Center for Interprofessional Practice and Education
at Washington University Medical Campus

Winter 2019 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.

CIPE Curriculum and Assessment Committee unveils Three-Phase IPE Curriculum Model

The Center for Interprofessional Practice and Education’s Curriculum and Assessment Committee (CAC) has released its new Three-Phase Curriculum Model, which represents a major milestone in teaching learners across the Washington University Medical Campus to work effectively on teams. The first phase of the model will launch this fall and will be focused on how social factors impact health.

The curriculum model is the product of more than two years of discussions between faculty, staff, learners and community and clinical partners across seven professions (audiology, deaf education, medicine, nursing, occupational therapy, pharmacy, and physical therapy).

“We were tasked with delivering a curriculum that meets accreditation requirements for interprofessional education in our seven professions,” said Heather Hageman, MBA, director of the center. “We seek to develop a curriculum that is forward-thinking, community-based and provides added value to existing clinical operations.”

As a collaboration of the schools on the Washington University Medical Campus (Goldfarb School of Nursing at Barnes-Jewish College, St. Louis College of Pharmacy and Washington University School of Medicine in St. Louis), the center’s Curriculum and Assessment Committee includes faculty and student representatives from each of the seven professions. The committee was created to design, review and evaluate the center’s interprofessional education curriculum and learner assessment in collaboration with individual programs and make data-driven recommendations for curricular revisions.

The committee started by defining program goals based on those created by the Interprofessional Educational Consortium (IPEC), a national organization responsible for guiding curriculum development for health professions schools across the U.S. and developing an overall curriculum framework.

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Figure 1: Graphic of Three-phase IPE Curriculum Model

The curriculum framework is being operationalized through a Three-Phase IPE Curriculum Model.

  • Phase I: The Introductory phase is designed to help interprofessional students assess and learn about the social determinants of health affecting patients/clients in the St. Louis community. Phase I contains three activities: a launching activity, a team formation activity, and a culminating activity.
  • Phase II: The Developmental phase is designed to intentionally match students where their professions naturally intersect. In this phase, learners will complete a selection of passport activities. Existing activities on topics such as transitions of care, ethics and proper use of inhalers could become passport activities.
  • Phase III: The At Graduation phase is designed to provide students with a final IPE experience. Details on the structure of this phase are still being determined.

Last fall, key stakeholders were invited to participate in a retreat where their feedback on the Three-Phase Curriculum Model was solicited. During the retreat, stakeholders and Committee members discussed how best to engage students. They ultimately decided to conduct a Poverty Simulation as the Phase I Launching Activity, capitalizing on the fact that many programs already have this activity in their curriculums.

“We really wanted an activity that would help students see that poverty is real and that it’s something they need to understand on a deep level without burdening the community,” said Dennis Chang, M.D., associate professor in the Division of Hospital Medicine and Interprofessional Education MD Thread Director at Washington University in St. Louis, and chair of the CIPE Curriculum and Assessment Committee.

The Committee is currently gathering additional student and faculty input on Phase I. In addition, the center has partnered with the Brown School Evaluation Center at Washington University in St. Louis to carefully monitor development and implementation.

“This is an example of true iterative curriculum design,” said Chang. “In the iterative process, you know that the idea you start with will change as stakeholders continue to provide input, and this input is hugely valuable to making the curriculum the best it can be.”

As the current president of the Health Professional Student Leadership Council, St. Louis College of Pharmacy P3 student Yoon Lee had the unique opportunity to serve on the Committee and provide her input on the development of Phase I. 

“Serving on the CAC has been a pretty eye-opening experience,” said Lee. “From a student perspective, the idea of making personal connections across the professions is very important, and I’m looking forward to seeing what opportunities there will be for students to connect as part of Phase I.”

In the coming months, the Committee will finalize specific plans for the three Phase I activities, including the interprofessional intentionality of the poverty simulation, as well as details of the team formation and culminating activities.

“This is a very exciting time for the center, our partners and the students across all of our professions,” said Hageman. “There are many big changes on the horizon, and we can’t wait to unveil what’s to come.”

Shelene Treptow, Assistant Director, Public Relations, Marketing and Communication, St. Louis College of Pharmacy

Practical Tips for Incorporating IPE into your Clinical Setting

With all the emphasis on interprofessional practice and education recently, most health professionals understand the importance of working closely with our interprofessional colleagues and are well aware of the many benefits of this close collaboration.  However, since many current practitioners were trained more uniprofessionally themselves, when it comes to day-to-day practice, many health care educators still struggle with identifying ways to tangibly and meaningfully incorporate IPE in the clinical setting while teaching.

