1. Instructional Methods Lessons Learned & Next Steps
Cultivating Collaboration: An Interprofessional Collaboration Skills Curriculum for Early Medical Students in Clinical Microsystems
Josette Rivera, MD1; Susannah Cornes, MD1; Allison Ishizaki, MPH1; Anna Chang, MD1;
Maria Wamsley1, MD
1University of California, San Francisco
Purpose & Background
Assessment Plan
Outcomes
Purpose: To teach and assess interprofessional collaboration skills of first-year medical students participating in a longitudinal clinical skills and health systems improvement curriculum.
Background:
Interprofessional education (IPE) traditionally focuses on the interactions of students of different professions
Situated learning theory posits that learning occurs through interaction with practitioners
Embedding students in interprofessional (IP) teams of practicing professionals may provide rich opportunities for formal and informal IP learning
Assessment of teamwork skills is important for ongoing program evaluation and to ensure students are prepared to function collaboratively in healthcare teams
We developed and piloted 3 assessments:
Written application of an IP communication tool (ISBAR) in month 5 (summative)
Simulation case in which each student negotiates a patient's care plan with a standardized social worker in month 8 (summative). Grading rubric emphasized ISBAR & rapport building skills. Sample rubric items:
Student expressed empathy utilizing at least one PEARLS statement (Partnership, Empathy, Apology, Respect, Legitimation, Support)
Student clarified roles and next steps for care plan
Two item feedback survey on students’ IP collaboration skills completed by non-physician team members in months 5 and 8 (formative):
“What does X do well in collaborating with other health professionals?”
“What does X need to improve to collaborate more effectively with other health professionals?”
Written ISBAR assessment: average score 60% (SD=2. 8%)
Standardized social worker assessment: average score 88%
(SD=8. 9%)
IP feedback survey results: please refer to McGinness et al1
Student Feedback
“Outside of our project and outside of our patient visits and outside of the time that we specifically had an assignment to talk to a healthcare professional-there weren’t many opportunities or times that we would seek other interactions” –MS12
Instructional Methods
“…it's healthy to understand the hard work that everybody in the healthcare team is doing. Actually going to the site and being able to see with your own eyes everything everyone is contributing is meaningful and helpful for first-year medical students.” – MS12
In the UCSF Clinical Microsystems Clerkship (CMC), groups of first-year medical students are assigned to a faculty coach and clinical microsystem for 15 months. Students spend one day/week learning direct patient care skills, interprofessional teamwork, and working on a systems improvement (SI) project.
We created a longitudinal IP curriculum embedded in the clinical microsystem intended to:
Increase student knowledge of roles/responsibilities of diverse healthcare professionals
Foster student IP collaboration skills including communication to deliver patient-centered care
IP curricular activities include:
Interview/shadow 1-2 non-physician team members
Observe an IP team meeting with an observation guide
Small group on IP communication skills/tools
Interview a patient about their IP healthcare team
Communicate with an IP team member about a patient care issue
Curriculum provides workplace-based IP learning while avoiding logistical challenges of bringing students of different health professions together
Curricular materials and assessments can be adapted for early learners of any profession with longitudinal clinical placements
Formal activities in months 1-5 are essential for student learning about the roles of their colleagues
High scores on summative standardized social worker interaction suggest acquisition of IP communication and rapport building skills
Discussion
Figure 3. Students preparing for standardized social worker interaction
Figure 2. Students observing IP team meeting.
Figure 1: Timeline of Interprofessional Education Program
in the Clinical Microsystem Clerkship
IP team member interview/shadow
IP communication small group
Month 1
IP team member interview/shadow, part 2
IP team observation
By Month 5
Practice IP communication tools in clinical microsystem
Interview patient about their care team
Month 7
Month 5:
IP Feedback Survey
Written ISBAR Assessment
Month 8:
Standardized Social Worker Interaction
Lessons Learned & Next Steps
The robustness of student IP interactions varied depending on team stability, whether the microsystem was accustomed to engaging with students, and the degree of faculty coach facilitation2
Next steps are to focus on informal IP learning opportunities, particularly via faculty coach development to help students recognize and reflect upon opportunities which often occur on the fly
Explore feasibility of incorporating IP colleagues in additional assessment activities
Create summative exam exercises to assess IP competencies such as conflict management and requesting consultations
Authors
References
Josette Rivera MD; UCSF;
Susannah Cornes MD; UCSF;
Allison Ishizaki MPH; UCSF;
Anna Chang MD; UCSF;
Maria Wamsley MD; UCSF;
The authors have no financial or other conflicts of interest related to the above materials
McGinness A, Wamsley M, Rivera J. Quality of Interprofessional Feedback for First Year Medical Students: A Content Analysis WGEA Poster.
Wamsley M, Rivera J, O’Brien B. ‘Getting out of that siloed mentality early’: Opportunities for interprofessional learning in a longitudinal clinical placement for early medical students WGEA Oral Presentation.