Cultivating Collaboration An Interprofessional Collaboration Skills Curriculum for

Cultivating Collaboration: An Interprofessional Collaboration Skills Curriculum for Early Medical Students in Clinical Microsystems Josette Rivera, MD 1; Susannah Cornes, MD 1; Allison Ishizaki, MPH 1; Anna Chang, MD 1; 1 Maria Wamsley , MD 1 University of California, San Francisco Purpose & Background Assessment Plan Purpose: To teach and assess interprofessional collaboration skills of first-year medical students participating in a longitudinal clinical skills and health systems improvement curriculum. Background: • Interprofessional education (IPE) traditionally focuses on the interactions of students of different professions • Situated learning theory posits that learning occurs through interaction with practitioners • Embedding students in interprofessional (IP) teams of practicing professionals may provide rich opportunities formal and informal IP learning • Assessment of teamwork skills is important for ongoing program evaluation and to ensure students are prepared to function collaboratively in healthcare teams Instructional Methods In the UCSF Clinical Microsystems Clerkship (CMC), groups of 5 - 6 first-year medical students are assigned to a faculty coach and clinical microsystem for 15 months. Students spend one day/week learning direct patient care skills, interprofessional teamwork, and working on a systems improvement (SI) project. We developed and piloted 3 assessments: • Written application of an IP communication tool (ISBAR) in month 5 (summative) • Simulation case in which each student negotiates a patient's care plan with a standardized social worker in month 8 (summative). Grading rubric emphasized ISBAR & rapport building skills. Sample rubric items: • Student expressed empathy utilizing at least one PEARLS statement (Partnership, Empathy, Apology, Respect, Legitimation, Support) • Student clarified roles and next steps for care plan • Two item feedback survey on students’ IP collaboration skills completed by non-physician team members in months 5 and 8 (formative): • “What does X do well in collaborating with other health professionals? ” • “What does X need to improve to collaborate more effectively with other health professionals? ” We created a longitudinal IP curriculum embedded in the clinical microsystem intended to: • Increase student knowledge of roles/responsibilities of diverse healthcare professionals • Foster student IP collaboration skills including communication to deliver patient-centered care Outcomes • Written ISBAR assessment: average score 60% (SD=2. 8%) • Standardized social worker assessment: average score 88% (SD=8. 9%) • IP feedback survey results: please refer to Mc. Ginness et al 1 Student Feedback “Outside of our project and outside of our patient visits and outside of the time that we specifically had an assignment to talk to a healthcare professional-there weren’t many opportunities or times that we would seek other interactions” –MS 12 “…it's healthy to understand the hard work that everybody in the healthcare team is doing. Actually going to the site and being able to see with your own eyes everything everyone is contributing is meaningful and helpful for firstyear medical students. ” – MS 12 Discussion IP curricular activities include: • Interview/shadow 1 -2 non-physician team members • Observe an IP team meeting with an observation guide • Small group on IP communication skills/tools • Interview a patient about their IP healthcare team • Communicate with an IP team member about a patient care issue Figure 2. Students observing IP team meeting. Figure 3. Students preparing for standardized social worker interaction Figure 1: Timeline of Interprofessional Education Program in the Clinical Microsystem Clerkship • Curriculum provides workplace-based IP learning while avoiding logistical challenges of bringing students of different health professions together • Curricular materials and assessments can be adapted for early learners of any profession with longitudinal clinical placements • Formal activities in months 1 -5 are essential for student learning about the roles of their colleagues • High scores on summative standardized social worker interaction suggest acquisition of IP communication and rapport building skills Lessons Learned & Next Steps • IP team member interview/shadow, part 2 • IP team observation • IP team member interview/shadow • IP communication small group Month 1 By Month 5 Assessment @ Month 5: • IP Feedback Survey • Written ISBAR Assessment • Practice IP communication tools in clinical microsystem • Interview patient about their care team Month 7 Assessment @ Month 8: • IP Feedback Survey • Standardized Social Worker Interaction • The robustness of student IP interactions varied depending on team stability, whether the microsystem was accustomed to engaging with students, and the degree of faculty coach facilitation 2 • Next steps are to focus on informal IP learning opportunities, particularly via faculty coach development to help students recognize and reflect upon opportunities which often occur on the fly • Explore feasibility of incorporating IP colleagues in additional assessment activities • Create summative exam exercises to assess IP competencies such as conflict management and requesting consultations Authors References 1. 2. 3. 4. 5. 1. Mc. Ginness A, Wamsley M, Rivera J. Quality of Interprofessional Feedback for First Year Medical Students: A Content Analysis. 2018 WGEA Poster. 2. Wamsley M, Rivera J, O’Brien B. ‘Getting out of that siloed mentality early’: Opportunities for interprofessional learning in a longitudinal clinical placement for early medical students. 2018 WGEA Oral Presentation. Josette Rivera MD; UCSF; Josette. Rivera@ucsf. edu Susannah Cornes MD; UCSF; Susannah. Cornes@ucsf. edu Allison Ishizaki MPH; UCSF; Allison. Ishizaki@ucsf. edu Anna Chang MD; UCSF; Anna. Chang@ucsf. edu Maria Wamsley MD; UCSF; Maria. Wamsley@ucsf. edu The authors have no financial or other conflicts of interest related to the above materials