• Jack Newman is a 54 y/o M who presents to establish primary care with acute complaint of polyuria and polydipsia.

• History of HTN, Hyperlipidemia, Type 2 Diabetes, Smoking and Obesity

• Visit #1 – before exposure to IPTC • Prioritize problem list and address self-care

• Hidden problem – Literacy

• Visit #2 – after exposure to IPTC• Identify discrepancies in self-reported data and medication reconciliation

• Hidden problem – Access to medications

Impact of an interprofessional ambulatory care APPE rotation on student behaviors related to interprofessional communication and

teamwork.Linda Chestnut PharmD Candidate 2016; Jana K. Zaudke MD, MA; Sarah Shrader

PharmD

• In the spring of 2011, the American Association of Colleges of Pharmacy joined five other national health professions associations in recommending interprofessional competencies . 1

• The WHO defines IPE: “When students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.”

• Proponents claim that we can transform our health care system if we move to a training model that values a team approach and places the patient central to health care delivery.

• To design an Interprofessional Standardized Patient Encounter for the outpatient primary care setting and deliver it using and interprofessional teaching objective structured clinical experience (iTOSCE) format.

• To integrate the iTOSCE into the educational curriculum of the interprofessional ambulatory care APPE rotation.

• To measure Interprofessional Communication and Team-Based Care using the iTOSCE before and after the exposure to the educational curriculum (Studio Pop) during rotation.

• In the fall of 2011, the Interprofessional Teaching Clinic (IPTC) was established in partnership with Schools of Medicine, Nursing, Pharmacy, and Health Professions.

• Patient care is provided by interprofessional teams – third year Medicine, fourth year Nursing, and fourth year Pharmacy students.

• Occupational Therapy (OT), Physical Therapy (PT) and Health Information Management (HIM) students rotate through IPTC one-half day a week.

• Psychology interns from KU-Lawrence campus rotate through IPTC three half-days a week.

• Law students from KU-Lawrence are available by consult through the KU Medical-Legal Partnership.

• Interprofessional student teams exposed to IPTC had higher iTOSCE scores at Visit #2 (post-IPTC) compared to Visit #1 (pre-IPTC)

CONCLUSIONS

JACK NEWMAN:THE INTERPROFESSIONAL STANDARDIZED PATIENTBACKGROUND

PURPOSE

THE INTERPROFESSIONAL TEACHING CLINIC

• During AY 2014-2015, a total of 64 students participated in this simulation with an 87% completion rate for the iTOSCE at Visit #1 (pre-IPTC) and Visit #2 (post-IPTC).

• Medicine = 20 students• Pharmacy = 36 students• Nursing = 8 students

• During AY 2014-2015, a total of 4 interprofessional faculty members participated with a 97% completion rate.

• Pre and Post IPTC rotation scores were compared by looking at faculty scores and then independently looking at student scores. This was done using unpaired t-test statistical analysis.

• This process was approved as exempt research by the institutional review board

• Interprofessional student teams were scored significantly higher on the iTOSCE by faculty and student evaluators (p=.005, and p=.0005, respectively) at Visit #2 (post-IPTC) than Visit #1 (pre-IPTC). • Faculty – 1.75 > 1.45; t(14) = 3.30, p = .005 • Students – 1.84 > 1.71; t(39) = 4.21, p = .0005

1.Interprofessional Education Collaborative Expert Panel (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative.

2. Shrader S, Kern D, Zoler J, Blue A. Interprofessional teamwork skills as predictors of clinical outcomes in a simulated healthcare setting. J Allied Health. 2013 Spring ;42(1):e1-6.

REFERENCES

Figure 1. Hallin K, Henriksson P, Dalén N, Kiesling A. Effects of “interprofessional education on patient perceived quality of care.” Medical Teacher. 2001; 33, 22-26.

• Interprofessional Teaching Objective Structured Clinical Experience (iTOSCE) rubric.2

• 3 subscales adjusted for outpatient primary care

• Interprofessional Teamwork• Patient Encounter

• Collaborative Patient Care Plan

• We added the IP Patient-Centered Communication questions using the ‘4 Habits’ model.

EVALUATION TOOLiTOSCE

I

In the second half of the event, the groups switch places, and Groups #1 and #3 observe #2 and #4.

Groups #2 and #4 get a chance to ‘do over’ the case.

EVENT TIMELINE

RESULTS

• Studio Pop is a necessary educational adjunct to IPTC.

• IPE curricula transform education and practice simultaneously.

• Interprofessional student teams see patients together in IPTC and have protected time together every Tuesday PM for:• Debriefing• Reflection• Simulations

STUDIO POP

FUTURE• Design and implement another standardized patient to be used along with Jack

Newman. (Sally Simpson)

• Determine the impact on lasting behavior change, such as carrying IP collaboration skills forward into other rotations, into residency and into practice.