Interprofessional Education: What the Textbooks and Lectures Didn't Teach Me

As current and future pharmacists, we know exactly what we have to offer. We spend 6-plus years studying medications. We know mechanisms of action, interactions, and the best way to optimize a patient’s medication regimen. A good pharmacist needs broader skills, however. Pharmacotherapy textbooks do not necessarily address communication among health care team members and empathy for patients; experience teaches these clinical skills. Interprofessional education (IPE) encourages collaboration among students from different health professions so that they will learn to provide the highest level of care for patients as a team. Knowing each professional’s roles and responsibilities on the health care team is invaluable, and its importance in pharmacy education is rising.

ACPE’s Interprofessional Experience Requirement

Accrediting bodies of many health professions schools—dental, nursing, physical therapy, pharmacy, medicine, and allied health—now require interprofessional experiences before graduation.

While revising its standards in 2014, the Accreditation Council for Pharmacy Education (ACPE) noted that all health care professionals should attain certain competencies during their education. At the top of the list were patient-centered care and collaboration with others on the health care team. ACPE added a new standard, IPE, to accomplish this goal. Beginning in fall 2016, every ACPE-evaluated school must incorporate didactic and experiential learning on interprofessional teams.

IPE at the University of Connecticut

The Urban Service Track (UST) at the University of Connecticut (UConn) is one example of successful IPE, as the Interprofessional Education Collaborative has cited it an exemplar program.

UST is a curricular track (a series of classes and experiential learning to accrue credit toward a degree) designed to produce patient-centered health care providers committed to serving urban underserved populations. It involves students, designated as Urban Health Scholars, from the UConn schools of pharmacy, nursing, medicine, dental medicine, social work, and from Quinnipiac University’s (QU) physician assistant program.

Representatives from 6 major health profession organizations composed “Core Competencies for Interprofessional Collaborative Practice,” a report that describes principles for IPE. The May 2011 report highlights UConn’s UST as an example for other health professions schools across the country developing IPE programs.

Urban Health Scholars have unique opportunities to work on interprofessional teams of health care students. The program is selective, accepting only 8 to 10 students per school per year. Since its first cohort of 24 students in fall 2007 from the schools of medicine, pharmacy, dental medicine, and nursing, UST has grown substantially. The QU physician assistant program and UConn School of Social Work students joined in 2011 and 2012, respectively, expanding the program to include critical disciplines. For the 2014-2015 school year, 169 Urban Health Scholars were enrolled. UST has matriculated 255 graduates overall, 54 of them from pharmacy.

Managing Expectations, Optimizing Learning

For students, the UST curriculum supplements clinical pharmacy course work. Learning retreats and outreach activities provide hands-on experience that galvanizes learning.

Learning retreats, which occur twice a semester, bring students together from all 6 schools to promote interprofessionalism and care for the underserved. Scholars assemble in interprofessional groups and work through clinical cases designed to highlight each team member’s roles. Figure 1 details the lessons I learned about my fellow health care students and their roles on the team.

Figure 1: Health Care Team Members’ Unique Roles and Abilities

Each learning retreat focuses on a different underserved population and the ways in which health care providers can serve them better. These populations include urban elderly and young patients, incarcerated and ex-offender populations, the homeless, individuals living with HIV or AIDS, refugee/immigrant populations, substance abusers, and veterans.

One of the more eye-opening experiences for me was hearing about Cambodian refugees adjusting to life in the United States and to Western medicine. Theanvy Kuoch, the executive director of Khmer Health Advocates in West Hartford, Connecticut, worked in refugee camps in Thailand and cared for Cambodians during the Khmer Rouge regime. The Cambodian patients suffered the loss of loved ones and physical torture, which predisposed them to a lack of social support and long-term health issues. The opportunity to hear from a survivor of torture and be educated about trauma-informed health care will influence the way I practice my career. I will strive to remain culturally competent for my patients, empathize with their personal situations, and consider how their circumstances affect their understanding of medicine.

Figure 2 shows just a few of the things that surprised me about some of the populations I worked with. Learning retreats increase awareness of the challenges found in unique populations and urban communities.

Figure 2: Unique Characteristics of Underserved Populations

Hitting the Road

In addition to learning retreats, Urban Health Scholars participate in more than 50 outreach activities, reaching 4000 to 5000 Connecticut citizens from underserved populations annually. Teams of interprofessional students and faculty/preceptors educate community members, including disadvantaged youth, about important health and nutrition topics. Urban Health Scholars also hold clinics and health fairs throughout the year to screen and provide other basic health services to community members. The activities give students the chance to make an impact on the health of those in our community while applying what we have learned in our clinical course work.

Summary

Upon acceptance to UST, I knew what most pharmacy students know about fellow health care professions: the basics. Through the additional UST curriculum, I have become more comfortable communicating on a health care team. Working on interprofessional teams in this environment has also taught me to take a holistic view of the patient.

Hippocrates wrote, “It is more important to know what sort of person has a disease than to know what sort of disease a person has.” I aspire to be a provider who recognizes that each patient deserves the best care, and that patients may require different kinds of care. UST has helped me appreciate differences between patients. It has also fostered my ability to know when I am the best person for the job and when I should call upon my best resource for help.

Kelsey Hutchinson is a 2016 PharmD candidate from the University of Connecticut.