Reena Antony

The health mentors program: three years experience with longitudinal, patient-centered interprofessional education.

Abstract Increased emphasis on team care has accelerated interprofessional education (IPE) of health professionals. The health mentors program (HMP) is a required, longitudinal, interprofessional curriculum for all matriculating students from medicine, nursing, occupational therapy, physical therapy, pharmacy, and couple and family therapy. Volunteer lay health mentors serve as educators. Student teams complete four modules over 2 years. A mixed-methods approach has been employed since program inception, evaluating 2911 students enrolled in HMP from 2007 to 2013. Program impact on 577 students enrolled from 2009–2011 is reported. Two interprofessional scales were employed to measure attitudes toward IPE and attitudes toward interprofessional practice. Focus groups and reflection papers provide qualitative data. Students enter professional training with very positive attitudes toward IPE, which are maintained over 2 years. Students demonstrated significantly improved attitudes toward team care, which were not different across programs. Qualitative data suggested limited tolerance for logistic challenges posed by IPE, but strongly support that students achieved the major program goals of understanding the roles of colleagues and understanding the perspective of patients. Ongoing longitudinal evaluation will further elucidate the impact on future practice and patient outcomes.

Transforming chronic illness care education: A longitudinal interprofessional mentorship curriculum

Despite the growing burden of chronic disease globally, a number of reports have documented the failure of our health care systems to provide quality care for patients with chronic illness. Interprofessional education (IPE) is widely advocated as a key element to promote effective, redesigned health care and is increasingly recommended to develop skills in team-based, patient-centered chronic illness care. A growing body of literature now documents successful strategies for incorporating IPE in health professions education. However, as recently as 2008, a comprehensive review identified only six studies documenting IPE’s impact on patient-centered outcomes (Cameron et al., 2009). In a review of the literature, Reeves et al. (2010) found that ‘‘further rigorous mixed method studies of IPE are needed to provide a greater clarity of IPE and its effects on professional practice and patient/client care.’’ (p. 230) Recognizing the need to train students in team-based care, an interprofessional team of faculty at our university developed a longitudinal patient-centered team-based curriculum that builds on senior mentor programs and uses the Chronic Care Model (Bodenheimer, Wagner & Grumbach, 2002) as the conceptual framework. Senior mentor programs were initially designed to deliver geriatric education to medical students and to promote patient-centered care (Eleazer, Wieland, Roberts, Richeson & Thornhill, 2006). Using patients as educators is gaining recognition as a strategy to deliver patient-centered education (Towle et al., 2010). The Chronic Care Model is a new model of health care delivery redesign that promotes collaboration between an informed, activated patient and prepared, proactive health care teams (Bodenheimer et al., 2002). Applying theChronic CareModel to our curriculum, the Health Mentor represents the informed patient/teacher and the students are developing practice teams. The purpose of this study was to perform qualitative analysis of student reflection essays to assess the impact of a longitudinal mentor with a chronic condition on the training of future health care teams.

Chronic illness care education: longitudinal interprofessional mentor programme.

and how to teach and then evaluate them. There is little medical education literature that directs curriculum designers to evaluation methods or formative educational assessment tools for IECPCP. What was done Stations for the OSCE were created based on clinical scenarios that require a team approach to care (hence ‘team OSCEs’ [TOSCEs]). Stations are 30 minutes in length and teams of five or six students work through scenarios, depicted by a standardised patient (SP) or a video clip, to determine an interprofessional care plan for the patient involved. Students are evaluated on a set of clinical competencies in an area of focus which varies from station to station (e.g. palliative care), and a set of standardised interprofessional competencies that are consistent across each station. Each station has two evaluators; one is an MD faculty member and one is a faculty member from another allied health profession such as nursing, social work, OT or chaplaincy. Each station includes 10 minutes for feedback given by the SP and the evaluators. Evaluation of results and impact Students and evaluators complete extensive surveys at the end of each TOSCE day. Both students (n = 141) and evaluators (n = 38) have reported a high degree of acceptability of the TOSCE, with 81–100% of respondents responding with ‘agree’ or ‘strongly agree’ to a series of acceptability questions. Similarly, the majority of both student and evaluator respondents (79–100%) agreed or strongly agreed that the TOSCE format was quite feasible. Of note, the students felt the 10 minutes of feedback following each station was amongst the most useful learning they had received in their training. Three more TOSCE stations are being introduced to evaluate the reliability and validity of the TOSCE. Student TOSCE scores are being compared with those on multiple-choice question tests and clinical application exercises in the same content areas. Thirty students will complete six TOSCE stations as part of this evaluation, which will include randomisation so that the effect of the group versus the individual can be investigated. The TOSCE holds promise for learners at all levels for a variety of clinical scenarios where both health care content and team-based skills are necessary. At the least, it is a formative educational tool, and current reliability and validity data will determine its effectiveness as an evaluation methodology.