Preparing Students for Team-Based Care for Vulnerable Populations

Abstract

Health professionals have an obligation to improve both the health of the individual and the public in a time of scarce resources. The Institute of Medicine (IOM), Healthy People Curriculum Task Force and professional education accreditation standards indicate the need for health care professionals to demonstrate competencies related to community engagement, basic health promotion skills and the ability to work effectively in interprofessional teams. An Interprofessional Course, IPE 413: Developing Care for a Vulnerable Population provides students the opportunity to collaborate to address health needs in cooperation with a community partner. Students work in teams to address the complex health care needs of an individual community member. The one hour elective course is open to students from nursing, occupational therapy, pharmacy, social work, and exercise science. Efforts are underway to explore the possibility of offering this course to medical students. Students are assessed on the knowledge and experience gained through this interprofessional experience using the Team Skills Scale and student reflections. Faculties from each of the disciplines utilize a collaborative model in the instructional design of the course. The content is co-taught and faculty not only role model interprofessional care, but also serve as mentors and resource personnel for the students as they work with their clients. Received: 07/10/2015 Accepted: 08/28/2015 © 2015 Laughlin et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Team-Based Care for Vulnerable Populations EDUCATIONAL STRATEGY 2(4):eP1087 | 2 Introduction Higher education in the health sciences is under multiple demands to prepare learners for the future of health care with a significant focus on team-based care, also known as interprofessional collaborative practice (IPCP). According to the American Hospital Association (AHA, 2015), practicing primary care providers are challenged to meet the current needs of health care populations. The AHA identifies that health care providers need “to practice to reach their potential in a team-based model of care delivery” (AHA, 2015, p. 5). In 2011, the Core Competencies for Interprofessional Collaborative Practice were established as the foundational skills all health care providers need for effective team-based care (Interprofessional Education Collaborative Expert Panel, 2011). Since this time, the accrediting bodies of the health science professions have put in place more stringent curricular requirements for interprofessional education (IPE) in order to prepare the health professions students for practice demands (Zorek & Raehl, 2013). Currently, academic institutions are now charged with implementing interprofessional education in order to prepare health sciences students for team-based care. Academic institutions have used multiple pedagogies to help students attain skills in collaboration and team-based care including simulation, case analysis, and service-learning. Dow, Blue, Konrad, Earnest, and Reeves (2013) identified challenges facing interprofessional education in higher education among the health sciences in regards to attaining the skills described in the Core Competencies (Interprofessional Education Collaborative Expert Panel [IPEC], 2011). One unmet area for IPE is related to health care providers working in underserved areas with vulnerable populations (Dow et al., 2013). Dow and colleagues (2013) report that current IPE has not been adequately preparing health sciences students for the complexities of providing care to patients affected by health disparities due to multiple social factors. According to Dow et al, “a student planning to practice in a resource poor, primary care setting needs specific skills in teamwork, leadership, and follower-ship that bolster collaboration by allowing all health care professionals to practice at the top of their licensed abilities” (Dow et al., 2013, p.353). An appropriate, yet complex pedagogy to prepare students for meeting the needs of vulnerable populations is community-based service learning. Several models regarding this approach to IPE have begun to emerge in the literature as exemplars in meeting the gap identified by Dow et al. (2013). Frequently identified in the literature as a pedagogical approach is the use of free clinics, which involve collaborative faculty participation and student involvement (Moskowitz, Glasco, Johnson, & Wang, 2006; Shrader, Thompson, & Gonsalves, 2010; Wang & Bhakta, 2013; Arndell, Proffitt, Disco, & Clithero, 2014; Farlow, Goodwin & Sevilla, 2015). These types of clinics in underserved communities are one avenue for exposing students to IPE with vulnerable populations. Students report learning how to collaborate and meet community needs in free clinic settings. Educational experiences with underserved populations also allow students the opportunity to learn the importance of overlapping roles and how to collaborate with limited resources to meet patient needs. This article will identify how an interprofessional community-based clinic course for health professions students frame their understanding of IPCP and builds proficiency based on the IPEC Core Competencies.