Team-Based Learning and Student-Run Clinic Support Interdisciplinary Education

By Nazanin Kuseh Kalani Yazd

The University of Colorado Anschutz Medical Campus approaches interprofessional education in a manner that mimics the reality of working on an interprofessional team. To prepare students to work in a field that requires coordination across many different disciplines, the University of Colorado takes advantage of the diversity at its health sciences campus by bringing together students from six professional schools in one interprofessional course. In the Interprofessional Education and Development (IPED) course, students in the medical, dentistry, nursing, pharmacy, physical therapy, and physician assistant programs collaborate to solve team-based exercises in 16 two-hour sessions over the course of two years. In each session, the course focuses on core competencies in quality and safety, teamwork and collaboration, and values and ethics. Using a team-based learning approach, IPED aims to prepare students to succeed in interprofessional teams in healthcare.

As a first-year medical student, I have had eight sessions of IPED thus far. Within my group, there are two nursing students, a physical therapy student, one pharmacy student, and two medical students. The majority of the session requires the team to establish and define roles in order to work toward solving a given situation. To ensure that everyone on the team is prepared and understands the session’s materials, students are required to study materials for an Individual Readiness Assessment Exam taken prior to the session. After the individual exam, students answer the same questions with the group in the Team Readiness Assessment Exam. The group is then given an activity with multiple tasks. For instance, in the teamwork and collaboration session, the team is given a situation in which a patient who visits multiple health professionals is adversely affected by the lack of communication between providers. The case requires the group to identify gaps in communication during the patient’s care and suggest methods to prevent similar situations in the future.

In the following week’s safety and quality session, the group is introduced to a more systematic way to assess adverse outcomes using the root cause analysis (RCA) model. Using this method, the group is given a new exercise, which includes completing an RCA and formulating recommendations for prevention. IPED’s approach allows students to work together to form a plan without a structured model before introducing a methodical way of resolving similar situations. Thus far, IPED group sessions have focused on interprofessional roles and responsibilities, quality and safety applications, ethical analysis and decision-making, informed consent, shared decision-making, and situational monitoring.

In my experience, IPED’s greatest strength is in its team-based learning. When my team is given a case, each member uses his or her own professional knowledge to contribute to the team’s progress. Not only have I learned to efficiently work within an interprofessional team, I have also been exposed to the variety of skills that other professionals can contribute to a patient’s healthcare. For example, as a medical student, I did not realize the crucial role physical therapy can play in the recovery of an individual after discharge from the hospital. Before this course, I was unaware of the magnitude of impact other disciplines can have on the care of a patient and how essential it is for the healthcare team to operate together in order to achieve a common goal. With each new IPED session and new situation, my peers have illustrated the wide array of perspectives and skill sets that each profession can contribute to a patient’s care. I have also realized how easy it is to lose continuity of care if team members are not proactive about communication. Conversely, the course has demonstrated that professionals working together in a respectful, diligent, and integrative manner can have a tremendous positive effect on the safety and quality of care that they provide.

I have been able to apply the new awareness and skills I have acquired during IPED at the University of Colorado’s student-run interprofessional clinic. The DAWN clinic, as it is known, was founded by students on the Anschutz Medical Campus and opened in Aurora, Colorado, in March 2015. Students and professionals from a variety of programs, including medicine, dental, physical therapy, behavioral health, nursing, undergraduate programs, and pharmacy, volunteer once a week to provide free comprehensive healthcare to the Aurora community. Its originality stems from the multidisciplinary care that it provides. A patient can receive dental, medical, and behavioral services in one visit. Each patient team can include—but is not limited to—a medical student, a nursing student, a pharmacy student, a dental student, and professionals from each respective field.

As a member of the quality improvement team for the DAWN clinic, I apply my interprofessional education when I volunteer at the clinic. Specifically, I observe the clinic work teams for utilization of tools such as closed-loop communication, situational monitoring, and brief/debriefs. I credit my success on the team to the skills I learned in the IPED course. IPED has allowed me to be cognizant of effective interprofessional communication at the DAWN clinic and later provide educated recommendations for improvement. The awareness, skills, and knowledge I have acquired during my interprofessional training at the University of Colorado Anschutz Medical Campus has allowed me to approach similar interprofessional work situations during my rotations and residency with confidence.

Nazanin Kuseh Kalani Yazd is a student at the University of Colorado School of Medicine (class of 2018) and may be contacted at nazanin.kusehkalaniyazd@ucdenver.edu.

Yazd is also vice president of the university’s chapter of the IHI Open School, which offers professionals and students online training in quality improvement and patient safety. Learn more at ihi.org/openschool.