Call it out: One of the most simple and efficient ways to incorporate IPE teaching is to simply be more explicit with our learners about the interprofessional interactions that we have on a daily basis.  Our learners may not be aware of the multiple conversations we have with each other throughout a typical work day, as many of these interactions occur in real-time, unplanned, spontaneous ways. 

For example, in the inpatient setting, a learner may be in another room when a physician and pharmacist have a brief conversation in the hallway about a medication change, or when a physical therapist stops by the work area to update a nurse on a patient’s progress with therapy. Simply taking a moment to update learners (or better yet, include them in these discussions if possible) can open their eyes to the importance of good teamwork among all members of the team.

Bring others in: Another way to make our learners more aware of interprofessional interactions in the inpatient setting is to involve as many professionals (and learners!) as possible in daily rounds.  In the pediatric inpatient setting, it is the standard of care to have multiple team members represented on rounds: nurses, physicians, pharmacists, patients, and family members are almost always present, and depending on the service, there are often socials workers, physical therapists, or occupational therapists as well.  If any of these professionals have students working with them, they are encouraged to join as well.   Having multiple perspectives presented and discussed on rounds helps us all make the best decisions possible, is more efficient, decreases medical errors, and increases patient and family satisfaction as well as modeling teamwork and respectful communication for all present. 

Involving multiple team members in initial discussions helps increase efficiency and decrease duplicated work in a primary care clinic as well.  These discussions are likely happening between professionals on a daily basis as well, and involving learners in them can model and teach the value of this communication.  This type of collaboration can be especially helpful when working with patients who face particular barriers such as loss of insurance or financial burdens since each professional brings to the discussion various suggestions or expertise unique to their experience.

The above examples are only a starting point; each clinical situation is different and offers unique opportunities to incorporate intentional teaching of IPE to our learners.  We’d love to hear about other ideas or suggestions you have found that work in your practice

 

Find additional tips and tricks here!

Colleen Wallace, MD Washington University School of Medicine

Day in the Life of a PT Student

Vincent_Ann.jpg

 

Today we’re having “dance rehearsal.” Yes, you heard me right. For the past four weeks, every therapist and patient here has been revving up for the annual On With Life Talent Show. We use this talent show to give patients something to look forward to, but also as a vehicle for providing our therapy. For example, the dance that Sally is currently working on was carefully choreographed by us to work on her weaknesses: standing from a low chair, dynamic standing balance, engaging her right visual field.  

Today, I wake up in Des Moines, Iowa, where I am spending ten weeks on clinical rotation at On With Life, a Brain Injury Rehabilitation Clinic. On With Life was founded with a focus on Traumatic Brain Injury (TBI), but quickly grew a reputation for inspired care, and has rapidly grown into a flourishing neuro facility. I see the whole gamut of neuro diagnoses as part of my caseload—TBI, stroke, Parkinson’s, post-concussive, and vestibular.

This morning, I’m on an outing to the Des Moines Sculpture Gardens with one of my patients. These outings are all about community reintegration. One of the worst things a patient can do after a devastating injury is cage themselves at home all day for fear of falling, judgment, disablement, whatever it may be. As a physical therapist, my role is helping patients get back to… well, life. Getting out into the community. Doing the things that make life worth living.

So I’m walking down the sidewalk alongside my patient, James, who’s absolutely engrossed in the sculptures to his right. So engrossed that he’s not paying all that much attention to propelling his wheelchair straight. James sustained a TBI from falling off a roof, and has neglect of (fancy word for doesn’t pay attention to) his left side. I see that he’s heading straight for a tree basin. I don’t say a thing. This is about learning, after all. His left wheel drops into the tree basin, and startled, James looks over at me sheepishly and says, “I wasn’t scanning.”

After the outing, I head back to the clinic to work with another one of my patients, Sally. We’re having dance rehearsal. Yes, you heard me right. For the past four weeks, every therapist and patient here has been revving up for the annual On With Life Talent Show. We use this talent show to give patients something to look forward to, but also as a vehicle for providing our therapy. For example, we carefully choreographed the dance that Sally is currently working to work on her weaknesses: standing from a low chair, dynamic standing balance, reaching out of base of support, engaging her right visual field.  

