A team students from the UMKC School of Medicine showed its mettle in winning an interprofessional education reasoning competition at Creighton University on March 24 in Omaha, Nebraska.
Fourth-year students Diana Jung and Saber Khan, and third-year students Yicheng Bao and Becky Kurian teamed with Creighton pharmacy students Amy Cimperman and Caressa Trueman to present the winning case in the 2018 Regional Interdisciplinary Clinical Reasoning Competition.
Teams were comprised of a mix of medical, pharmacy and nurse practitioner students.
Each team was presented a patient case, similar to a real-life encounter. They then had two and a half hours to evaluate the chief complaint and medication list, make a working diagnosis, and order needed lab tests and treatments. Teams that advanced to the final round then presented their case to a panel of judges to defend their reasoning and gain feedback.
The UMKC team ranked first among four competing schools in team work and collaboration, concise and professional presentation, and demonstration of appropriate clinical judgement and management.
“I attribute this largely to the early exposure that we get in patient interaction and the presentations we get during our curriculum through clinic, rotations and DoRo,” Jung said. “It was fun and a great learning opportunity.”
Jung said the experience drove home the need for teamwork among health care providers in giving patient care.
“Being able to rely on our pharmacy students for their expertise, played a huge role,” she said. “And having medical students in different years of study allowed us to approach the patient case in a broader point of view.”
The UMKC Interprofessional Education program conducted its second health sciences schools IPE competition on April 7 at the School of Medicine. Four teams of students from the schools of medicine, pharmacy, and nursing and health studies took part in the two-round, case-based competition.
The team of fifth-year medical students Joseph Bennett and Luke He and nursing student Joseph Bredvold won the first-place Emeritus Chancellor Morton Award for Interprofessional Excellence. The second-place team included fourth-year medical students Saber Khan, Zach Randall and Louis Sand, and pharmacy student Ann Lee.
A team of fifth-year medical students Kent Buxton and Christian Lamb, and pharmacy student Brad Erich, tied for third place with the team of Shannon Demehri and Hunter Faris, fifth-year medical students, and nursing student Caleb Jockey.
A panel of interprofessional faculty judged the competition based on diagnosis, treatment, pharmacotherapy, teamwork, communication and decision making. Judges for the event were Paul Cuddy, Pharm.D., Maqual Graham, Pharm.D., Cydney McQueen, Pharm.D., Eileen Amari-Vaught, Ph.D., M.S.N., F.N.P.-B.C., Doug Cochran, M.D., Jim Wooten, Pharm.D., and Emily Hillman, M.D.
Stefanie Ellison, M.D., associate dean of learning initiatives, said many students helped to develop and plan the event and provided support during the competition. Those involved included medical students Jordann Dhuse, Paige Charboneau, Niraj Madhana, Isioma “Miracle” Amayo and Mesgana Yimmer, and pharmacy students Michael Scott, Ijeoma Onyema and Joseph Bredeck.
On the Health Sciences Campus at UMKC, interprofessional education, or IPE, is an important learning tool. It brings together students from dental, medicine, nursing and pharmacy and places them in learning activities focused on team-based patient care. A new video highlights this IPE program and its benefits filmed during a recent poverty simulation exercise.
The UMKC Health Sciences IPE program is directed by Stefanie Ellison, M.D., associate dean for learning initiatives at the UMKC School of Medicine and emergency physician at Truman Medical Centers; and Valerie Ruehter, Pharm.D., director of experiential learning and clinical associate professor for the UMKC School of Pharmacy.
“We can create individual practitioners, but in health care today, it takes an entire team to create positive patient outcomes,” said Ruehter. “With IPE, we give students the chance to become familiar with what every discipline brings to the table, which hopefully will make a more seamless health care system.”
That’s a goal of IPE, said Ellison. “If we have our students learning in silos, but they are expected on day one in practice to begin working together as a team, then we haven’t really done our job. At UMKC, we are breaking down those silos.”
In Kansas City, nearly one in five residents live below the poverty line — a harsh reality shared by many patients UMKC students see on Hospital Hill and beyond.
