Using an Interdisciplinary Community Based Fall Prevention Clinic to Foster Leadership in IPE.
Purpose: The purpose of this interdisciplinary, inter-institutional fall prevention clinic is multi-fold: 1. To bring students across 2 instutions and 4 healthcare disciplines together to experience interprofressional collaborative practice, and to enhance communication, clinical reasoning and critical thinking skills through interprofessional education (IPE). 2. To facilitate leadership opportunities for students in a team approach 3. To engage students in meaningful student led collaborative activites designed to enhance the IPEC core competencies of interprofessional team based practice; interprofessional communication; values and ethics for interprofessional practice and to define roles and responsibilites for collaborative practice. 4. To provide valuable, pro-bono coummunity based health screenings to underserved seniors in the Central Valley with the hope of carry over into leadership roles in future careers. 5. To meet CAPTE accreditation standards through high-impact learning opportunitiesMethods and/or Description of Project: This project evolved out of a grant with the initial purpose to start a student led Fall Prevention clinic for community dwelling older adults. Over several years, the Clinic was integrated into the Doctor of Physical Therapy curriculum as an extension of the on-campus Gait Balance and Mobility Clinic (GBMC), established in 1997. The student led Fall Prevention Clinic was further expanded to include nursing and kinesiology students from Fresno State. About 5 years into the project, the SAFE (Senior Awareness and Fall Education) - Central Valley Coalition was established to expand the program across multiple facilities and bring Fall Prevention educational seminars across the Central Valley. Finally, pharmacy students from the California Health Sciences University were included to further expand this student led initiative. Students from multiple disciplines, under faculty guidance, work collaboratively to lead quarterly comprehensive, team-based balance, health and fall risk assessments, medical reconciliation, and fall history screening to community dwelling older adults. Students then collaborate, with faculty oversight, to give individualized, interprofessional recommendations including balance classes, home exercise programs, home assessments, educational materials, referrals to health care professionals or GBMC and medication reconcilliation. The quarterly screenings are planned and implemented by student team leaders who advertise, schedule and coordinate all necessary materials and equipment. Student team leaders and faculty facilitate a quarterly interdisciplinary orientation where students are divided into teams representing each discipline and to discuss IPE, roles and responsibilities of each discipline, learn about falls and fall prevention and the assessments used for the screenings, and end with a case study for each team to discuss and apply interdisciplinary clinical reasoning skills. Students are then divided into teams for the quarterly screenings and student team leaders are selected for each team. Students complete the Entry Level Interprofessional Questionnaire (ELIQ) prior to the orientation and again after the community balance screening to determine student’s attitudes towards interprofessional education and collaboration. In addition, the clients that attend the screening are asked to complete a Satisfaction Survey to determine the success of the balance screening.Results/Outcomes: The student led fall prevention clinic has served over 700 older adults since 2007 and has involved more than 500 undergraduate and graduate students across 4 healthcare disciplines and 2 institutions. Over 30 lectures have been given throughout the Central Vallley through SAFE. Additionally, since all DPT students at Fresno State participate in the Fall Prevention Clinic, more than 20 student led prevention and wellness doctoral service learning projects have evolved out of the Fall Prevention Clinic, ranging from health fairs, evidence based seminars, mini-screenings at various facilities throughout the Central Valley, group balance classes, mini-clinics and more. Multiple students have used the Fall Prevention Clinic as a starting point for their EBP Doctoral manuscript and oral defense. Two student posters using data from this project have been presented at CSM and CPTA conferences, one of which has now been written as a full manuscript currently accepted for publication, pending final review. One DPT student, as a direct result of participation in the Fall Prevention Clinic, is now negotiating with a future employer to start a Fall Prevention Clinic modeled after the one at Fresno State, in her new position. Each year, students from the third cohort use their leadership skills gained through this project to prepare the second year cohort for this experience. Anecdotal evidence from alumni interviews indicates that the Fall Prevention Clinic has directly influenced our graduated student's clinical practice. Additionally, Post ELIQ surveys were completed by 311 students (92/311 physical therapy; 121/311 nursing; 58/311 pharmacy; and 35/311 kinesiology; and 5/311 public health) over the last 6 semesters. Results indicate student’s self-assessment of communication, interprofessional learning and perception of interprofessional learning were rated high post screening. Additionally, results showed that respect and collaboration betweent he disciplines improved. 121 clients completed the patient satisfaction questionnaire. 