Interdisciplinary
education on the HSC
campus
Report to the Kaiser Permanente
Foundation December 16, 2009
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IPE Relationships
AHEC
HSC
MD, PA,
SODM,
SOPH, SON
Rural Colorado
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Campus vision
The Anschutz Medical Campus of the
University of Colorado Denver was
intentionally designed to facilitate
collaborative, interprofessional education.
Shared instructional facilities
 Shared faculty locations
 Interdisciplinary Student Academic
Communities (SACs)

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What is IPE ?
I. Students working in another
discipline
II. Students working together
III. Education and training programs
are conducted together.
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I. Students learning about or
working in another discipline
 Provides opportunities for:
Awareness
 Appreciation
 Knowledge transfer
Example:
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Shadowing (Learning by observation)
SOM, PA, Pharm and Dent.
Oral health introduced into SOM
Systemic topics taught in SODM
Started in November ‘09 with
However, one student is at home, the
other is not.
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IIa. Students working together as
peers
 Problem solving in an instructional setting
 Example:
Interdisciplinary rural track sessions
• Healthy communities session 11/5/08
• Suicide prevention session 4/22/09
• Brown bag medication reconciliation 12/16/09

Dental students teaching medical
students about the oral examination
 New topics:
 Disaster
training and triage
 Pandemic flu preparation
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IIb. Students working together as
peers
 Clinical service and problem solving
 Direct
patient care that is collaborative and
benefits the patient. Ongoing examples:
• Disease management clinics
– Diabetes
– Anticoagulation
•
•
•
•
NWSS health screening clinics
Health Action Day
Cinco de Mayo
Merino school health fair
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III. Education and training
programs conducted together
 This level of IPE activity requires campuswide collaboration and is a work-inprogress of the IPE steering committee
 Schedules
 Curriculum overlap
 Matching various levels of students
 Faculty roles
 Budgets
 Etc.
 Etc.
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III. Education and training
programs conducted together
 This is a goal not only of the Kaiser IRTS

program, but also of the HSC.
IRTS partners from SOM, PA, SOPH, Pharm, Dent
and Nursing have been contributing, and leading
the way on this goal by actively participating in
the HSC IPE Steering Committee:
Albino, Judith; Armstrong, Gail; Barley, Gwyn; Barton, Amy; Bowler, Fara; Brown,
Kristen; Brunson, Diane; Burtness, John; Carrothers, Terri; Childs, Marguerite;
Deutchman, Mark; Earnest, Mark; Elashvili, Ana; Erickson, Vicki; Ericsson, Barbara;
Franson, Kari; Gascoigne, Jan; Glicken, Anita; Glover, Jackie; Hemstreet, Brian; Huff,
Jim; Kluender, Randy; Krugman, Richard; Levine, Mark; Madigosky, Wendy; Magee,
Deidre; Magilvy, Kathy; Melillo, Allegra; Mellis, Karen; Montgomery, Linda; Mouton,
Melissa Jo; Nair, Kavita; Potter, Brad J; Rapport Mary Jane; Silsby, Bradford; Turner,
Christopher; Valdez, Connie; Yancey, Lynne
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III. Education and training
programs conducted together
 The Kaiser IRTS program piloted a model
IPE program in June, 2009 in the form of
the Rural Immersion Week in Sterling
Colorado.
 Other existing models:
 Campus-wide ethics curriculum – ongoing
 IRTS oral health workshop 10/21/09
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IPE initiative overview
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IPE structure and programs
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Health Mentors Program
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Interprofessional teams of 4‐6 students
Paired with health mentor from the community with a
chronic physical or mental illness or disability
Teams remain together for two years.
Teams meet every six weeks with their mentors to complete
specific tasks
Health history, experiences with access to care and care integration
 Experiences with illness and care, an individualized wellness plan
 Behavioral and mental health
 Prescription and over the counter drugs and safety
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Embedded in this curriculum and within each task will be
an exploration of roles and orientations of the different
professions involved and skills building in teamwork and
communication.
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IPE Rotations
 Interprofessional collaborative
practice experiences at clinical
training sites with school-specific
requirements
 Model IP practices at underserved
sites
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IPE Clinical Transformation
 Interprofessional simulations, video
monitoring and feedback