To better understand the challenges and frustrations of those living in poverty, students participated in a large-scale poverty simulation, part of the Interprofessional Education (IPE) program on the UMKC Health Sciences campus.
In November, more than 100 UMKC medical, nursing, pharmacy and dental students, along with faculty and volunteers, joined to experience the virtual realities of poverty and its effects on patients. The simulation was designed to incorporate IPE, an emerging teaching approach addressing the future of health care, in which a close-knit team of dentists, physicians, nurses and pharmacists provides personalized, integrated attention to patients.
In the simulation, one of five such sessions this fall, students role-played living for a month in poverty, with each “week” lasting 15 minutes. The goals were to keep their home, pay all bills, hold down jobs and feed their family and children each day – all while managing issues such as an illness in the family, a stolen car and expenses to repair their plumbing.
Students could rely on stations around the room, such as employers, a grocery store, a health care center, social services, a pawn shop and a quick cash outlet, to help them meet their goals. Following the simulation, the group members spent time sharing their experiences and discussing lessons learned.
”It was sad to realize that all my time was spent thinking about just getting the minimum needs taken care of, and that sometimes even the minimum isn’t enough,” one student said.
Interim Chancellor and Provost Barbara A. Bichelmeyer addressed the participants after observing the simulation. She noted that the first place people went was the employer, and that many sought help from the pawn shop rather than turning to other resources. And the one station that didn’t get much business? The medical center, a point not lost on the room full of future health-care providers.
“Today’s program shows poverty is not about people not being well-intentioned, but about people not being well-resourced,” Bichelmeyer said.
The simulation, created by the Missouri Association for Community Action, was created to help people — such as future health-care providers — understand the challenges of living in poverty day to day. It lets participants look at poverty from a variety of angles and then discuss the potential for change within their communities.
The UMKC Health Sciences IPE program is directed by Stefanie Ellison, associate dean for learning initiatives at the UMKC School of Medicine and emergency physician at Truman Medical Centers; and Valerie Ruehter, director of experiential learning and clinical assistant professor for the UMKC School of Pharmacy.
According to Ellison, who coordinated the simulation with Ruehter, the day purposely included data about poverty in Missouri.
“The activity is very personal and designed to have students walk in the shoes of someone in poverty,” Ellison said. “The takeaway is to empathize with our patients and learn very specifically about the problems our patients face.”
“We sometimes get frustrated when our patients aren’t doing what we asked them to do or don’t show up for clinic appointments,” Ruehter said. “This is an opportunity for students to come together and wear the other shoe, to see that it’s not always as easy as we think it might be. We can create individual practitioners, but in health care today, it takes an entire team to create positive patient outcomes. With IPE, we give students the chance to become familiar with what every discipline brings to the table, which hopefully will make a more seamless health care system.”
That’s a goal of IPE, Ellison said. “If we have our students learning in silos, but they are expected on day one in practice to begin working together as a team, then we haven’t really done our job. At UMKC, we are breaking down those silos.”
At the conclusion of the simulation, students heard a call to action: to do more, learn more, go where the patients are and ask how you can help change the system, even a little bit.
“If what we do at UMKC is to help our health-care professionals in the future think about the humanness of the people they are working with, both their peers and their patients, then I think we will have made a really significant contribution,” Bichelmeyer said.
More than 400 students from the UMKC School of Medicine, School of Pharmacy, School of Dentistry and School of Nursing and Health Studies have taken part this fall in five interprofessional education sessions of the Missouri Community Action Poverty Simulation.
In each simulation, about 80 students act as people living for a month in poverty. Students are assigned to families and receive a description of their role and goals of the simulation. They work to keep their home, pay all bills, keep their jobs, and feed their family each day. Some students serve as teenagers or young children and are asked to behave as their character descriptions.
Participants receive challenges such as an illness in the family, expenses to repair their plumbing, and getting robbed or fired. Students spend four “weeks” living in poverty. Each “week” lasts 15 minutes. There are stations around the room for students to visit to help meet their goals, such as the employer, a “Foodarama” for groceries, a health care center, child care, community action agency, inter-faith services, social services, and a pawn shop and quick cash business.
