Promoting Student Resiliency through Interprofessional Education Collaboration

Monday, 9 November 2015: 1:45 PM

Nassrine Noureddine, EdD, MSN, BSN, RN1
Darla K. Hagge, PhD, MA, BA, CCC-SLP2
Debra Brady, DNP, MSN, RN, CNS1
Will Ofstad, PharmD, BCPS, CDE3
(1)School of Nursing, California State University Sacramento, Sacramento, CA, USA
(2)Department of Speech-Language Pathology & Audiology, California State University Sacramento, Sacramento, CA, USA
(3)Center for Team-Based Learning, California Northstate University, Elk Grove, CA, USA

Health professional students must learn how to be resilient.  Today’s global society is increasingly diverse and complex requiring resiliency to successfully navigate challenges in the workplace.  Healthcare students learn core knowledge, skills, attitudes and values and are asked to quickly apply learning to a clinical or functional setting.  Their ability to move from receiving direct instruction to clinical practice is facilitated through supervised interprofessional training in simulation, experiential opportunities, and co-curricular settings that develop practitioner resilience which predicts long term success better than GPA or IQ.  This presentation will present two universities’ experiences and outcomes with Interprofessional Education (IPE) that involved three healthcare disciplines: Nursing, Speech-Language Pathology and Pharmacy.

BACKGROUND AND SIGNIFICANCE:

Traditionally, students in health professions are educated and trained in silos, isolated from other disciplines.  After graduation, however, students are expected to collaborate successfully on a team that represents many disciplines and perspectives.  Given this education model, it is not surprising that communication problems among health care personnel have been implicated as a cause of most patient errors (IOM, 2001, 2003; American Association of Critical Care Nurses [AACN], 2005; Joint Commission, 2005, 2007, 2008; Wachter, 2004). In addition, the Joint Commission reported that breakdowns in communication were the leading root cause of sentinel events between 1995 and 2006 (World Health Organization, 2007).    

In an effort to improve healthcare delivery and patient outcomes, the Institute of Medicine (IOM) strongly advocates that “health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team” (IOM, 2003, p. 20).  The IOM (2003) reports that “health professionals are asked to work in interdisciplinary teams, often to support those with chronic conditions, yet they are not educated together or trained in team-based skills” (p. 19). 

After fifty years of gathering data, there is sufficient evidence indicating the efficacy of interprofessional education as a means to support interprofessional practice (WHO, 2010).  Interprofessional education (IPE) exists when students from two or more healthcare disciplines have the opportunity to “learn about, from and with each other to enable effective collaboration and improve health outcomes” (WHO, 2010, pg. 7).  Therefore, the purpose of IPE is to prepare healthcare professionals who are ready to collaborate in multidisciplinary teams and provide improved services to patients that result in stronger health outcomes and improved patient safety (WHO, 2010).

The concept has only recently emerged in studies focusing on students’ learning contexts and experiences in higher education.  Walker et al. (2006) defines resiliency as the “…ability to recover rapidly from difficult situations” and the “…capacity to endure ongoing hardship in every conceivable way” (p. 251).  Resiliency (also known as grit) is a learned trait that educators in the United States’ educational system are beginning to advocate for its incorporation into the curriculum.

Grit can be defined as the “perseverance and passion for long-term goals,” and is an emerging noncognitive characteristic strongly linked to success across education, professional, and personal achievement domains (Duckworth, et al., 2007; Eskreis-Winkler, et al., 2014).  Duckworth and Quinn (2009) have proposed and validated a short survey to assess grit, the Short Grit Scale (GRIT–S).  Grit outperforms intelligence and GPA in predicting success, and educators see grit as a game changer in education and healthcare (Raehl  et al., 2012-2013).  Finding meaningful ways to cultivate resiliency is central to student development and a predictor for achieving mastery.  The US Department of Education looked at 50 programs targeting the development of perseverance and grit and have drafted a number of recommendations for educators to promote grit by educators.  Two key research-based recommendations include [Recommendation 2a]:

“students need to have the opportunity to take on long-term or high-order goals that, to the student, are “worthy” of pursuit”

“provide a rigorous and supportive environment for accomplishing their goals”

Interprofessional education set in co-curricular, simulation, and active learning experiences create opportunities for students see their didactic knowledge, skills, attitudes, and values put into practice with teams and scenarios reflecting real practice settings.  Students report these experiences to be highly engaging across the interprofessional literature.  These experiences are rigorous but supportive and include reflection and feedback that is inquiry driven rather than evaluative.  Interprofessional education for healthcare students may be an ideal pedagogy to develop grit and is a key focus of this research group.

PURPOSE

The purpose of the IPE curriculum developed by the authors is to prepare collaborative practice-ready resilient health care professionals that have applied the essential skills of working in teams across a variety of clinical and educational settings and environments.

METHOD

By design, a variety of required and voluntary IPE opportunities were integrated into each discipline’s curriculum.  To enhance student learning, multiple pedagogies and teaching strategies were used to train the nursing, pharmacy, and speech-language pathology students.  These approaches included experiential, transformation and resiliency:

  • Cross-discipline didactic education and training
    • Team-based learning – Pharmacy & Nursing; SLP & Nursing
    • Case-based learning – Pharmacy & Nursing; SLP & Nursing
    • Integrated Simulation Experience
      • Simulation Lab – Pharmacy & Nursing; SLP & Nursing
      • Community Engagement – Pharmacy, Nursing & SLP volunteers
        • Saha Health Center
        • CSUS Shot Clinic
        • CSUS Communication Recovery Groups and Communicating Through Art, Life Participation Approach Programs for Persons with Aphasia
        • Interprofessional Cross University Research Team
          • Interprofessional Education Research Academy  (IERA) – Pharmacy, Nursing & SLP student and faculty collaborators

RESULTS

The outcome data (qualitative and quantitative) from two integrated simulation experiences involving pharmacy, nursing, and speech-language pathology students will be presented demonstrating positive learning outcomes related to IPE goals.  Development of grit will be measured using the Short Grit Scale (GRIT–S).  In addition, learning outcomes from community engagement activities will be presented.