100% indicated they would recommend the screening to a friend and 96% indicated they plan to make changes because of something they learned at the screening. The clients also ranked the student teams very high on professionalism, knowledge, and making them feel comfortable.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: According to Dean and Duncan (2016), "Physical therapy curricula must prepare physical therapists to function in ever-evolving health care systems and environments of accountability, and with new reimbursement models. The curricula need to engage students to develop the necessary attributes, knowledge, and skills in health leadership, policy, advocacy, and research to ensure the next generation of physical therapists can be partners to transform health care practice." Zorek and Raehl (2012) maintain that interprofessional education (IPE) and interprofessional collaborative practice (IPCP) will become increasingly important for healthcare delivery, and therefore, for healthcare professional education. Using IPE and IPCP, the student led, interdisciplinary Fall Prevention Clinic at Fresno State has provided leadership opportunities across multiple projects, assignments, doctoral projects, poster presentions and manuscripts, through an interdisciplinary, collaborative, team based, student lead pro-bono clinic. Students are able to blend leadership with clinical practice in this high-impact educational activity. Our results indicate that students gained an better understanding of roles and responsibilities of different members of the healthcare team and improved communication through this educational activity. Additionally, students indicated that the interprofessional educational experience was a positive experience. Clients of the Fall Prevention Clinic rated the student's professionalism high. Anecdotal evidence from faculty and student perspective indicate that students were able to step into leadership roles and effectively lead interdisciplinary teams regardless of healthcare discipline. Students indicate that the Fall Prevention Clinic allowed them to develop a leadership role with clients, which correlates to clients satisfaction with students knowledge and professionalism. In an ever-changing health care arena, Doctors of Physical Therapy are poised to be leaders in healthcare policy and delivery and high-impact educational experiences prepare students for this role.References: 1. https://www.tamhsc.edu/ipe/research/ipec-2016-core-competencies.pdf 2. Baxter P, Markle-Reid M. An interdisciplinary tean approach to fall prevention for older home care clients 'at risk' of falling: healthcare providers share their experience. International Journal of Integrated Care. 2009;9:1-12. 3. Wise H, Frost J, Resnick C, Davis B, Iglarsh Z. Interprofessional education: An exploration in physical therapist education. Journal of Physical Therapy Education. 2015; 29(2):72-83. 4. Zorek J and Raehl C. Interprofessional educational standards in the USA: A comparative analysis. Journal of Interprofessional Care. 2012;EarlyOnline:1-8. 5. Drynan D and Murphy S. Understanding and Facilitating Interprofessional Educaiton: A guide to incorporating interprofessional experiences into the practice education setting. 2nd Edition. 2013.www.chd.ubc.ca 6. Desveaux L, Chan Z, Brooks D. Leadership in physical therapy: Characteristics of academics and managers: A brief report. Physiotherapy Canada. 2016; 68(1);54–58; doi:10.3138/ptc.2015-02 7. Dean C and Duncan P. Preparing the next generation of physical therapists for transformative practice and population management: Example from Macquarie University. Physical Therapy. 2016; 90(3):272-274. 8. Jensen G, et al. Recommendations for enhancing physical therapist education: Acdemic, clinical and residency. https://www.acapt.org/docs/default-source/default-document-library/pte-21recommendationstable-v2015-dec1.pdf?sfvrsn=0. Retrieved March 26, 2018. 9. Black J, Palombaro K, Dole R. Student experiences in creating and launching a student led physical therapy pro-bono clinic: A qualitative study. Physical Therapy. 2013; 93(5):637-648. 10. Commission on Accreditation in Physical Therapy Education. Accreditation handbook:evaluative criteria PT programs. Commission on Accreditation in Physical Therapy Education website. Available at: http://www.capteonline.org/uploadedFiles/CAPTEorg/About_CAPTE/Resources/Accreditation_Handbook/CAPTE_PTStandardsEvidence.pdf. Updated 12/17. Retreived 3/19/18.Course Objectives: By the end of this course the learner will: 1. Understand the definitions of Interprofessional Education and the IPEC Core Competencies and apply them to educational activities 2. Apply concepts of Interprofessional Education (IPE) and Interprofessional Collaborative Practice (IPCP) to currucular design and mapping 3. Be given a model for designing high-impact, structured, educational activities that foster leadership skills in DPT students. 4. Be able to map interprofessional education, leadership, communication and other CAPTE criteria, APTA Core Competencies and other institutional criteriaInstructional Methods: Lecture, video, questions and answer sessionTentative Outline/Schedule: 5 minutes: introductions and disclosures 30 minutes: Interprofessional Education in Healthcare, Intercollaborative Clinical Practice, Best Practices for IPE, IPEC Competencies and development of leaders in Physical Therapy through IPE 30 minutes: Weaving IPE, leadership and IPCP into Physical Therapy curriculum - an example from California State University, Fresno 10 minutes: meeting CAPTE criteria and APTA Core Competencies through IPE and IPCP 15 minutes Discussion, Questions and Answers