1. Joe Schwenkler, MD Medical Director Physician Assistant Program School of Health Related Professions Rutgers Biomedical & Health Sciences Experiential Learning in Interprofessional Educa tion

2. Experiential Learning Reflection, critical analysis and synthesis Opportunities for students to take initiative, make decisions, and be accountable for the results Opportunities for students to engage intellectually, creatively, emotionally, socially, or physically A designed learning experience that includes the possibility to learn from natural consequences, mistakes, and successes Source: Experiential Learning Center University of Colorado

3. Established on February 12, 2013 Representatives from four schools: –Rutgers PA Program Joe Schwenkler, MD- chair Lori Palfreyman, PA-C –RWJ Medical school Rob Zachow, Ph.D. Joyce Afran, MD –Rutgers College of Nursing Maureen Esteves, Ph.D., R.N. –Ernest Mario School of Pharmacy Rolee Pathak Das, Pharm. D. Students from each program participated in the planning sessions

4. Principles of Interprofessional Education Longitudinal training, developing relationships with peers Opportunities for collaborative problem solving Explore how to function effectively on teams Ensure that graduating students have the foundation for collaborative practice On-going program evaluation

5. Rutgers/RWJ InterProfessional Education Initiative Website http://moodle.rutgers.edu/course/view.php?id=4289 Moodle Course utilized for central storage of case info and suggested readings

6. 2013/2014 IPE Seminars (students) IPE Patient Centered Medicine run by RWJMS –Geriatrics (250) –Caring for patients with limited English proficiency (180) IPE Physiology Small Groups run by RWJMS –Asthma (250) –Nephrotic Syndrome (180) –Uncontrolled Hypertension (180) IPE Case Conferences –CVA run by PA Program (350) –Medical Errors run by Pharmacy, Scheduled on 3/19/14 (400) IPE Simulation Sessions run by the College of Nursing –To start with asthma case scenario April 3, 2014 –Plan to expand to 48 students every other week #

7. New IPE seminars planned for 2014/2015 IPE Case Conference: The Hospice Team –To be coordinated by the School of Social Work –Modeled after the CVA Case Conference with the addition of New Brunswick Seminary students PCM Shadow Experience Nurse/PA Cadaver Lab New simulation scenarios emphasizing IPE

8. IPE Case Conference : CVA (11/25/13 ) Seven programs participated (# students): –Robert Wood Johnson Medical School (130) –School of Health Related Professions: Physician Assistant (45) Dietetics (18) Physical Therapy (30) –Rutgers College of Nursing (70) –Ernest Mario School of Pharmacy (25) –Rutgers School of Social Work (40)

9. Case Conference Goals –Realize the importance of patient care being provided by Interprofessional (IP) teams in the real world –Learning to work as a collaborative unit –Skill-building to be able to function as part of an IP collaborative team –Understanding the roles, strengths of IP colleagues and what each individual and discipline can bring to patient care –Develop relationships with colleagues outside of the student’s own discipline

10. Research Initiative Collected pre- and post-activity data using validated instrument (about 300 surveys completed) –Readiness for Interprofessional Learning Scale (RILS) –Paper-based, will use Qualtrics* for future activities Looking at attitudes and perceptions about other disciplines and IPE –Assesses value of cooperative learning, trust, respect, professional limitations and professional identity –First step toward developing a comprehensive IPE curriculum Identify real and perceived barriers to IPE * Qualtrics is a web-based survey design and collection program

11. Major Challenges Scheduling –Several programs had limited student availability due to scheduling conflicts –Need to plan further in advance Logistics Case presentation Facilitator training Reflection Data Collection and analysis

12. Logistical Challenges Getting over 350 students and 50 facilitators to the right place at the right time Creating 30 small groups and finding enough rooms –About a dozen students did not show –Created an imbalance in several groups Balance student representation in each small group Ensure student educational levels are similar

13. Logistical Solutions Utilized Access Database to store data –This relational database allows for instantaneous queries and reports –Easy to create mailing lists Each participant picked up a place card –Name, Program (color coded), and breakout room Also received a list of students & facilitators in their small group

14. PA students served as the “hosts” Enlisted PA students to organize the traffic flow, greet participants, and stand in the aisles Red carnation identified the 45 students hosting the event

15. Case Discussion Challenges Need to utilize a case that encourages collaboration Need to have aspects of care that relate to all the disciplines involved Need to present the case in a manner that promotes group problem solving Need to emphasize the process taking place within the small group

16. Case Discussion Solutions Build on a CVA case used by the PA faculty for 2 nd year students Utilize a comprehensive appendix for facilitators Role-play the ER entrance of a “stroke patient” in front of the entire audience –Let the students take the history and ask for physical exam findings

18. Case Discussion Solutions (cont.) Break out into thirty small groups with a mix of twelve students and one or two facilitators –Groups with the best balance “performed” the best This “stroke team” follows the patient from the entrance to the ER until they return home Build in challenges the team needs to deal with (i.e. acute delirium, dysphagia, falls, family issues)

19. Facilitator Training Challenges Bringing a heterogeneous group of about fifty clinicians up to speed on the case Getting the information to the facilitators ahead of time Getting the facilitators to preview the material Getting all facilitators to attend a training session in advance of the case conference

20. Facilitator Training Solutions Distribute case discussion in advance Comprehensive appendix Postings on website Train the facilitators via mailings –Working in an Interprofessional (IP) Group Dr. Afran’s document distributed in advance One hour case review over lunch Debriefing for facilitators at the end of session

21. Student Reflection at the end What do you feel you learned about the role of other professionals in the care of older patients in particular? Were there any challenges to working as an IP group today? Do you think these challenges come up when providing interdisciplinary care in the actual clinical setting? What are some of the key factors in making IP care work? How has IP communication and dialogue been facilitated?

22. Ways to improve? Goal is to have equal # students per program –Ensure that all who sign up participate Students should have similar level of education Goal to have two facilitators per small group –Each program to supply at least 1 facilitator per 10 students –Enlist practicing clinicians: speech therapy and occupational therapy –Invite top senior students from each program Develop a webinar for facilitator training

23. Any Questions/Comments/Suggestions?