The simulation is required for students pursuing M.D., D.D.S. B.S.N., Pharm.D. and P.A. degrees. Doctor of Nursing Practice graduate students help run the simulations along with past participants and volunteer faculty and staff.
The final session this semester took place on Nov. 11.
Interprofessional education at UMKC’s health sciences schools has spawned an interprofessional competition.
Nearly 50 students from the schools of dentistry, medicine, nursing and pharmacy worked together as members of nine interprofessional teams putting their combined skills to the test in the first Interprofessional Education and Collaboration Healthcare Reasoning Competition.
The daylong, case-based simulation competition took place in conjunction with the fifth-annual Interprofessional Education Faculty Symposium at the School of Medicine. It was the brainchild of a smaller group of seven students from different disciplines who formed a UMKC IPE Student Interest Group to promote interprofessional education.
“This started with the IPE interest group,” said Stefanie Ellison, M.D., IPE coordinator for the School of Medicine. “Seven or eight student were really interested in this. It was their energy that made it happen and everything fell in place.”
Members of the student interest group include Morgan Beard, Vincent Cascone, Maggie Kirwin, Grant Randall, Alie Reinbold, Mitchell Solano, and Robert Weidling.
Weidling said the group developed the competition after taking part in a similar event at Creighton University. The team spent the next eight months working on the structure of the competition. Ellison and Emily Hillman, M.D., assistant program director and clerkship director for emergency medicine, and faculty sponsor for the school’s Sim Wars team, provided faculty guidance.
“The most important goal of our event was to help students understand the importance of interprofessional teamwork,” Weidling said. “We wanted students to be put into a position where they were forced to augment their weaknesses with the strengths of the other interprofessional students, such as relying on pharmacy students to employ complex pharmacological treatment plans, medicine students to produce a robust differential diagnosis, and nursing students to craft care plans.”
For the competition. At least two different schools were represented on each team of five to six students. Each team was given a case with pertinent patient history and vital statistics, then given 90 minutes to prepare a treatment plan using their personal skills and other resources, such as Internet access. After 90-minute, teams gave 10-minute presentations to an interprofessional panel of judges made up of faculty from the health sciences schools. Each presentation offered the team’s treatment plan for the patient and how the team worked together to develop the plan.
The top four teams from the first round of competition were then given a new, unique case to prepare without using any outside resources.
Teams were evaluated on skills such as collaboration, demonstration of medical knowledge, ability to manage health-care decision and using their individual roles and responsibilities, and use of evidence-based medicine.
Ellison said the winning teams maximized their roles.
“Their knowledge and the skill sets of each team member allowed them to best take care of the patient,” she said. “That’s how we function every day.”
Weidling said the students enjoyed the event and that group is already planning for the next competition with hopes of creating a regional event for health sciences school throughout the midwest.
“The most common comment I heard was that all of the interprofessional team members felt valued and left with a greater appreciation of what each of our varying medical disciplines do,” Weidling said.
The top four winning teams selected by the judges were:
More than 500 students from the University of Missouri-Kansas City’s four health sciences schools — dentistry, medicine, nursing and pharmacy — gathered across the health sciences campus on Feb. 19 to gain a better understanding of each other’s roles and responsibilities as health care providers. The day marked the beginning of the third year of a campus-wide interprofessional education program.
Health professions programs across the country have accreditation standards to provide activities for students to learn with, from and about one another so that they are practice ready to provide safe, team-based care. School of Medicine Associate Dean for Curriculum Stefanie Ellison, M.D., one of the event coordinators, said the interprofessional education program at UMKC has achieved those standards with its series of activities spread throughout yearly activities within each professional program.
“All of these programs have their own accreditation requirements for interprofessional education,” Ellison said. “With our curriculum, we believe we’re now meeting all of those requirements.”
The afternoon-long activity focused the students’ attention on how to provide patient care in a safe manner.
