MAY / JUNE 2006

HARVARD MACY

Multidisciplinary collaboration seeks to focus different perspectives on common challenges

The Harvard Macy Institute’s Program for Educators in the Health Professions has been a popular vehicle for professional development for institutions all over the United States and abroad. Formerly known as the Program for Physician-Educators, the course was renamed to reflect the growing interest among non-physician faculty who have participated in the program in order to help promote education excellence across a diversity of health care-related disciplines. In recent years, in addition to physicians, educators in nursing, pharmacy, and dentistry have attended the course.

In 2005, five faculty from the University of California-San Francisco (UCSF) attended the program with the goal of designing interdisciplinary modules emphasizing the importance and efficacy of interprofessional collaboration in delivering high-quality patient care. Preetha Basaviah, MD; Carrie Chen, MD, MSEd; and Shieva Khayam-Bashi, MD represented the UCSF School of Medicine. They were actively teaching and creating curricula across the pre-clinical to clinical continuum for students. Similarly, Rosemary Plank, RN, PhD from the School of Nursing and Sharon Youmans, PharmD, MPH from the School of Pharmacy shared a passion for curriculum development and teaching at their respective schools. Together these five educators sought to create an innovative inter-professional curricular program, which would bring together students in the Schools of Medicine, Nursing, and Pharmacy for training in collaborative patient care. They hypothesized that collaborative learning in the classroom and clinical settings would facilitate inter-professional teamwork, resulting in improved patient safety and outcomes. What follows is a summary, authored by the team, of their project and experiences.

Rosemary Plank: “Attending the Harvard Macy Institute as part of a team that included three physicians, a pharmacist, and a nurse opened a journey into understanding health care education from multiple perspectives. Not only did this program provide an opportunity to hear, interact, and be mentored by world renowned health educators, it defined education in a new way. Viewing teaching and learning from the perspective of the multiple rather than the single profession opened a door to reviewing new ways of teaching and collaboration. Most enlightening was the effect that interprofessional communication has on professional competence and patient outcomes.”

UCSF has always been involved in some aspects of interprofessional practice by virtue of grant funding processes. Frequently when grant monies ended, collaborative practice ended or transitioned into some other entity. 

In 1966 the Primary Care Education and Clinical Training task force identified that collaborative efforts in training and education should occur between the four professional schools: dentistry, medicine, nursing, and pharmacy. Studies conducted at the time demonstrated significant overlap and redundancies in curricula, course offerings, and clinical training experiences, with little or no inter-professional collaboration in the formative basic education curricula.

Recognizing this absence, a small and informal group known as the Interprofessional Task Force was formed, and gathered to discuss the potential for collaborative education in the professional graduate schools at UCSF. Dentistry was designing a new curriculum and decided to join the group following curriculum implementation. It was suggested by an alumnus of the Harvard Macy Institute that each professional school select a person to create a proposal to submit to the Institute for acceptance to their 2005 Program for Educators in the Health Professionals.

After three months of collaboration, UCSF submitted and had accepted an abstract proposing the development of an interprofessional educational project for students transitioning from the academic setting into the clinical practice setting. Thus in January the group joined 60 other participants selected from national and international universities for the two-week program at Harvard Medical School. The UCSF group was the only interprofessional group to attend during that year.

To maximize the educational opportunity, UCSF team members chose to attend separate sessions and, if small group process was used, were assigned to small groups from the general community. In the evenings our group would meet to discuss the day and apply principles learned to project development. Prior to the conclusion of the January 2005 session, the team decided to title the required May poster presentation “InTICE: Innovative Transitional Inter-professional Clinical Education.” The project would focus on interprofessional communication in the clinical practice setting and be developed into a poster presentation for the May session of the program.  

With input from Harvard Macy Institute mentors and others we met, conversed with, questioned, and argued with to find previously unexplored ways of knowing, we developed an acute awareness of the “other”—the disciplines outside our own professional domain. As we discussed and planned, the “other” became the “us”; we transitioned from a group to a team. We became more established in our developed roles, but any member could function for another in the event of an absence.

Preetha Basaviah was the group leader, Shieva Khayam-Bashi was the person who centered us, Carrie Chen was the time manager and idea generator, Sharon Youmans was the questioner, always looking for new ways to apply principles, and Rosemary Plank was the glue for team cohesiveness. We shared leadership, coordination, idea generation, and follow-up. We educated each other on “the ways of our respective schools” and began to process methods in which our schools could work together.

The team was comprised of five expert educators who now had a common base that was provided by the Harvard Macy Institute experience. During the interim between the January and May sessions, we met according to a schedule and developed the May project plan. We discussed possible funding and, because we desired to interview patients to gather their perspectives on how professional communication affected their care, we began planning for our Committee on Human Subjects Review process.

The Interprofessional Task Force is now a formal group involved in planning interprofessional learning experiences and activities. Our team reports to them on a monthly basis, updating them on our progress toward the goal we set prior to participating in the Harvard Macy Institute’s course: the development of five communication modules for improved provider communications related to patient care. All of the factors mentioned are necessary to make interprofessional education work at UCSF.

Participation in the Interprofessional Task Force and the Harvard Macy Institute Program for Educators in the Health Professions has provided us with insight and impetus to continue on our collaborative path toward improved education. We use the term improved not because education is needy in any of the schools themselves, but because professional students and practitioners now have the opportunity to be in the same classroom and discuss nuances of care with others they will be interacting with in the clinical setting. The “single profession” discussions are now becoming the “multi-profession” discussion.

Copyright 2006 Harvard Medical International