Bulletin of Dental Education

Models of Interprofessional Curriculum in Dental Education

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ADEA President Sandra C. Andrieu addresses a packed house regarding models of interprofessional curriculum.At this ADEA Presidential Symposium, Dr. Sandra C. Andrieu presented three models of interprofessional education (IPE) curricula currently under way at three different dental schools. Faculty from the University of Florida, University of Minnesota, and Western University of Health Services presented their curriculum models and discussed the challenges and successes of each program. All three programs share a common goal: for graduates to demonstrate an understanding of other health professions and to provide and promote a team approach to patient care and health care management, which leads to improved patient care.

Dr. Andrieu introduced the symposium by first defining what IPE is not. It is not students in the various disciplines of dental education learning together in a classroom, lab, or clinical setting. IPE is also not students in different health education professions learning together in a classroom or lab setting. Nor is it a faculty member from a different profession leading a classroom learning experience.

IPE is instead defined as students from various health care professions evaluating and treating patients in a team-based environment. Through this process is developed a respect and common language between and among the health care professions, with the ultimate goal of improved overall patient health. The role of IPE is for students to learn to function as a member of an interprofessional team and to carry such knowledge, skills, and values into practice. This ultimately provides patient care as part of a collaborative team focused on improving overall patient health.

Progress toward IPE comes from individual schools and health sciences centers integrating IPE components into the curricula, designing entire programs around the process. Dr. Andrieu identified IPE as a top ADEA priority for 2011, encouraging and supporting academic dental institutions in integrating models of IPE. Three institutions currently have various working models of IPE within their curricula and were presented to the 400 members in attendance.

Ms. Rosemary Monehen presented the IPE model of the Western University of Health Sciences. Western’s mission statement for their IPE initiative is to “produce humanistic healthcare professionals who provide and promote collaborative patient-centered care and coordinated health care management.” There were several factors involved in Western’s initiative, including recognizing the growing number of elderly with chronic conditions that make coordinated care essential and valued, that interprofessional practice can minimize cost and maximize patient potential for improvement and recovery, that IPE breaks down training silos through collaborative education practice, and that students value an IPE experience.

Western’s model is a required, comprehensive program for their health professional students and includes nine health care disciplines: medicine, optometry, dentistry, podiatry, veterinary, physical therapy, physician assistant, nursing, and pharmacy. The planned IPE curricula is threaded and integrated through the respective programs and is broken into three phases: didactic, experiential, and clinical care.

Western faced several challenges, finding primarily that students were missing foundational knowledge on communication, scope of practice, and why IPE is important. Not all faculty were initially on board with the program, and grading was found to be too subjective and variable between facilitators. The university addressed these challenges through post-course focus groups and a revamp of various components. A foundational lecture (with online component) was introduced into the first-year course. Grading would now include objective testing with credit/no-credit for the 2011-12 school year. New behavior style assessment tools are in development for case-based, simulation, and clinical care IPE experiences. Western also hopes to add interprofessional clinic rotations to the on-campus Patient Care Center, and institute interprofessional grand rounds and journal clubs at the area hospitals where less than four of the health professional program students rotate. The university has found that to successfully implement and sustain an IPE curriculum, there must be proper administrative support, permanent IPE personnel, faculty participation and training, facility space, team development of courses and cases, and ongoing assessment.

The University of Minnesota School of Dentistry is part of the university’s Academic Health Center (AHC) that was formed 40 years ago, due in large part to IPE. Several of the strongest current drivers of the program are the state emphasis on patient quality care, the National Health Care Reform Act, IPE competencies in accreditation standards, and student and international pressure. Seeing the need for a more formal and inclusive structure for IPE, the AHC began the 1Health initiative in 2010.

1Health’s vision and mission is to represent the AHC’s vision of health for Minnesota, establishing a longitudinally integrated structure through which the health professional programs can orchestrate the curriculum necessary for students to achieve interprofessional collaboration competency.

There are three phases to the 1Health initiative: orientation to IPE, establishing the IPE toolbox, and providing an authentic experience. The third phase is still in development, with a goal of confirming partnerships with stakeholders and determining graduate attributes through a retreat facilitated by outside consultants and audience response systems. Through the initiative’s progress so far, the AHC knows that IPE is not an option for optimal patient care and that the curriculum must be redesigned to best incorporate IPE’s critical elements.

The University of Florida College of Dentistry is part of the university’s Health Science Center (HSC). Their vision is to “create unstoppable momentum toward the goal of improving individual and community health through discovery, clinical and translational science and technology, exceptional education, and patient-centered, innovative, high-quality health care.” The HSC consists of six colleges (dentistry, medicine, nursing, pharmacy, public health and health professions, and veterinary medicine) and the Institute of Food and Agricultural Sciences, totaling 119 faculty members and 612 students. The driving factors behind the HSC started in 2000 by the College of Medicine faculty’s drive for community involvement and student exposure to other disciplines. In 2011, the HSC’s focus is on patient safety and improved health outcomes, which has been incorporated into the HSC Strategic Plan and Core Values.

The HSC is currently involved in Phase I: Interdisciplinary Family Health, which began in 2000. The main component for the College of Dentistry is the course DEN 5010, Interdisciplinary Service Learning. The course is required for all first-year students in medicine, dentistry, pharmacy, accelerated nursing, physical therapy, clinical and health psychology, and graduate nutrition, and recently included all first-year nursing students and veterinary student volunteers. The course lasts for two semesters and includes six small-group seminars, four home visits (by student teams of three), and online patient safety modules. While grading is centralized, the grade status of the course is determined by each college—the College of Dentistry lists it as a satisfactory/unsatisfactory course.

Faculty from each college meet annually to review course evaluation data and to set policies or revisions. All involved faculty also meet prior to each course’s start to share best practices, course content, facilitation, and team development; new faculty members are also each teamed with an experienced faculty member.

Student learning outcomes focus on three main competencies: patient care, interpersonal and communication skills, and professionalism. The family home visits are a large part of the student evaluation and include community assessments, family health surveys, small-group discussion, case studies, reflection reports, a consult with social services, and peer evaluations, among other processes. Student response to the home visits have been very positive, with many agreeing in post-course evaluations that they learned helpful information that otherwise could not have been obtained through a health setting, and enhanced the student’s ability to communicate ideas about disease prevention and promote health habits.

The three models of IPE discussed differ significantly in their approaches, but retain the primary focus of graduates developing an understanding of other health professions through teamwork in regards to patient care and health care management, ultimately leading to improved patient care.

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