Center for Advancing Professional
Excellence (CAPE)
 TeamSTEPPS training (developed by
AHRQ)
 Shared
model and language for clinical
communication
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Student Interprofessional
Academic Communities
 16 student-lead gathering places in
Education II including:
Rural Health
 Global Health
 Wellness and Fitness
 Urban Underserved, and
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Current IPE programs and
how KIRTS leads the way
IP Service Learning
Oral-Systemic Health curriculum
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SOM Phases I - IV
Medical presentations to dental students
CF-3 program (state-wide)
Rural Immersion week
Rural clerkship integration
Support for the Rural Health Student
academic community (SAC)
 Support for SODM Rural Track and others
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This work has involved formation
of an extensive, complementary
network of partners
 Kaiser Foundation
 Colorado Area Health Education Center
 Department of Family Medicine
 Delta Dental of Colorado Foundation and Frontier
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Center
School of Dental Medicine
The Children’s Hospital
Colorado Trust
Caring for Colorado
Cavity-Free-at-Three program
NWSS
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IP Service Learning
 NWSS
 Courage Classic
 Strides for Epilepsy
 Health action day
 Cinco-de-Mayo
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Need data on number of participants in
various IP Service Learning programs
 NWSS
 Courage Classic
 Strides for Epilepsy
 Health action day
 Cinco-de-Mayo
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Interdisciplinary
Oral-Systemic Health Curriculum
Oral Health Systemic Health
Dental Home
Medical Home
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A unique public/private partnership…
University of Colorado Denver
School of Dental Medicine
and the
Delta Dental of Colorado Foundation
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THE FRONTIER CENTER
Forging a New Link Between Dentistry
and Medicine for Better Patient Care
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Create an educational
paradigm that focuses
on the oral-systemic
connection and builds
inter-professional
understanding
Oral disease is a disease like any other, and should be treated.
Everything in the body is connected - having a chronic infection is
a serious problem...that can have systemic impact.
Prevention and shared preventive practices among various health
providers can improve systemic health.
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Inter-professional
partnerships enhance
patient care by building
bridges
Through educational programs targeted at
medical and dental students, medical residents
and practicing dentists and physicians, we are
working to improve understanding about the oralsystemic connection and its impact on our
patients’ general health.
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Impact on the MD Curriculum
First Year: PBL case on oral lesions and oral cancer
Second Year: oral/systemic connection lecture
Third Year: oral exam workshop with dental
students
Fourth-year: two-week electives:
Acute Dental/Oral Problems in Adults & Children
Child Oral Health
Resident Education: Faculty development
workshops on implementing Smiles for Life oral
health modules
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Impact on Practicing Medical
Providers
CME events:
Child oral health
Oral emergencies
Fluoride varnish application
Motivational interviewing
Cavity-Free-at-Three program
15 public health sites trained
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Medicaid Payment Change
- initiated July 2009
 Medical providers are eligible for payment for
child oral exams, oral health counseling and
FL varnish application
 Children age 0 through 5th birthday
 Can be billed four times per year
 CF-3 or Smiles for Life training needed
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Impact on the DDS Curriculum
First Year:
Interaction between dental and medical homes
Child oral health in general dentistry
Blood pressure reading techniques
Second Year:
Periodontal disease impact on health.
New Health History Form
Oral Pathology: oral cancer and systemic diseases.
Simulation lab
Third year:
Medical interviewing and SP’s
Medical topics: CV disease, pregnancy, dermatology
Fourth Year:
Work directly with ACTS preceptors.
Medical topics: hepatitis B and C
Adult Preventive Care Guidelines
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Frontier Center Future Directions
PREVENTION! - Maximizing the
impact of Cavity-Free-at-Three
Involving all health team members
Catalyze a shift from treatmentbased philosophy of oral care to a
more prevention-focused approach
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Cavity Free at Three Program
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Cavity Free at Three Program
Need some data from Su and Karen
Start date
Funders
# trained
Sites
Taken over by AHEC 9 months ago
Activity since takeover
9 months 10sites 150 individual providers
2000 kids
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CF-3 Training
 Didactic and on-site hands-on
through AHEC
 Didactic and TCH-based hands-on
through TCH CF-3 clinic
 CF-3 will be a standard element of
KIRTS for students from all
disciplines.
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Interdisciplinary Rural Immersion
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Interdisciplinary Rural Immersion
Sterling, CO June 5-9, 2009
 “Experience what
a rural community has
to offer, with an eye toward assessing
health – in the broadest sense of the
word.”
 Interdisciplinary participants:
√
6 MD students
√ 3 PA students
√ 6 Pharmacy students
√ 2 Nursing student
√ 1 Public Health student
√ 1 Psychology student
√ 3 Spouses, 2 children
√ 3 Faculty
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Interdisciplinary Activities
Interdisciplinary investigation groups:
 Acute
health care
 Community & economy
 Criminal justice/law
enforcement
 Education system
 Long-term care
 Mental health
 Public health and safety
Group visits
Hospital
 Prison
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Social Activities
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Dormitory housing
Group meals
Ranch visits
Drive-In movie
Publicity
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Newspaper
Radio
Television
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What we learned…
 Close interrelationships between
community groups and agencies
 Community members play multiple roles
 Local problem-solving
 Rich opportunities for individual growth
and leadership
 Interest in rural life positively reinforced
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Sponsors and Costs
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Sponsors:
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Costs:
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Colorado Trust
Kaiser Foundation
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Planning and making community connections
Travel, housing, food
Student stipends
Faculty time
Future plans
Repeat annually in new sites
 Caring for Colorado grant application

