Better Care by Learning Together
BY NOAM BERLIN
I'm learning medicine with doctors, but I know I’ll be practising it with nurses, pharmacists, and other providers. That’s why I was drawn to the Interprofessional Education (IPE) Curriculum right away in my first year of medical school at U of T. So far, I’ve taken ten elective credits — and I have to say they’ve been some of the most valuable experiences I’ve had in my medical education.
Before medical school, I worked in a long-term care centre and saw how many problems were caused by misunderstandings and miscommunications among workers on the same team. People worked in silos.
In the IPE curriculum, I’m not only learning about medicine, I’m learning how to be part of the health care team. My generation of physician accepts that we’re moving toward team-based care, as the research shows better patient outcomes. We know that errors come from not understanding each other’s roles and problems in communication. And I’ve seen first-hand how patients are far better off when you sit down as a team.
I’ve learned that social workers know about resources I never knew existed. I had no idea that speech language pathologists have expertise with eating and swallowing disorders and can provide therapy. I’ve observed that nurses are experts on their patients, holistically. I’ve learned that the patient-centred approach is ingrained in their curriculum. To be honest, I was very surprised at how demanding these other programs were, and how much earlier they get to see patients than we do.
I also realized very quickly how much I need my colleagues. I’m not alone: 96 per cent of medical students say IPE is important to their careers, and two-thirds of senior medical students say IPE has become more important to them during the four years (Interprofessional Health care Students’ Association Survey, May 2014).
I’ll admit not every student shares my enthusiasm for learning alongside other professions, maybe because electives are an extra burden or they don’t see the benefit. And that’s okay. I think the tide is shifting, and in future, interprofessional education will be integrated into all of our courses in a way that we can really use in practice. It seems like common sense: the more exposure you have early to interprofessional cooperation, the better you’re going to be at it. This is simply a skill today’s doctors need.
Noam Berlin is a second-year medical student at U of T, interested in specializing in Internal Medicine. He currently serves as Vice President of Interprofessional Education of the Medical Society and as President of the Interprofessional Health care Students’ Association.
Interprofessional Education: More Student Perspectives
As a first year resident in pediatrics at Alberta Children's Hospital, I’m suddenly expected to have a vast array of knowledge. My IPE experience has taught me that there are multiple professionals and students ready and willing to share their expertise. From the respiratory therapist who walked me through my first neonatal intubation to the nurse who patiently taught me how to place an IV in a screaming baby, I am grateful for the continual interprofessional contribution to my education. I look forward to interprofessional learning and collaboration throughout my career and feel that the IPE curriculum at U of T was an important starting point.
Dr. Nikki Fischer, Medicine, class of 2014
I had a great week of interprofessional patient care on my Endocrinology rotation at St. Michael's Hospital. In the Diabetes clinic, the chiropodist took time out of her schedule to fit in a 15-minute teaching session for myself and other residents. She taught us the basic diabetic foot exam, including how to do a monofilament test, which I have not learned before. She also reminded us not to forget to check the shoes as well! I learned from the dietician the basics of taking a diet history, how carb counting works and practical advice I can suggest to patients before they are able to meet with a dietician. Now I can be more efficient when it comes to assessment of a patient’s diet. I can help the dietician to be more efficient too by asking patients to keep a food diary for three consecutive days before their appointment with a dietician. I had to start a Multiple Daily Injection (MDI) insulin regimen on an inpatient yesterday. It was so beneficial to have a diabetes nurse educator as part of the team. There are so many details about managing MDI. The nurse educator was able to give further education and reinforce key messages about how to manage a MDI regimen once the patient goes home.
Kaspar Ng. 4th year clinical clerk, Medicine
As a first year nursing student, the IPE curriculum broadened my understanding of how health care actually works and how a team approach is really the only option in providing safe, quality and effective care. It also gave me a chance to learn about roles of other professions that I was not previously aware of. For example, the important work Speech Language Pathologists provide when assessing and rehabilitating the speech and language of someone who had suffered a traumatic brain injury.
I recall a pharmacy student taking a very thorough and detailed health history of a patient actor -- asking questions that I wouldn't have even thought of, but will now always remember (think toxicology). I constantly saw each profession bring their role and expertise to the table and with this, and was able to improve my understanding of the patient's perspective. For example, while completing an elective based on the lifetime trajectory of an autistic child, I learned the importance of psychologists and social work counsellors working with family members.
I have already experienced numerous clinical settings, however I find as a student, it is very easy to focus on your own skills and role. The IPE program emphasizes the importance of the team and gives you an excellent resource to learn and bring the interprofessional approach into the workspace.
James Marcus, 2nd year student, Nursing
Working in an interprofessional group, I learned pharmacists can help patients with smoking cessation. I feel this will greatly benefit my future patients as there is another community resource that can be used to help patients improve their health behaviours and ultimately outcomes.
During Pain Week, I learned a lot more about non-medicinal treatments and management plans for chronic pain from physiotherapy and occupational therapy students than I would have without having being placed in an interprofessional group. Having curricular experiences that involve patient cases and realistic interprofessional collaboration mimics our future workplace. We have a common goal, which is why it’s a great learning environment.
Navjot Rai, 3rd year clerk, Medicine
I learned there can be a lot of overlapping roles and tasks among the different healthcare professions, which could be good if one person is away, someone from another profession could better cover for the absent person. Cohesive interprofessional teams are possible and the healthcare system is continuing to strive for this initiative. This is great as each professional can communicate and rely on other team members for knowledge and skills when providing care to clients.
Karen Yau, 2nd year student, Occupational Therapy