The song that Sally chose for this dance was “This is Me” from The Greatest Showman. If you haven’t heard it yet, stop everything right now. You need to listen to it. The chorus of the song goes:

“This is brave. This is bruised.

This is who I’m meant to be—this is me.”

Sally stays seated for most of the dance, but it is at this moment in the song that she gathers all her strength for a glorious stand. And then she stands there, arms out, chest proud, chin high. Staring unapologetically at the audience. This is me. My clinical instructor chokes back tears every time we get to this moment in the song. I’m not ashamed to say that I’ve shed a few as well.

It’s hard to grasp the power of this moment unless you saw Sally when she was first admitted to this clinic. She suffered a devastating stroke, couldn’t walk, couldn’t stand. She went from being a successful florist, leader in her church, a fiercely independent woman to needing a mechanical lift to get out of bed.

A week later, when she performs this in front of the entire clinic, friends, and family, she’s met with raucous applause, whistles, more tears.

I wanted to highlight these two parts of my day, because I think they are unique aspects of my clinic. They are how we embody the principle of salience: choosing meaningful interventions for the patient. I haven’t mentioned the other stuff. The countless repetitions of weight-shifting, weight acceptance, stepping. Home evaluations. Aquatic therapy sessions. There’s just not enough room to discuss it all.

But if you want to learn more about what it’s like to be a PT student, talk to one! Our work is exciting, challenging, and humanizing. We help people get better so they can do the things they love. It doesn’t get much better than that.

Vincent Ann

Washington University in St. Louis

Program in Physical Therapy ‘19

 

The Doctor of Physical Therapy Program at Washington University School of Medicine is a professional, full-time clinical doctorate course of study that prepares students for the practice of physical therapy. The three-year program combines clinical and classroom learning. In the classroom, faculty present material as it relates to clinical application. Students develop hands-on clinical skills working with each other and with clinical subjects. Classes also feature case studies and training at off-site clinical locations. Students encounter increasingly difficult cases as they move through the curriculum. Part-time clinical experiences are distributed throughout the curriculum; four blocks of full-time clinical training — 38 weeks in total — provide real-world experience. Graduates leave the program fully prepared to diagnose movement dysfunctions and implement effective, evidence-based treatment plans. The Program in Physical Therapy is committed to recruiting, enrolling and educating a diverse student body.

Pharmacy Students of Health Professional Leadership Council (HPSLC) and Washington University School of Medicine (WUSM) Collaborate to Bring Clinical Pharmacy Services to the Saturday Neighborhood Health Clinic (SNHC)

The SNHC is a volunteer, student-run clinic held in the Family Health Care Center in the Forest Park Southeast neighborhood that provides free medical care to uninsured patients to address acute needs. The clinic opened in 1998, run by medical students at Washington University School of Medicine. The clinic’s goal was to incorporate other health professions into their clinic to provide interprofessional patient care, with the first partnership developed being with Washington University’s clinical psychology graduate students, who volunteer in the clinic by providing psychology specialty services. After this success, the SNHC and WUSM wanted to continue to build strategic interprofessional partnerships, including a partnership with pharmacy.

Suzie Chen, a fourth-year pharmacy student at St. Louis College of Pharmacy (STLCOP), discovered the SNHC four years ago as an undergraduate at STLCOP and noticed an opportunity to incorporate pharmacy students right away. She began working with the student leadership team of the SNHC to make this vision a reality.

In the past year, Chen, Yoon Lee, a third-year pharmacy student at STLCOP, and STLCOP’s HPSLC pharmacy faculty mentor, Dr. Lara Kerwin, have made exponential progress with incorporating pharmacy students in the SNHC.  

Pharmacy students and faculty have conducted three successful pilot visits since the summer. First, Chen, Lee, and Dr. Kerwin assessed the clinic’s needs and capacity to provide clinical pharmacy services. During each pilot visit, medical students and pharmacy students interviewed the patient as a team and discussed their findings collaboratively with the medical and pharmacy preceptors to formulate an appropriate treatment.

