A Model for Providing Free Patient Care and Integrating Student Learning and Professional Development in an Interprofessional Student-Led Clinic

Abstract

BACKGROUND AND PURPOSEMany individuals face significant barriers to accessing adequate, affordable health care. The report, Health Wanted: The State of Unmet Need for Primary Health Care in America, calls upon community-based health clinics to provide comprehensive care eliminating health care barriers, which will in turn reduce costly trips to emergency departments and expensive hospital stays.1 The Indiana University Student Outreach Clinic (IU SOC) is such a clinic serving the near eastside community of Indianapolis, Indiana. The mission of IU SOC is to provide medically underserved and uninsured populations within Indiana communities with access to free health care while providing students from multiple disciplines opportunity for professional development. Its primary goal is to decrease health care inequality.The IU SOC is a student-led, interprofessional, pro bono health care clinic, formed as a partnership in 2009 between IU medical students and the Neighborhood Fellowship Church (NFC). The clinic is located within the heart of a neighborhood with many unmet health needs that began with economic hardships in the 1940s and have continued through the turn of the century, resulting in a substantial uninsured population. Historically, this community has had the highest emergency department visit rate within the county. While the main focus of the clinic is on decreasing the health disparities within the community, the clinic affords an equally important benefit to students by providing an avenue for experiential learning in the areas of patient care, interprofessional education and collaborative practice, and leadership.In October 2012, Doctor of Physical Therapy (DPT) students from IU and the University of Indianapolis (UIndy) established a novel collaboration to provide free evidencebased physical therapist (PT) services. This addition added to the comprehensive nature of the clinic, which includes pharmacy (Butler University), legal (IU), social work (IU), dental (IU), physical therapy (IU, UIndy), occupational therapy (IU), public health (IU), and nursing (IU). This collection of services in 1 location provides the IU SOC with the opportunity to make a significant impact on health disparities in this community. The collaborative nature also makes it an ideal setting for applied interprofessional education and collaborative practice (IPECP). The World Health Organization (WHO) defines interprofessional education (IPE) as occurring when two of more professions learn about, from and with each other.2 IPE is an essential step in preparing learners for collaborative practice which happens when multiple health workers from different professional backgrounds work together with patients... to deliver the highest quality care.2 This is important since WHO recognizes IPECP as an innovative strategy that will play an important role in mitigating the global health workforce crisis.2Student-led free clinics are becoming more prevalent as the need for affordable and accessible health care is ever-growing. Moreover, educators are realizing the benefits of collaborating with community partners to improve patient care while enhancing student learning. A literature review was performed in PubMed, CINAHL, ProQuest, and Academic Premiere databases using the key words student-led, student-run, pro bono, multi-disciplinary and interprofessional clinics, and interprofessional education and collaborative practice. Findings from this review indicate educators are recognizing and beginning to evaluate the impact these clinics have on improving collaborative care as well as student learning.3,4 Several universities have found students who participate in a pro bono health clinic reported increased confidence, self-reflection, and civic mindedness.5-7 Other studies have reported that students indicate improved clinical skills after participation in a student-led clinic.8,9The literature review also revealed that there are many different clinic models with multiple disciplines and community partners; however, only a few include PT students, and even fewer with students from more than 1 university (Table 1). …