Published March 25, 2019
Imagine you’re doing a major renovation on a home you’ve owned forever. You know what you want done and are ready to build. During the project, your architect doesn’t talk to the contractor. The contractor talks to neither the electrician nor the plumber. The concrete guy comes and goes as he pleases. How confident would you be about the workmanship?
It’s not a good idea for managing a major construction project. As it turns out, it isn’t such a great idea for managing patients’ health care either, so medical professionals throughout the country are increasingly using the team approach to solve patient health issues.
By removing themselves from their silos and collaborating with colleagues from other disciplines, professionals are giving their patients better, safer health care at a lower cost. Collaboration in health care closes communications gaps and promotes a patient-centered approach where health care professionals work as a team interprofessionally, instead of waiting their turn to care for a patient. According to the National Academies of Science, Engineering, and Medicine, merely reducing preventable medical errors alone could save up to $29 billion a year.
The University at Buffalo and the School of Pharmacy and Pharmaceutical Sciences embrace this national trend by providing students with learning opportunities in Interprofessional Education (IPE). This training provides students with core competencies that will help them work more effectively with other professionals in this new paradigm once they graduate and enter the workforce.
While many universities provide training in IPE, UB recognized its importance with an institutional commitment and set up an office to coordinate education in this discipline across the university. The instruction extends to schools beyond the health professions and includes students in the schools of management, social work and law.
The students learn IPE by progressing through three levels. The first exposes them to the value of IPE and principles of interprofessional collaborative practice through interactive, online learning and group engagements. Here they also learn teamwork skills, the scope of practice of other professions, and the impact of culture on health care delivery. The second develops competency by immersing the students in interprofessional simulations and community-based service learning. The third continues student development in communication, leadership and teamwork while working with patients in interprofessional clinical teams.
“I think there was a realization that it had to be more deliberate so that all graduates were having entry-level competence in this area,” said Nicholas Fusco, PharmD ’10, interim director of the School of Pharmacy and Pharmaceutical Sciences’ Office of Experiential Education. He’s also a clinical associate professor and the school’s representative on the UB IPE leadership team.
“Our feet are going to be held to the fire now with regard to integrating interprofessional education,” says Fusco. “People are better understanding the value of these activities in the curriculum and the feedback from students has been pretty positive with regard to how they view the experiences and how they think it’s influencing their training.”
According to the National Academies of Science, Engineering, and Medicine, merely reducing preventable medical errors alone could save up to $29 billion a year.
To achieve these core competencies, the university’s IPE office and the school work together to ensure that students across the health science schools understand the scope of practice from other professions, communicate effectively to ensure high-quality patient care, and foster the ability to plan, deliver and evaluate patient-centered care. The university takes guidance from the Interprofessional Educational Collaborative (IPEC), a national organization dedicated to working with academic institutions to prepare students to work collaboratively with other professions.
Aside from classroom training and learning about the team-based approach as an abstract notion, the UB Office of Interprofessional Education integrates activities into student education with both large scale and smaller events. IPE forums engage pharmacy students with students from across the university for an experience that is much more interactive than a traditional lecture. Each forum has a theme and keynote speakers to discuss an important issue and its implications. A recent forum involved confronting the nation’s opioid crisis with Erie County Health Commissioner Dr. Gail Burstein and the Medical Director of Substance Abuse Services for Catholic Health, Dr. Paul Updike, as keynoters, which the school hosted in the Pharmacy Building.
After the keynote, the student audience is broken down into smaller groups, each group having student representatives from each discipline. Here, a facilitator engages the students and has them offer solutions for care.
“Once they get into the meat of the activities, they really start to realize how they can individually contribute to the team and also how each of the other individual team members contribute to the ultimate goal of a care plan for a patient,” Fusco said. Pharmacy students bring a unique skill set to these direct patient care activities, providing education in pharmacology, pharmacotherapeutics and self-care.
Mason Chan, a third-year PharmD student, was enlightened after going through the forum. He said that he expected students would share things within their own scope of practice, but got more when his Interprofessional group was presented with a scenario to create a care plan for a hypothetical patient.
“It was a lot different than what I expected. [I was surprised by] how well we worked together and how much knowledge and different perspective we got from other health professions,” Chan said. “Being able to see it through their eyes, sitting down with them and saying, ‘Hey, this is how I would approach the problem…’ helped us better understand and communicate with each other.”
The instruction extends to schools beyond the health professions and includes students in the schools of management, social work and law.
In addition to the training en masse, students get IPE experiences in smaller settings that are both fun and educational. Recently, pharmacy and nursing students met to participate in a unique escape room activity specially designed for IPE collaboration. Their mission: to unlock the mystery of a patient’s ailment through solving medically based puzzles. However, in this situation they had to rely on one another’s medical expertise to solve the riddle…just as they would have to do in real life.
“It was a fun time, I loved it!” said Jessica Swiderek, a third-year PharmD student. “All the clues were medically based. One clue was ‘Find the dosing of this medication,’ so that’s where the pharmacy students would help out. There were other things that nursing students would know that pharmacy students wouldn’t, and that’s how we would help each other out. It was very interesting!”
During their first three years of the PharmD program student will engage in ten hours of IPE training, which prepares them for their final year of advanced experiential training. During their fourth year, students experience interprofessional collaborative practice in its realworld application as they immerse themselves in regional and national practice sites. All pharmacy students also have the opportunity to see interprofessional education “up close and personal” during medical mission trips, where they help the less fortunate throughout the world as part of an integrated health care delivery team.
Both Chan and Swiderek were able to apply their IPE skills while volunteering for the nonprofit Remote Area Medical (RAM) in rural Virginia. Chan also volunteered for Camp Affinity where pharmacy students worked together with nursing and medical students to monitor glucose levels of children with type 1 diabetes. Swiderek also went to the Dominican Republic where she worked side-by-side with other health science students and health care professionals. In these missions, SPPS students help by providing assessments, medication counseling, and preparing and packaging medications in rural medical clinics.
To further emphasize its interprofessional education commitment, UB just launched a micro-credential in Interprofessional Collaborative Practice (IPCP). A micro-credential is the university’s official validation of a set of educational experiences pertaining to a certain area that falls outside of the curriculum. While it is doesn’t rise to the level of an academic minor or even a certificate program, it’s more flexible and easily customized, so it can be based on a student’s particular needs. When a student accomplishes and documents a predetermined number of designated experiences, the university places the micro-credential on his or her transcript. It can also be digitally displayed on social media accounts, digital resumes and email signatures via a digital badge.
There is no additional cost to get a microcredential, and it provides a unique selling proposition both academically and professionally. Fusco believes having an IPCP designation will help students when applying for a job or other training programs, as it is an attestation these students have worked effectively within an interprofessional team in a variety of practice settings.
“This takes it up a step, where the student went out on their own and did other activities that fall slightly outside of the curriculum; so they have to have some individual initiative,” Fusco said. “It will hopefully give them a little bit of a leg up.”
Through its emphasis on IPE, the university and the School of Pharmacy and Pharmaceutical Sciences are providing our students with the insights and training to be the leaders of integrated real-world health care delivery, resulting in improved patient outcomes and enhanced research collaborations.