Enhancing Interprofessional Education: Integrating Public Health and Social Work Perspectives

摘要

National stakeholders in health system improvement and patient safety including accreditation bodies have requested health professional educational programs to include multiple interprofessional experiences through didactic and experiential opportunities. Clinical and population health faculty at the University of South Carolina redesigned and expanded an introductory interprofessional course to include more than 500 students from public health, social work, medicine, pharmacy, and nursing. Students participated in 3 live class meetings and completed required online coursework to explore concepts related to social determinants of health and health disparities, health system improvement, patient safety, cultural competency, and ethics to address interprofessional education core competencies. Course modifications and expanded student enrollment improved understanding of key health concepts and appreciation of interprofessional collaboration. During the past decade, interprofessional education (IPE) for the health professions has proliferated in educational settings across the United States. Early activities typically involved clinical disciplines such as medicine, pharmacy and nursing, partially in response to compelling calls for changes in the health care delivery system from the Institute of Medicine 1 and World Health Organization. 2 With the development of the Core Competencies for Interprofessional Collaborative Practice, 3 inclusion of professions such as public health in IPE efforts has increased; currently, schools of public health are mandated to provide an interdisciplinary learning environment. 4 Interprofessional collaborative practice is critically important to progress toward the triple aim of better care for individuals, better health for populations, and lower health care costs 5 and meeting Healthy People 2020 objectives. 6 This practice best occurs when health profession students develop core competencies through IPE experiences, 3,7 including attention to the social determinants of health. 8 Accordingly, central administration at the University of South Carolina (USC) created an interprofessional education committee. The committee, which quickly expanded from 5 members representing 5 schools and colleges in 2011 to more than 20 in 2014, was tasked to facilitate and deliver IPE learning and service opportunities to students from these colleges. One significant effort of this committee was the creation and implementation of a foundation IPE class, “Transforming Health Care for the Future.” This course initially paralleled a similar course developed at the Medical University of South Carolina 9 and started in 2012 for 201 medical and pharmacy students. In 2013, the class of 432 included nursing students. For the third delivery in 2014, the class included more than 500 students ( Table 1 ), including all students in the physical therapy program and the Department of Communication Sciences and Disorders; public health and social work students—both graduate and undergraduate—could take the class as an elective. In this paper, we explore changes in the end-of-course evaluation based on course objectives and specific content areas after a substantial course revision, which was developed by a group of course coordinators to meet the needs of the expanded enrollment representing all USC health professions students. TABLE 1— Interprofessional Class Participants Faculty/Student Facilitators Students School/College (Level) 2013, No. 2014, No. 2013, No. 2014, No. Medicine (first year) 8 4 96 97 Nursing (senior) 10 5 228 226 Pharmacy (first year) 12 8 107 109 Public Healtha (varied) 1 4 0 60 Social Work (varied) 1 2 1 12 Other 0 2 0 0 Total 32 25 432 504 Open in a separate window aIncludes physical therapy and communication sciences and disorders. Because of varying curriculum and accreditation requirements of the separate programs, the course requirements were embedded into other larger courses for medicine and nursing but comprised stand-alone courses for pharmacy, public health, and social work. The overarching goals of the course were to address the competency domains articulated by the IPE Collaborative 3 : values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teams and teamwork. The course included 3 live meetings and a series of 6 web-based modules that students completed either individually or with assigned small groups. All groups included representatives from as many of the various professions as possible. Each team had its own discussion board in the campus learning management system. In 2014, the live meetings were more interactive, with student-centered facilitation. Through experiential activities (readings, case discussions, interactive exercises, and systems-based problem analysis) conducted in interprofessional teams, this course provided students with foundational knowledge on collaborative care, teamwork essent