An important early lesson for tomorrow’s health-care providers
“Coming together is a beginning. Keeping together is progress. Working together is success.” ~Henry Ford
Although Henry Ford was referring to a business environment, team work remains every bit as important in the health-care setting, where interdisciplinary input leads to better communication and improved patient outcomes. And the earlier students in this field learn this important lesson, the better. With that in mind, it’s no surprise that the Perelman School of Medicine is bringing together students from different health-care professions early in their training, to observe and learn what clinical team work is all about.
According to Stanley Goldfarb, MD, associate dean for Curriculum, the overreaching goal of the Interprofessional Team Assessment Program (ITAP) is to “instill in students the importance of interdisciplinary team work. If they have these experiences early in their training, they’ll have different attitude towards their colleagues when they’re in practice.”
Team work, in and of itself, is not new at the School of Medicine. Indeed, Penn medical students have been working in teams since 2004. Five years later, these teams moved into a ‘real-world’ environment, observing and assessing different clinical teams throughout the Health System. That program’s success led to ITAP, an expansion that’s brought nursing and pharmacy students into the mix.
“Interprofessional team training is an essential part of educating the next generation of leaders in the health-care field,” said Amy Corcoran, MD, of Geriatric Medicine, who worked with Goldfarb and leaders from different health-care fields to create the program.
Cathy Poon, PharmD, vice dean of Pharmacy Practice and Pharmacy Administration at University of the Sciences, agreed. “Many practitioners -- including physician residents and attendings, pharmacists, nurses –- may already have pre-conceived notions about working together. Team work needs to start really early.
“If you’re comfortable with each other, you can learn from one another,” she continued. “We need to share our strengths for the one common goal: the patients.”
Learning to Function as a Team
ITAP, which started in January, introduced a fourth-year student from Penn’s School of Nursing and a third- or fourth-year student from USciences Philadelphia College of Pharmacy into an already-formed group of six or seven first-year med students. Working as a team, the students observed their assigned clinical team in rounds, interviewed team members, and critiqued what they saw, ranking it in terms of collaboration, communications, the roles of each member, and other factors, including the statement ‘I’d like to be a member of the clinical team we observed.'
Harrison Kalodimos, a med student who plans to enter primary care medicine, loved seeing the interaction among the disciplines. “I’m interested in the transition of primary care to a more interdisciplinary approach that’s less reliant solely on the physician. The more opportunities I see with this kind of interaction, the better."
Pharmacy student Rakesh Gadde, agreed. “This was a great opportunity to hear everyone’s input on the team. I learned a lot about group dynamics.”
“I loved working with pharmacy and nursing students because it’s a real-world application,” said medical student Sarah Huepenbecker. She found her experience with HUP’s Lung Transplant team “enlightening. It helped us function better as a team.” Another student echoed these sentiments. “I saw mutual respect among the team. I saw members giving each other credit. That acknowledgement fosters a good environment.”
“We don’t have a lot of time to communicate with med students in our clinical experiences, and pharmacy students aren’t generally included,” added nursing student Lauren Sommero. “So it was great getting their perspective on things.” Noting their different levels of clinical experience, she said, “As a team, we helped each other out, some of us explaining things that others weren’t as familiar with.”
“ITAP gave our students confidence to work within an interprofessional group. Being some of the most experienced students in the groups, they learned to share their clinical knowledge as well as work effectively in teams," said Patty Rogers, advanced senior lecturer at Penn’s School of Nursing.
This program also proved to be a winning experience for the clinical teams. Donna Chojnowski, MSN, CRNP, director of Clinical Operations in the Penn Heart and Vascular Center, noted, “The ITAP team has inspired our team of nurses, doctors, clinical medical assistants, and administrative assistants to improve our processes. We are utilizing their observations and recommendations as we modify our workflows.”
A post-ITAP assessment survey showed that students’ understanding of the roles and responsibilities of health-care professionals doubled from a pre-ITAL survey, and their confidence to coordinate and communicate as part of an interprofessional team rose 50 percent.
Like any program in its infancy, challenges came to light and Corcoran said her team is already meeting to address these issues. Still, overall, she is very pleased with the results. “All of the students gained an appreciation for each other’s roles and responsibilities as well as an understanding of how teams function in a health-care system.”
“It’s an important first step for all of us to start collaborating,” Rogers concluded.