Interdisciplinary Clinical Student Training in Teamwork and

Geriatric Assessment:A Student Pharmacist’s

PerspectivePresented by:

Catherine Liu, PharmD 2016University of Rhode Island

Objectives (Pharmacy Technician)

• Identify at least two of the four key elements for effective health professional education as defined by the Institute of Medicine (IOM); and• Explain the importance and rationale for an interprofessional team

for the care of older adults.

Objectives (Pharmacist)

• Identify recommendations for interprofessional education from IOM and ACPE; and• Describe an ongoing RI interprofessional clinical student

training activity in geriatrics.

Interdisciplinary Education

• Traditionally, the education and early practice experiences of most healthcare professionals has been in “silos”• Institute of Medicine report on Health Professions Education:

A Bridge to Quality report• Accreditation Council for Pharmacy Education expectations

for interdisciplinary / interprofessional education (IPE)

IPE at the University of Rhode Island

• Collaboration between URI Colleges of Pharmacy and Nursing, Brown University School of Medicine, and Rhode Island College of Nursing and Social Work• Simulation Center in URI College of Pharmacy and collaboration

with College of Nursing for freshmen students in both disciplines• Interdisciplinary courses at URI• Rhode Island Geriatric Education Center clinical student training

in teamwork and geriatric assessment

Rhode Island Geriatric Education Center• Established in 1996, RIGEC was one of 45 federal geriatric education

centers (GECs) for providing interprofessional geriatrics education and training to practitioners, health professions students, and academic faculty. • Directed by Phillip Clark, ScD• Funded by the Health Resources and Services Administration (HRSA) of the

Department of Health and Human Services• Interdisciplinary clinical student team training in geriatrics was a

component added to RIGEC in 1985• In 2015, RIGEC was awarded a Geriatric Workforce Enhancement Program

(GWEP) grant which continues clinical student team training component.

RIGEC Faculty:Clinical Student Team Training• Alicia Curtin, PhD, GNP,

Director of Geriatrics , Memorial Hospital of Rhode Island• Anne L. Hume, PharmD, FCCP, BCPS

Professor of Pharmacy, Memorial Hospital of Rhode Island• Kim Rickler, MSW Memorial

Hospital of Rhode Island• Phillip Clark, ScD, Professor of

Gerontology, University of Rhode Island• As well as many other RIGEC faculty

Interdisciplinary Clinical Student Training• RIGEC faculty actively recruit 2 to 3 students from their disciplines to

attend a once monthly half-day program each fall and spring semester• Students vary in their clinical experiences and level of education• 3rd or 4th year student pharmacists• 4year BS nursing students to geriatric nurse practitioner students• 4th year medical students• 2nd year MSW students• PhD physical therapy students• 1st year MS dietetics students

Monthly Meeting

• 1 hour team seminar• 2nd year family medicine resident presents one of their more

challenging older patients• Review of the prior week’s home visit• Initial questions / concerns from students

• In clinic assessment of the patient +/- family member or caregiver• Team discussion of patient’s strengths and weakness• Discussion of the team process

Team Seminars

• An introduction to healthcare teams• What is a healthcare team?• Comparing the education of team members

• Promoting effective communication • Assessing communication styles

• Identifying and addressing conflict • Assessing conflict management styles

• Leadership on a healthcare team• Who is the team leader?• Is an MD always the leader?• What are the leadership roles?

Student Assessment

• Students who participated in at least one the four sessions completed a questionnaire at the end of training• Retrospectively accessed pre-training and post-training level

of agreement in statements of attitude and mastery of skills in team training• Scale from 0 – 100• Pair sample t- test

Fall 2014 – Spring 2015• There needed to be increased average

levels of agreement that were statistically significant to demonstrate improvement from pre- to post-test• 8 attitudinal items• 2 mastery of skill items

• Findings showed statistically significant improvement on 7 out of 8 items

• Level of agreement was above 90% at baseline for half of the items

• “Hospital patients who receive team care are better prepared for discharge than other patients.” was the only item to fail to reach significance

Results of Attitudes of Skills

*<.05 **<.01 ***<.001 n.s. = no signficant

Results of Attitudes of Skills

*<.05 **<.01 ***<.001 n.s. = no signficant

Results of Attitudes of Skills

*<.05 **<.01 ***<.001 n.s. = no signficant + = approaches significance at 0.58Six participants did not have attitude #6 included on their survey

Results of Attitudes of Skills

*<.05 **<.01 ***<.001

Results of Mastery of Skills

***<.001

PharmD Students’ Experiences

• “…helped me to better understand and appreciate the role of other health professionals, as well as realize that the caring of older adults is inclusion of many social factors.” Monica Dougherty, Spring 2015

• “Learning how everyone approaches a problem from a different direction has helped me understand the true value of a comprehensive individualized patient care plan.” Michael Bly, Spring 2012

• “…with an interdisciplinary team, each team member can focus on their specialty, which brings patient-centered quality of care to a whole new level” Chris Cicero, Fall 2015

My Experience

• Education on different professions’ roles• Differing clinicians’ thought processes • Interactions with the patient• Health assessment tools

• Awareness of the variety factors that affect patient’s adherence• Health literacy• Accessibility and function• Cost

• First clinical patient experience• Holistic care• Personal growth of intrapersonal communication skills

My Experience

• Gerontology Across the Professions and the Atlantic• Graduate level course for students in various health professions• Focused on the international provision of health care for older adults• Participants were from the United States, Canada, and Norway• End-of-seminar meeting in Bergen, Norway in May 2015

Questions?