissue, and home exercises. Most importantly, we relate this information to her daily life.

11:30 am: I work with my other clinical educator, Katie McQueen, OTD, OTR/L, CHT, to treat an individual with breast cancer. Our treatment centers on utilizing core occupational therapy concepts such as activity modification, energy conservation and home health management to promote independence.

12:00 pm: Documentation!

2:00 pm: My 2:00 pm patient cancelled, allowing time for an in-service. Guided by an experienced therapist, we discuss tendinopathies and ligamentous diagnoses of the wrist. We discuss expected precautions and functional limitations. We anticipate questions that patients may have and work through appropriate responses.

4:00 pm: Because Milliken is close in proximity to our referring physicians, we get a rush of “walk-in” patients at the end of the clinical day. It’s all hands on deck to evaluate and treat each one. I repeat the Milliken mantra: “Do what’s best for the patient.”

6:00 pm: At the end the day I return home to relax, read assigned articles and book chapters, and work on my research paper.

Hopefully, this gives some insight to one occupational therapy student’s experience!

 

The Program in Occupational Therapy is ranked as the number one occupational therapy program in the nation by U.S. News & World Report. We offer several entry-level professional and post-professional degrees:

  • Clinical Doctorate of Occupational Therapy (OTD): The clinical doctorate degree is for entry-level students and licensed occupational therapists who want to assume a leadership position in practice, management, teaching and/or clinical research. In addition to coursework, students complete the doctoral experiential component to prepare for a selected area of practice. This is a 40-month, full-time program.
  • Master of Science in Occupational Therapy (MSOT): A master’s degree is required for entry into the profession of occupational therapy. This is a 28-month, full-time program. 

Please visit ot.wustl.edu for more information about our degrees and admission requirements.

Professional Development Opportunities

Have you signed up to be a First-Year IPE facilitator yet?

Contact robinyoung@wustl.edu to find out more information. 

 

Mark your calendar for AY 18-19  

Integrating the Arts Into a Health Professions Curriculum

Wednesday, Oct. 10, 4-6 p.m.

EPNEC, Room 301

The workshop will showcase the Kemper Art Museum’s Art of Observation program and demonstrate how it can fit into a health professions curriculum. Artist Maria Ojascastro will lead a hands-on activity designed to emphasize team collaboration.

 

IPE in Your Clinical Practice

Tuesday, Nov. 13, 4-6 p.m.

(Networking reception from 6-7 p.m.)

St. Louis College of Pharmacy - Academic and Research Building

A practical, active and fun workshop providing tips on how health care providers can impact the culture of practice settings by intentionally integrating interprofessional learners into processes of care.

 

Trauma Informed Care

Tuesday, Dec. 11, 4-6 p.m.

(Networking reception from 6-7 p.m.)

Goldfarb School of Nursing

Research shows that adverse events and stress, particularly persistent, toxic stress or traumatic incidents, lead to disease. Learn more about how incidents and stress can affect your patients/clients and members of your health care team.

 

IPE 101: Facilitating Interprofessional Small Group Facilitation*

Friday, Jan. 11, 8 a.m. to 4 p.m.

Washington University School of Medicine - Farrell Learning and Teaching Center

Participants will learn about the IPE competencies and the emerging CIPE longitudinal curriculum. Those in attendance will also gain knowledge about implicit bias and the stereotypes of professions and the culture of teams, and have the chance to hone their facilitation and debriefing skills. This event is meant to be a foundational workshop which will be supplemented by our monthly workshop series on specific skills.

 

IPE 201: Managing Challenging Scenarios in Interprofessional Small Group Facilitation*

Tuesday, Feb. 19, 4-6 p.m.

(Networking reception from 6-7 p.m.)

St. Louis College of Pharmacy – Academic and Research Building

Participants will learn about different conflict management styles and strategies for facilitating interprofessional teams through challenging situations.

 

Please register by clicking on the title of each workshop above. Reminder emails will be sent in advance separately for each.

Visit us online at cipewumc.org to learn more about the center and upcoming events.