With all the buzz about interprofessional education (IPE) across UNC’s medical campus and beyond, you’d be forgiven for thinking that IPE is the very latest trend. However, since 2012, a group of “Geriatrics Champions” from all six Health Sciences Schools has presented a multidisciplinary, team-based geriatrics education event for hundreds of students annually.
IPE Geriatrics Experience is a two-day event held in January that brings 10 faculty members and 250 students from 10 disciplines (Physical Therapy, Occupational Therapy, Social Work, Nutrition, Speech and Hearing, Dentistry and Dental Hygiene, Nursing, Pharmacy, and Medicine) together to discuss case studies and collaborate on care plans. For many students, it’s a rare chance to learn in a team environment with colleagues from different disciplines and Schools. The 2019 IPE Geriatrics Experience took place at the School of Social Work on the last two Wednesdays in January.
IPE Geriatrics Genesis
The idea for the event came from a committed group of “Geriatrics Champions” from a handful of disciplines. Each expert knew the value of team-based interdisciplinary care, especially for older patients, whose multiple chronic conditions can make diagnosis and treatment challenging.
Sue Coppola, MS, OT/L, OTD, FAOTA, a faculty member with Allied Health Sciences’ Division of Occupational Sciences and Occupational Therapy, describes how the work began decades ago in partnership with Florence Soltys, a pioneer for aging advocacy at the School of Social Work. Earlier IPE Geriatrics events included 5 to 6 disciplines. “Each year we added another discipline, and through our collegial relationships, we continued to grow the event,” says Coppola. “We kept it going out of love for the experience for our students.”
The Department of Medicine and the Division of Speech and Hearing Sciences are the most recent (2018) additions to the roster. The Center for Aging and Health’s Carolina Geriatric Workforce Enhancement Program grant has contributed funding for the event from 2016 through 2018. Since 2012, the robust pre- and post-program evaluation, led by Cherie Rosemond, PhD, PT, shows strong learning outcomes for all disciplines.
Myth-busting and Misconceptions
Students pre-register for the event, often with encouragement from their professors. On Day 1 they assemble in the School of Social Work auditorium to hear case studies and observe an interprofessional team meeting led by the panel of Geriatrics experts. The goal is to model a multidisciplinary, team-based discussion of case studies with each faculty member contributing to the conversation and plan for care.
“We give them some guidance with the cases,” says Coppola, “but it’s more about showing each others’ roles and what you can do in the team.”
Next, students head to breakout rooms for working group discussions; the groups contain one student from each discipline. Often, discussions reveal misconceptions or gaps in understanding about what their colleagues actually do.
A big part of the experience is students learning the roles of other professions and “myth busting,” says Amanda Holliday, MS, Assistant Professor in the Department of Nutrition at Gillings School of Global Public Health. For example, says Holliday, students learn that nutrition experts “are not just the food police.”
With good nutrition connecting so directly to health, students learn about higher rates of undernourishment in older adults and the need to screen older patients for food insecurity at hospital discharge. It’s important for all team members to think about food and know how to connect food-insecure patients with food in their community, says Holliday, because “we aren’t yet at the point where we can universally prescribe a grocery bag of food like we can a prescription for a bottle of medication.”
IPE in the Real World: Making the Vision Reality
With the need to develop case studies, register students in advance, secure work spaces, and assign students into 25 groups with balanced representation across disciplines, a lot of planning goes into making IPE Geriatrics Experience a success. And with both undergraduates and graduate students participating, there are some levelling challenges, says Roxanne Dsouza, RDH, MH, with the School of Dentistry and an IPE Geriatrics Fellow. Dsouza helped recruit and register dental school students and assign them to working groups. Even finding days in the academic calendar to meet and plan takes determination. “Finding a date when all the disciplines can get together, that’s huge,” says Coppola.
On Day 2 of the IPE Geriatrics Experience, students meet for closing remarks and reflections. Participants point to the gap between IPE exposure as students and the ability to train and work as a team in the field. In general, clinical training sites aren’t able to accommodate teams of students. Yet increasingly, health care is provided by teams.
“Students say this is all great, but are we ever going to see this in the real world?” says Holliday.
With insurance companies and Accountable Care Organizations interested in better patient outcomes, lowered costs, and effective team care, the real world may start to walk the IPE talk. The IPE Geriatrics Faculty team has always envisioned and worked for what might be, rather than what is. They hope that someday the vision in the field will match the vision they have for their students.
In the meantime, even though IPE Geriatrics Experience is just a short amount of time, says Coppola, “the students get to shine by sharing their discipline’s contributions. And, they get excited about teamwork.”
Addison Francis, a Graduate Student Clinician in Speech Language Pathology, says that the importance of teamwork, especially for geriatric patients, was a key takeaway: “We can’t do it all on our own. A single profession is not able to provide adequate services. In the geriatric population, patients are often living with a number of co-morbidities. An interdisciplinary team is essential to ensure that the patient’s needs are met.”
IPE Geriatrics Experience Participating Faculty
Sue Coppola, Clinical Professor, MS, OT/L, OTD, FAOTA, Division of Occupational Sciences / Occupational Therapy, Department of Allied Health Sciences
Denise Dews, MSW, Clinical Assistant Professor, School of Social Work
Christine Downey, DDS, MS, Clinical Assistant Professor, Adams School of Dentistry
Carol Guiliani, PT, PhD, FAPTA, Professor, Division of Physical Therapy, Department of Allied Health Sciences
Cris Henage, EdD, Program Manager, Geriatric Workforce Enhancement Program, Carolina Geriatric Education Center, Center for Aging and Health, Division of Geriatric Medicine, Department of Medicine
Amanda Holliday, MS, Assistant Professor, Department of Nutrition; Director, Practice Advancement and Continuing Education Division, Gillings School of Global Public Health
Shannon Mitchell, RDH, MS, Clinical Associate Professor and Director of Dental Hygiene, Adams School of Dentistry
Carrie Palmer, DNP, RN, ANP-BC, CDE, Associate Professor and Lead Faculty, DNP Division, School of Nursing
Ellen Roberts, PhD, MPH, Research Associate Professor of Medicine, Division of Geriatric Medicine, Department of Medicine
Cherie Rosemond, PhD, Adjunct Associate Professor, Gillings School of Global Public Health and Director, Partnerships in Aging Program
Kimberly Sanders, PharmD, Clinical Assistant Professor, Eshelman School of Pharmacy
Amy Weil, MD, Professor of Medicine and Social Medicine, Division of General Medicine and Clinical Epidemiology, Department of Medicine
Sharon Williams, Associate Professor and Director, Division of Speech and Hearing Sciences, Department of Allied Health Sciences