Connected in care

Course — started at UND — puts eight health care disciplines in same room in challenging scenarios to foster collaboration

In the late afternoon of Aug. 28, Ellen Grabinski stormed into a tiny room on the top floor of the School of Medicine & Health Sciences (SMHS) at the University of North Dakota. Four people awaited her arrival with hints of anxiety and amusement on their faces.

Cutting their introductions short and refusing to shake hands, Grabinski fervently inquired about her hospitalized father.

A short discussion, punctured by halted explanations and terse reproaches, followed. The man had an adverse reaction to a penicillin drug. His health care team had overlooked an allergy note in his file. The team had also ignored an allergy band on his wrist.

From a doctor to a nurse to a pharmacist, all apologized for the slip and offered solutions.

In less than five minutes, it was all over. There were laughs and sighs. Everyone reflected on what went well, what did not, and what could be improved.

Someone quipped that the intense interaction felt real.

But it was not.

It was an exercise in role-playing for students at the interprofessional health care course (IPHC) at UND.

A diverse group of student from the Colleges of Arts & Sciences and Nursing & Professional Disciplines, as well as the SMHS played out the dreaded situation of having to reveal a medical error to a patient’s distraught relative.

“It was fun to act out the different scenarios of being angry, being sad or being in shock because it is real life,” said Grabinski, a junior nursing student who is taking the class. “Everyone is going to act differently and it is interesting to be on the family end just because you get to portray those things to help others prepare for what they will have to deal with in the future.”

It is these kinds of predicaments that the IPHC focuses on through its dynamic educational activities. The concept – which is now part of medical schools’ curricula across the United State – emerged in the early 2000s in an attempt to enhance patient safety.

Outside the known

First developed at UND in 2003 and overhauled a decade later through a grant partnership with the University of Missouri and the University of Washington, the IPHC teaches communication and collaboration to students from eight different disciplines.

These include medicine, nursing, social work, occupational therapy, physical therapy, communication and sciences disorders, counseling psychology, and nutrition and dietetics.

The goal is for budding health care providers to understand medical realms outside of their own.

“The literature suggests that students who learn this way, provide better quality care,” said Dr. Eric Johnson, interprofessional education director at the SMHS. “They are less likely to have burnout. They are more likely to understand how to work with each other and how to talk to each other, which are huge tools.”

Each of the Colleges involved in the course elects faculty to serve on the IPHC management team, which Dr. Johnson leads with Michelle Montgomery, and volunteers to facilitate team-building interactions.

“We are a little bit ahead of the curve at the University of North Dakota for interprofessional education,” said Dr. Johnson. “Some institutions have an entire interprofessional curriculum in a single seminar a day.”

At UND, students bond over real-world medical situations, which they tackle in teams of up to 14. At different academic levels and of various talents, they learn with, from and about one another.

“In health care, it is a team approach,” said Montgomery, who is a wellness advocate in the UND Department of Psychiatry & Behavioral Science.

She has grasped the course’s synergic tenets on disparate rungs. She took it as a student, participated as a facilitator and now helps run it.

“I wanted to learn the language of the other people […] and to really learn what some of them do because until I took this course I didn’t know the difference between physical therapist and an occupational therapist, per se,” Montgomery said.

Caring together

There are 124 students registered in the IPHC – an all-time high as well as the capacity cap for the course, which transpires over five weeks, twice a semester.

“We could not even take one more student right now,” said Dr. Johnson.

Some of the robust enrollment comes from recent program updates in the College of Nursing. Another portion of it, however, arises from students’ own pursuit of interdisciplinary and interpersonal knowledge.

The latter is particularly commendable, said Craig Burns, assistant professor of social work. It matches what patients themselves demand.

“Transparency and patient knowledge have increased,” said Burns, who is to join IPHC on both the management and facilitation teams for its second installment later this term.

“They expect more communication, too. So, it is the expectation of patients as well as professionals.”

Before coming to UND from Guam this fall, Burns garnered cross-professional experience at the Department of Veterans Affairs and the University of Hawaii’s John A. Burns School of Medicine, where he was part of a team focused on infants’ health.

For him, the aptitude to cooperate stems from the diffusion of the “mystique” around medical practitioners.

“If you are sitting, talking with them in a class and you know them as an individual, it makes communication easier,” he said.

This is especially true in North Dakota, whose it-is-a-small-world character often translates into lifelong connections that blossom from the classroom into the practice. And ultimately, the IPHC is all about relationships in the name of care.