CIPE Longitudinal Curriculum Update

The CIPE Curriculum and Assessment Committee (CAC) held a retreat in August 2021 to flesh out the logic model for Phase III of the longitudinal IPE curriculum, and better connect the three phrases. To aid in this connection, the CIPE formalized its partnership with the St. Louis Community Health Worker Coalition to infuse the client/patient voice and secure their expert lens in development of a curriculum that will equip students to work in teams in community, as well as clinical settings. This partnership includes adding a community health worker as an ex-officio member of the CAC. 

Phase I:

The CIPE Phase I Fall 2021 virtual curriculum involved 71 facilitators and 521 learners across six professions divided into 65 interprofessional teams meeting asynchronously and synchronously on three Wednesday afternoons. Learners identified the experience of working with an interprofessional team as the strongest component of Phase I; interacting with a client/patient continues to be a highlight. Learners also appreciated the solid introduction to social and structural determinants of health and communication/active listening strategies. The CAC will incorporate learner and facilitator feedback toward improvement of the experience in fall 2022, focusing on the new CIPE online course environment and clarifying expectations for project assignments. 

Phase II:

The CAC mapped existing Phase II activities (Transitions of Care Case-Based Discussion (TOC), Standardized Patient Team Experience (SPTE) and Hotspotting) and determined that the first two each effectively address most of the Phase II objectives while the last should move to Phase III (see below). Currently, neither the TOC nor SPTE address the conflict or ethics-related IPE objectives. This spring the CAC will develop the structure for learners to achieve the Phase II objectives. Issues for consideration include the number of activities each program can allow their learners to attend and the alignment of the timing of the CIPE educational programs so there are interprofessional pairings of learners from more than one profession in each activity. 

Phase III:

When the CAC developed the logic model for Phase III it became apparent that the current Hotspotting experience more appropriately fits in this phase than the planned Phase II. While that experience is very structured, the rest of Phase III will focus on clinical and community rotations already scheduled for CIPE learners within their programs. Based on the TDM for IPE framework, the CAC will design materials for learners to use to learn from, with and about other learners on their rotations. Meanwhile, the CIPE Professional Development Team will continue to educate preceptors of CIPE learners. 

Student-Resident Interprofessional Teaching Certificate Program:

Seven upper-level health profession students and one medicine resident from the CIPE’s collaborating institutions completed the Center’s pilot Student-Resident Interprofessional Teaching Certificate Program in calendar year 2021. Students participating were from the audiology, MD, and nurse educator programs. 

Certificate requirements included attending educational workshops, either teaching within the CIPE curriculum or leading an educational project and attending CIPE Professional Development Workshops. The CIPE Professional Development Team partnered with Dr. Denise Leonard, associate director of educational development for the Washington University Center for Teaching and Learning to develop and deliver the workshops. The 2021 cohort attended five two-hour virtual workshops from April to August 2021 on the curriculum design and assessment processes, active learning, inclusive teaching, fundamentals of interprofessional education and how to facilitate an interprofessional team. The program is intentionally flexible so those not able to attend the workshops were paired with faculty from other professions to fully experience the content interprofessionally. Students attended specific training for and facilitated teams in the fall CIPE Phase I curriculum while the resident is a Hotspotting coach through spring 2022. 

Participants commented that they appreciated the flexibility of the program and the hands-on facilitation experience. Two-thirds of the students who facilitated in Phase I received ratings from their teams higher than the overall facilitator mean while the remaining third was close to the overall mean. 

Thank you to the CIPE Professional Development Team, Dr. Denise Leonard, Drs. Dennis Chang & Amber Deptola of the WUSM MD program, Dr. Patricia Kao of the Washington University Teaching Pathway Program for Medicine Residents, and former CIPE intern Mali Sati for development of this certificate program. 

Interest in this program should be directed to Heather Hageman, CIPE director, hagemanh@wustl.edu

Teaching Teamwork

“Placing a group of individuals from different disciplines in the same room does not mean they will function as a team.” (Stock, Mahoney, & Carney, 2013) 

Like health professionals from different disciplines, students in the health professions need skills for working in teams; these skills require intentional teaching. In CIPE, we have been dreaming about how wonderful it would be if the teachers within different health professions used a consistent framework for teaching teamwork, whether the teaching occurs in an individual program or in interprofessional education activities. We think we have found just the framework we need in the Team Development Measure for Interprofessional Education (TDM for IPE)! 

The original Team Development Measure was created to assess teamwork among interprofessional teams that provide care in clinical settings. (Stock, Mahoney, & Carney, 2013) More recently, educators at the University of Colorado and Virginia Commonwealth University adapted this tool for student teams in interprofessional education. (Lockeman, Madigosky, & Hanson, 2021) This 30-item tool measures four domains of teamwork, with the values and ethics of interprofessional collaboration woven throughout the four domains. 