Students from the School of Medicine’s anesthesiologist assistant and physician assistant programs participated in the program along with third-year students in the M.D. program. Students from all of the health sciences programs were divided into groups of 10 to participate in the first of this year’s three collaborative learning activities. A second group activity is planned for next September with a focus on ethics and values. The third group session focusing on interprofessional communication and teams and teamwork will follow in October or November.
The IPE activities occur annually so that all health professions students in ten programs will gain skills and attitudes in interprofessional practice as they contribute in all three events before obtaining their professional degrees.
Ellison said IPE coordinators at UMKC’s heath sciences schools are also working on events such as service learning projects and other activities that can be embedded into each school’s curriculum to create an on-going practice of interprofessional collaborative learning.
Faculty from the UMKC Health Sciences Campus at Hospital Hill recently attended the Fourth Annual Interprofessional Education Symposium: Building a Bridge Between Education and Practice in the Bloch Executive Hall Auditorium.
The UMKC Schools of Dentistry, Medicine, Nursing and Health Studies, and Pharmacy continue to emphasize interprofessional education in curriculum through large-scale instructional activities and at clinics through team grants.
Attendees said they want to increase the infusion of team education and practice in the curriculum because it is best for patient care.
“Hospitals are the third leading cause of death, and when you say that out loud, it’s frightening,” said Karen Cox, executive vice president and COO at Children’s Mercy, a panel speaker at the event. “That’s why we have to work together. We may be different, but not that different.”
Other panel speakers included Mark Steele, chief medical officer and COO at Truman Medical Centers; Tony Huke, clinical manager and residency director at Truman Medical Centers; Brett Ferguson, chair of oral and maxillofacial surgery at Truman Medical Centers; and Felicia Menefee, chief nursing officer ambulatory care at Saint Luke’s Hospital. Mattie Schmitt, professor emerita at University of Rochester, was the keynote speaker.
Donald Bowman, a patient, provided his perspective.
“Remember that an important member of an interprofessional team is the patient,” he said. “It’s important that team members, though they are likely to change, communicate deeply and thoroughly with their colleagues and show me that they care.”
UMKC will take center stage at the Kauffman Foundation Center on Dec. 2 with a seminar on how its health sciences schools are working together to promote and implement interprofessional education.
Former School of Medicine Dean Betty Drees, M.D., and School of Pharmacy Dean Russ Melchert, Ph.D., collaborated to bring about the seminar and provide a look at how the schools of medicine, dentistry, nursing and health studies, and pharmacy are working to promote interprofessional education in the areas of student research, student-led social activities, global health initiatives, curriculum and assessment, and diversity. As part of the program, faculty members will display work in those areas and share information about upcoming activities across the health sciences campus, said Stefanie Ellison, M.D., School of Medicine associate dean for curriculum.
“Developing a culture of interprofessional practice and collaboration is a goal on this health professions campus in order to provide safe and high quality care for patients in Kansas City,” Ellison said.
Ellison and the School of Medicine took part in organizing the first joint curricular activity among the health sciences schools last February. A second interprofessional activity, Dr. Hotspot and the Ethical Delivery of Care, took place on September 13 with classes held throughout the School of Medicine and the Health Sciences Building.
The activity, developed jointly by the health science schools on the Hospital Hill campus, included more than 465 students and nearly 50 faculty and student facilitators. The overall focus of the September class was on exploring values and ethics in team-based delivery of care, Ellison said. The class allowed students to work on an original case focusing on chronic disease and to understand and manage their patient’s social determinants of health as they answered questions and created a plan for their patient.
Classes were based on the small group learning sessions of student teams that began working together at the February 2014 activity. Those interprofessional students groups, called IMPACTs (Interprofessional Medical Patient Advocacy and Collaborative Teams), worked together before the class to identify the resources needed for their own patient population and to prepare for discussion on the day of the event a list of resources necessary for their practice area. Students were also asked to watch a video by Dr. Atul Gwande, a nationally recognized leader in health reform also known as Dr. Hotspot, to prepare for the event.
“There are more curriculum activities in IPE planned for our students in the upcoming years,” Ellison said.