November 2, 2012

Treating Doris: Health sciences students practice team-based clinical problem solving

UW Health Sciences and UW Medicine

Oct. 30 2012 inteprofessional training event

Ashley Wiggin

In a team training session, UW health sciences students receive guidance from a faculty member as they work on a patient case.

No health care professional is an island. On October 30, nearly 450 UW Health Sciences students from four schools convened as teams to apply their diverse skills in a medical scenario. Groups consisted of first-year physician assistant students, second-year pharmacy and medical students, and senior nursing students. Interprofessional education had earlier covered simulated urgent care situations and medical errors, but today’s situation forced the teams to reconsider their treatment plan for a hospitalized patient. In this case, an actress portrayed a fictionalized patient, Doris.

The student teams started by discussing diagnoses for Doris’s condition. Thirty professionals from all areas of the health sciences offered assistance when students were stuck. Teams created and submitted an initial plan of care, keeping in mind elements like medications, patient safety, comfort, follow-up, and psychosocial needs. Then, teams watched a video of Doris. She was telling them that she refused their recommendations. The student teams then brainstormed on the ethical, clinical and personal issued they were going through in figuring out what to do now in caring for Doris.

Ashley Wiggin

A scene at the health sciences interprofessional training session Oct. 30 attended by 450 UW students from various health professions.

During the second half of the training event, videos of medical professionals who had cared for patients in similar situations applied their experiences to the complex case at hand. A physician explained efforts made to educate the patient about heart medications. A nurse talked about wanting to support the patient’s autonomy, yet being frustrated with the decisions the patient was making. The social worker addressed safety issues in the community. The pharmacist talked about trying to explain prescribed medications in a difficult situation. The occupational therapist shared concerns for the patient’s well-being.

In the end, student teams developed a care plan that met Doris’s preferences and she was discharged to her home. Students were disappointed at this outcome. They recognized that it is easier when patients do what the team wants, but that occurrences like this one require teams to communicate well and coordinate their care expertly.

As the training sessions came to a close, students rolled out buzzing with energy. Amy Tung, a pharmacy student, said she felt that “events like this prepare us to work in a team and remind us that we aren’t alone in making tough decisions.”

Ashley Wiggin

A faculty member listens to students’ ideas as they reconsider a treatment plan for a patient who did not accept their initial recommendations.

Other students were overheard praising their teammates and expressing respect for the breadth of knowledge and interest. Faculty member Sarah Shannon offers her perspective on the importance of these collaborative training events: “As new health care professionals, we are educated in silos, but expected to practice in teams. During my own nursing education, I had no experiences learning with other members of the care team. An experience like this or the other IPE [interprofessional education] events that our UW students have the opportunity to engage in would have better prepared me for the real world of patient care.”

Coordinators were Karen McDonough, associate professor of medicine; Sarah Shannon and Mayumi Willgerodt, both associate professors of nursing; Jennifer Danielson, clinical assistant professor of pharmacy, and Linda Vorvick, senior lecturer in the MEDEX physician assistant program. The Josiah Macy Jr. Foundation provided funding that helped to build this faculty teaching team. The UW Center for Health Science Interprofessional Education, Research, and Practice hosts and designs other events like this and is dedicated to teaching collaboration among health professionals.

For more information about the Center visit http://collaborate.uw.edu/.