Teaching Health Care Teamwork

Monday, January 9, 2017

Program brings together future doctors, nurses, other caregivers

By Mark Donahue

Surgery is no simple thing. And it’s no solo performance.

Before, during and after their procedures, patients receive care from a host of professionals, all on hand to ensure things run smoothly and safely. There’s the surgeon, of course, but also an anesthesiologist, nurses, physician assistants and others. Additional health care workers are involved outside the operating room — for bariatric surgery, perhaps a clinical nutritionist; for orthopedics, a physical or occupational therapist.

Team-focused medicine is the norm today. As health care specializations have multiplied, the concept is filtering down to the very start of a caregiver’s path: in school. It wasn’t always the case.

“Traditionally in medical and nursing school and the other pre-professional schools, training has been very siloed,” says Christopher Bruti, MD, assistant professor in the Rush University departments of Internal Medicine and Pediatrics. “Everyone trained in their own discipline, and all of a sudden in the clinical realm we put everyone together and said, ‘OK, well, hopefully everything goes great.’”

New program brings together hundreds of students from all four Rush colleges

Rather than wait until care providers find themselves working together, more and more today, future doctors, nurses, allied health professionals and researchers are being asked to consider how they interact, before they interact.

Thanks to a $1.2 million grant from the U.S. Health Resources and Services Administration, or HRSA, Rush University has piloted interprofessional education programs over the past three years. Now with additional support from Rush University Medical Center, the effort is expanding.

In fall 2016, more than 350 students participated in an interprofessional program aimed to break down job silos. Covering all four Rush University colleges and nine academic programs, the effort was primarily aimed at first-year students.  Rush is looking to double this participation in 2017 and grow it until all in-coming students are involved.

The concept of interprofessional education helps future health care providers not only to work better together, reducing stress and errors while increasing mutual respect, says Joanne Miller, PhD, RN, associate professor in the Rush University College of Nursing. It also teaches them how to lead in critical moments.

“It might be the nutritionist who needs to take the lead for a patient for a while, and then maybe it’ll rotate to an occupational therapist or the physician or nurse,” she says. “The team itself will know each other’s roles and will be able as a group to meet the needs of that patient.”

Interactions with patients, other students yield greater understanding

As the program’s centerpiece exercise, groups of five to six students were put together by Rush faculty, with at least three health care disciplines represented in each team. David Tentler, a student in the Master’s in Biotechnology program in the Graduate College, joined a small team last fall to work with a Rush patient volunteer — a “health mentor” — who’s suffering from Parkinson’s disease.

Each team’s health mentor told the students about living with a chronic condition. The teams then worked with their health mentors to develop a wellness goal they hoped could improve their mentors’ quality of life.

Coming from a program with a research focus, Tentler found contact with a real patient invaluable. “It put a face to the disease,” he says.

“If others could get this implemented in more universities, I feel like people who are doing research would be more motivated to want to help. I wanted to help [my health mentor]. She was a really amazing person.”

Patients benefit from student interactions as well

Rich Lukes, a Rush Information Services employee, served as a health mentor in the fall. After hearing of the opportunity, Lukes felt he was a good candidate, having struggled with a number of health issues in his life.

Lukes says he enjoyed interacting with the students and was inspired to be more active in his wellness.

“I think it’s beneficial [for both students and health mentors] because I received things out of it as well, things I should be looking for, like joining the gym,” Lukes says. “I’ve been putting that off for two years now, and I promised I would do it and I did.”

Interprofessional student groups met afterward to discuss how their different disciplines interacted during the health mentor experience. For Nicole Swiderski, a Master’s in Occupational Therapy student in the College of Health Sciences, this experience brought new insight.

“It really helped me learn about other health care professionals’ roles and responsibilities,” she says. “We were given the opportunity to develop the skills necessary for communicating with other health care professionals in regards to patient care and for working effectively as a team.”

Growing the effort

As the Rush interprofessional education effort grows in 2017, more activities will be added, says Miller. They will include online readings, discussion opportunities and additional face-to-face time to develop communication skills.

Continuing to break down professional silos is critical to providing better patient care in an increasingly complex field, she adds. To have that happen sooner than later for practitioners during their education is key.

“It’s pretty obvious how fields are different,” says Tentler, the research student. “But when we get together and work together, we really draw each other in and we’re able see similarities and the ties between us all.”