“Beneficially Uncomfortable”: Outcomes from a Holistic Interprofessional Care Plan Developed for a Live Patient
Purpose: Given the complex and dynamic nature of health-care environments in current contemporary practice, effective communication and teamwork are necessary skills of competent health care professionals. Providing authentic experiences to develop these competencies is a critical part of health professionals’ interprofessional education (IPE). The purpose of this study was to examine, using a mixed method design, the impact of a two session IPE experience using a live patient case. This experience was part of a larger year long pilot program, focused on development of interprofessional education curricula for Health Science students at the University of Mary Hardin-Baylor. Methods/Description: Eleven student volunteers representing the Doctor of Physical Therapy, Professional Counseling, and Nursing programs in the Mayborn College of Health Sciences were placed into two teams. Participants were informed that this was a two session IPE experience that culminated in each team presenting a care plan to a live patient in a public forum of peers, professors and college administrators. Objectives for this experience were based upon the Institute of Medicine’s (IOM) core competencies and included: 1) roles/responsibilities and teamwork, 2) teamwork and communication to manage differing priorities, and 3) to develop a holistic care plan for the presented patient. Outcomes were measured via participant self-report during a verbal debrief, a short answer survey and completion of the Interprofessional Socialization and Valuing Scale-21 (ISVS-21). In addition, faculty completed the Modified Ottawa McMaster Scale for each student during the presentation session. For the initial session, participants watched a video of faculty interviewing a patient to gather past medical history, current medical needs, concerns and functional level, as well as to identify possible goals that could be addressed by the interprofessional team.The IPE teams were able to ask faculty clarifying questions after viewing the video, and as they began to collaborate to develop their holistic care plans over the next three weeks. During the final session of this experience, participants presented their care plans to the patient and her family, and then were asked questions by those attending the event. The final part of the evening was a verbal debrief facilitated by a student who was not involved in the program and was skilled in group process. Results/Outcomes: Initial thematic analysis of participant reflections and the debrief session reveal a strong appreciation of the live patient case experience. Participants stated that this was a “much more real” experience that created a “safe environment” to practice collaborating, yet made them “stretch their comfort zone”. One participant summed this experience as “beneficially uncomfortable”. Self-report of session engagement averaged 95% (0-100 sliding scale) with 100% of participants rating this experience as ‘extremely valuable’ for their interprofessional learning. Specific rating on all elements of the larger pilot were available and reveal that participants reported an engagement value score of 6.78 (1-7 scale) for the live case planning versus a score of 6.22 (1-7 scale) for written case planning, paired t-test p= .051. Results of the ISVS demonstrate ongoing growth with case planning with paired t-test p=.033. Scores on the Modified Ottawa McMaster Scale demonstrate growth across the entire program with most students achieving ‘above expected’ ratings. Conclusions/Relevance to the conference theme: The student performance and feedback during this live patient case scenario show that this is an innovative IPE experience that pushes students to develop along all IOM competencies. Putting the patient at the center and using a low-stakes but high pressure team presentation format pushed student participants to form collaborative, high functioning teams. This event is an excellent bridge from interprofessional education to interprofessional practice. It is likely to remain a part of future interprofessional activities at the University of Mary Hardin-Baylor.