  • Role Clarity involves learning clear role definitions and expectation for the different professionals on the team. 
  • Communication involves communication on the team for good decision-making and problem solving. 
  • Cohesiveness is the social glue that binds the team’s members to form an effective team. 
  • Goals and Means Clarity means that team members clearly define their goals and the means to reach them. 

The items in the tool provide details needed for teaching skills and providing specific feedback when observing clinical encounters. To learn more, check out the TDM for IPE video.

– Janice Hanson, Professor of Medicine, Director of Education Scholarship Development, Co-Director of the Medical Education Research Unit (MERU), Washington University School of Medicine

References

  • Stock R, Mahoney E, Carney PA (2013) Measuring Team Development in Clinical Care Settings, Family Medicine, 45(10), 699-700. 
  • Lockeman KS, Madigosky WS, Hanson JL (2021) A multi-institutional, multi-phase quest to measure team development among students in interprofessional education. Paper presented at the American Educational Research Association (AERA) 2021 virtual meeting, April 11, 2021. 
Intern Spotlight: Torrie Real, Washington University MPH Candidate 

Clients/patients seek care when they are experiencing an emergency, but what do they do outside of a health crisis? What do they do with most of their time spent outside of the health care system without resources to meet their health care and social needs? These two questions drove my work as I continued my Masters in Public Health (MPH) practicum with the Center for Interpersonal Education and Practice (CIPE) at Washington University Medical Campus. As an intern, I researched how CIPE can incorporate non-clinical professions like public health and community health work on Hotspotting teams. Community health workers are liaisons between health and social services and vulnerable communities that lack access to care. As trusted members of the communities that they serve, they are more than equipped to help build individual self-sufficiency and community capacity through outreach, health education, informal counseling, social support, and advocacy.  

Recognizing the value of this profession, I completed the Community Health Worker Accelerated Job Training at Saint Louis Community College. My knowledge of the structural and social determinants of health fit seamlessly with the scope of practice of community health workers (CHWs) as frontline public health workers who address access to resources on the system and client/patient levels. CHWs trained in social determinants of health can be the liaisons within care teams to improve patient agency within the health care system. Partnerships like the one between the CIPE and the St. Louis Community Health Worker Coalition acknowledge that client/patient wellbeing must go beyond the traditional client/patient-clinician relationship. Public health professionals and CHWs can help interprofessional care teams put client/patient needs at the forefront because of their shared interest in promoting self-sufficiency by supporting all facets of client/patients’ needs including those outside of a clinical setting. 

The CIPE Spring Line Up 

Join us for an exciting line-up of interprofessional development workshops this spring! Highlighted themes include teamwork and scholarship. Learn from health care professionals about how they are: implementing interprofessional collaboration at local institutions (BJC HealthCare and The Washington University Living Well Center), exploring the Team Development Measure framework for teaching teamwork, and supporting the care team and patients/clients by serving as community health workers. The final workshop of the series will allow participants to brainstorm potential interprofessional projects and review published articles to explore scholarship in interprofessional education. Many workshops are offered twice so you can choose which session works best for your schedule. Register today –  we look forward to seeing you! 

Recent CIPE Scholarship

Medicine Resident Lauren East, MD, spearheaded a validation study of a new observation tool piloted with the Standardized Patient Team Experience and presented the work at the Nexus Summit 2021 this past fall. 

What We’re Reading 

Organizational structure and resources of IPE programs in the United States: A national survey 

From the CIPE director: As noted in this article, central organization of interprofessional education (IPE) efforts is key to successful implementation of such initiatives. Our Center’s success is based on the forethought of the leaders of our three collaborating institutions coming together in 2015 to organize operationally and financially around building authentic interprofessional education activities. As we finalize Phase III of our longitudinal curriculum and support interprofessional collaboration in clinical settings and the community we are mindful to develop clinical IPE learning experiences that truly add value to those settings. 

Abstract: Interprofessional education (IPE) initiatives are growing due to the Interprofessional Education Collaborative’s core competencies being incorporated into health professions educations programs’ accreditation criteria. This investigation examined organizational models and structures of US IPE programs using mixed methodology of quantitative survey and qualitative analysis. Responses (61% response rate from the 131 institutions surveyed) were examined to identify relationships between IPE program organizational factors. Despite marked heterogeneity in most aspects of IPE program infrastructure including administrative structure, financing, and role of the academic health center (AHC), several key relationships emerged. A centralized administrative structure was most common and was associated with dedicated resources. The majority of programs were in AHCs and this was associated with financial structure, annual budget size, program maturity, number of students participating, and references to IPE in promotion and tenure guidelines. IPE learning experiences occurred predominantly in academic settings, identifying a critical need for development of clinical IPE learning experiences. Clinical IPE learning experiences were generally not in mainstream healthcare delivery systems but filled gaps or complemented healthcare efforts for underserved populations. Qualitative analysis results supported the survey results. Continued research in IPE organizational structures is needed to determine external and internal drivers associated with program success and continued trends in the IPE field.