Examples of other interprofessional activities including providing patient education about new medications and follow-up and even help student doctors learn about the proper way to write prescriptions. One of the biggest takeaways for participating students of all disciplines was enjoying the opportunity to experience a meaningful, collaborative approach to providing care to actual patients in a real clinically setting. After each visit, the feasibility and success of incorporation of pharmacy services into the workflow of the clinic was evaluated. Moving forward, the team of Chen, Lee, and Dr. Kerwin are discussing the best roles for pharmacy students in the clinic at different stages of their professional training, how pharmacy students will document their clinical activities and recommendations, and how to systematically train student pharmacists in preparation for participation of this real-world, interprofessional environment. In the upcoming months, they hope to solidify the details of the collaboration and fully incorporate the pharmacy service into the clinic on a regular basis.

For more information on SNHC and HPSLC, please visit:

Authors: Suzie Chen and Yoon Lee

Spring 2019 Professional Development Workshops

Spring 2019 Professional Development Workshops

Please save the following dates to join your colleagues from across Washington University Medical Campus for a series of interprofessional workshops.

IPE 201: Managing Challenging Scenarios in Interprofessional Small Group Facilitation*
Tuesday, February 19th, 4:00pm-6:00pm; networking reception 6:00pm-7:00pm

St. Louis College of Pharmacy – Academic and Research Building

Learn about different conflict management styles and strategies for facilitating interprofessional teams through challenging situations.

Disabilities: Telling Our Stories
March 28th, 4:00 – 5:30pm

St. Louis College of Pharmacy – Academic and Research Building

The presentation will include an overview of disability issues, anchored by stories from faculty, staff, and students across campus. Presenters: Joan Lipkin, the DisAbility Project, and Playback Now! St Louis.

Evidence-Based Practice: An IPE Approach
Tuesday, April 9th, 4:00pm-6:00pm; networking reception 6:00pm-7:00pm

Washington University Medical Campus

Co-developed by the librarians from GSON, STLCOP and WUSM this workshop highlights best practices for IPE across professions and will expose attendees to literature from other professions.

Applying Trauma Informed Principles When Working Within Healthcare Teams

May 14, 4:00-6:00pm, networking reception 6:00pm-7:00pm
Washington University Medical Campus

This is a practical workshop to build tools that can be applied within your practice.  This is a follow-up to the December 2018 Trauma Informed Care workshop and will be focused on applying the principles of trauma informed care to work effectively and collaboratively within healthcare teams.

Email cipewumc@stlcop.edu to learn more about the center and upcoming events.

*IPE 101 and 201 are foundational development workshops for CIPE Master Professional Educators. Go here for more information: http://cipewumc.org/educators/mastereducator.html.

Award of Excellence in Experiential Education

Congratulations to CIPE Champion, Gloria Grice (PharmD, BCPS, FNAP, St. Louis College of Pharmacy) and a team that she led for winning the AACP Award of Excellence in Experiential Education for their work on Intentional Interprofessional Education in pharmacy curricula. 

This prestigious award is given annually to an individual, school/ college of pharmacy or group of individuals who have made recent outstanding contributions to or achievements in pharmacy experiential education.

This talented group of experiential educators were tasked by AACP to develop a definition of intentional interprofessional experiential education (IIEE) in pharmacy curricula. The committee felt that this work was cutting-edge and impactful, yet relevant and practical. The outcomes were published in the American Journal of Pharmaceutical Education 2018; 82(3) Article 6502.

National IPE News

Two significant updates in interprofessional practice and education were released last week: consensus guidance for institutional leaders, deans, faculty and accreditors regarding quality interprofessional education and guidance toward the development of optimal interprofessional clinical learning environments. 

The Health Professions Accreditors Collaborative and the National Center for Interprofessional Practice and Education jointly released a document Guidance on Developing Quality Interprofessional Education for the Health Professions. The consensus guidance was developed through a multi-year, multi-phase consensus process aimed at supporting the development and implementation of quality interprofessional education (IPE). The Liaison Committee on Medical Education (LCME), the Council on Social Work Education (CSWE), the American Psychological Association (APA), the Accreditation Council on Pharmacy Education (ACPE) and the National Center served as the lead writing team. 
To access the guidance, FAQ and press release, visit https://nexusipe.org/

2.  The National Collaborative for Improving the Clinical Learning Environment (NCICLE), convened by the Accreditation Council on Graduate Medical Education, released its guidance, Achieving the Optimal Interprofessional Learning Environment: Proceedings from an NCICLE Symposium. This guidance articulates the characteristics, value and role of leadership in interprofessional clinical learning environments. Together with the National Center, NCICLE is working to articulate how an optimal clinical learning environment can better serve patients, learners, health systems and academic health centers. 
To access the guidance and learn more, visit https://ncicle.org/