Collaboration Through Interdisciplinary Education and Its Impact on Future Health Care Practitioners

With our ever changing and increasingly complex healthcare system, there are indications that health care practice must adapt to provide safe, effective, precise, and cost effective care.   This practice must start from the foundation: Interprofessional Practice made applicable through Interprofessional Education (IPE). The University of Connecticut’s Urban Services Track (UST) provides the foundation upon which future healthcare professionals are able to provide interprofessional care by instilling collaborative values from a healthcare student’s academic infancy. The Urban Service Track is designed to produce a cadre of well qualified health care professionals committed to serving Connecticut's urban underserved populations. As Urban Health Scholars, participants represent a select group of students enrolled in the University of Connecticut Schools of Pharmacy, Nursing, Medicine, Dental Medicine, Social Work, and Quinnipiac University's Physician Assistant Program (Clark-Dufner & Gould, 2016).

Interprofessional practice through collaboration can be defined as “a process which includes communication and decision-making, enabling a synergistic influence of grouped knowledge and skills” (Bridges, et al. 2011).  Students within UST, participate in a 2 year curriculum that provides enhanced learning opportunities delivered through formal learning retreats and community service.  The curricular focus includes competency development in 11 key areas: culture and linguistics, population health, health policy, advocacy, health care financing and management, leadership, community resources, interprofessional healthcare teams, and quality improvement.  The ultimate goal of the program is to provide health profession trainees interested in providing care to vulnerable underserved patients with  the knowledge and foundational concepts central to interprofessional care so that they remain effective contributors during interprofessional interventions with patients.  A core belief within the program is that breaking down the barriers and stereotypes of other health professions through interprofessional education allows for greater appreciation and understanding of provider roles, which in turn fosters collaboration.

The methodology of UST lies in that the scholars from the indicated schools aforementioned intervene in twice a semester learning retreats, from which they are required to attend two community outreach events.  The scholars are guided into leadership roles that vary from forming their own outreach activity to leading an established event.   The learning retreat curriculum covers issues pertinent to vulnerable populations inclusive of children and youth, the elderly, veterans, immigrants and refugees, substance abusers, those with HIV/Aids, and incarcerated and ex-offenders.  Interprofessional education provided within each learning retreat allows for applicable education in a circuitous manner brought about by each outreach activity; from migrant farm clinics to health education fairs and senior centers to summer research projects.

In verifying the efficacy and relativity of UST, data from the past 9 years has found the program relevant.   A review of 9 years of survey data as students exit the program, along with core data of students contacts, community programs, clients reached, involved volunteer service hours, and the correlated service value in dollars indicates the successful program progression and involved learning experience.  In the most recent evaluation data from 2014-2015, 98% (N=87) of scholars indicated familiarity with other health professions, 94 % (N=87) indicated value in interacting with interprofessional faculty, and 96.5% (N=87) of scholars noting value in the content provided from each learning retreat.

An accurate depiction of a selected UST semester includes 45 events scheduled with 266 engaged scholars for a cumulative total hours of service being (Event X length of event X # of students = Hours) 1121.5, where 1,462 patients received UST healthcare in the Fall of 2015.

From the indicated values, an example of the pertinent services provided through IPE is an outreach where the scholars lead a “Better Breathing Program” in an urban area in CT where the school is noted to be in the top 10 worst schools, along with having a diagnosed asthma rate of 42%. This program focuses on teaching elementary students and teachers about Asthma, inhaler use and mouthcare while utilizing age approprate teaching methods and assessments. 

The following are indications of success based on final thoughts provided by our UConn scholars at graduation:

-       “My time in UST as one of the most memorable and valuable experience in my time at UConn.  My perspectives on the value of interprofessional, team-based health care delivery developed from my experience volunteering with and leading UST programs.” - Scholar (School of Dental Medicine)

-       “UST is an incredible  experience and I am so proud of my myself for having had this desirable experience.  Than you so very much.  I am beyond a shadow of a doubt assured it will guide muy future clinical practice all the more holistically.” - Scholar (School of Nursing)

-       “UST elevated my medical education experience to include a curriculum on professionalism and teamwork that would have otherwise been missing.  I know without any doubt that every UST alumni has had the values of teamwork, communication, and service instilled in us and that our collective practices will be better for it.” - Scholar (School of Medicine)

 The opportune outcome to this program is to ready our student healthcare professionals to readily participate in an interprofessional workforce.  Measurable outcomes have been established in a nonrandomized study that utilized a controlled before and after design measuring reaction, changes in knowledge and skill, attitudes and behaviours when utilizing interprofessional education.  The conclusion indicated that an “IPE program with a replicable teaching protocol could effectively improve knowledge of best practices and collaborative care...and help healthcare professionals change practice behaviors” (Cohen, et al. 2016). Furthermore research notes that “training programs providing education in these essential areas are successful in enhancing the function and effectiveness of interdisciplinary...teams (J Am Geriatr Soc 62:961–965, 2014).  As a caveat to this, an area of growing interest and a future study would be to propose and reflect on how the IPE provided to UST scholars influence patient outcomes.  

As the purpose of this presentation is to enhance provider knowledge, it also serves as a manner to emphasize the importance of academics engaging students in thinking about interprofessional practice and, as a stepping stone to initiating IPE within academic institutions nationwide.  In conclusion, author, Afaf I. Meleis (2016), summarizes the importance of instilling interprofessional values best in stating, “It is timely for all health professional educational institutions to engage in robust dialogues on the best strategies to implement some ways of educating students from the different health fields together, to evaluate the results, and to test the outcomes on patient care.”