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Upcoming Rural Immersion
June 14-18, 2010 in Delta CO area
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Rural clerkship integration
 Planning started in July 2009, first
cohort implemented in Nov, 2009
 Students from Medicine, PA,
Pharmacy and Nursing shadow each
other.
 Started with six cohorts
 Initial evaluation completed
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Clerkship
integration
schedule
for Q1 2010
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Clerkship integration
January 2010
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Januay 2010 IPE links
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Clerkship integration
evaluation (Nov-Dec ‘09)
 Need data from Diedre
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Clerkship integration activities
in development
 Shadowing
 Disease management clinics
 Diabetes

Anticoagulation
 Community health
Health fairs
 School screenings

• Oral health
• Immunizations
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Clerkship integration activities
in development (continued)
 Hospice visits
 Nursing home visits
 Community mental health visits
 Service learning:

School Health Professions counseling
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Interdisciplinary Rural Tracks
CHA/PA Program
Pharmacy ??
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CHA/PA program Rural Track
 Started in 1993
 3-5 month clinical rotation block in a
rural community of less than 15,000
in the 3rd year
 65% of RT graduates are practicing
in rural communities
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SOM Rural Track
 Started in 2005 with a grant from the
Colorado Trust
 Goal: increase the number of
students who eventually enter, and
remain, in practice in rural areas.
 About 10% of the SOM classes
 Emphasizes but does not require
primary care
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SOM RT Curriculum
 Longitudinal over 4 years
 Twice weekly in first 2 years
Seminars
 Workshops
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 4-week summer rural preceptorship
 Intersession meetings in years 3 & 4
 Residency/community links
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SOM RT Class of 2009
Match results:
7 Family Medicine
(5 in Colorado)
2 Pediatrics
(1 in Colorado)
2 Emergency Medicine
(1 in Colorado)
1 General Surgery
(in Colorado)
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RT 2010
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RT 2011
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RT 2012
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RT
2013
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School of Dental Medicine RT
 Newly starting 100-hour program
 Seminars on dental topics
 Rural Grand Rounds
 Rural Track activities with SOM
 Interdisciplinary Rural Immersion week
 Rural ACTS rotation
 Rural Health SAC activities
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Interdisciplinary RT sessions
 Follow Rural Grand Rounds once monthly
 Rural Tracks form the base of student
participants for RT sessions and
immersion weeks:
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SOM
PA program
Dental Medicine
Pharmacy
Public Health
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RGR and IRT seminars
Rural Grand Rounds
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1/09 Rural healthcare policy
2/09 Rural diabetes care
3/09 Public Health
4/09 HPRN – Asthma/Colon CA
5/09 Air medical transport
9/09 What’s wrong with Rural CO
10/09 Oral Health
11/09 Rural HIV
12/09 CORHIO
1/10 Child abuse
IRT seminars
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Healthy communities
11/5/08
Suicide prevention 4/22/09
Summer preceptorship
reports 9/11/09
Oral health workshop
10/21/09
Summer immersion reports
11/18/09
Medication reconciliation
12/16/09
2/10 Healthcare policy (CRHC)
3/10 Health professions (CHI)
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IRTS Publicity: Ritter

As part of its community benefit program, Kaiser
Permanente made a $2.4 million dollar grant to establish the
University of Colorado Denver’s Interdisciplinary Rural
Training and Service Program (IRTS).
“I applaud the University of Colorado Denver and Kaiser
Permanente, two local health care leaders, for pushing the
envelope and thinking innovatively about the type of publicprivate partnership that can address critical health needs in
our state.”
http://www.cufund.org/2009/06/11/students-may-be-solution-to-shortage-of-medical-professionals-in-rural-colorado/
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IRTS Publicity: Calonge
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The numbers demonstrate the need. According to the Colorado
Rural Health Center, seven counties have no dentists, six have no
full time primary care physicians, and one has no primary care
physician.
“Colorado is largely a rural state and many of our rural counties
are facing significant shortages in health care professionals living
and working in their communities,” said Ned Calonge, chief
medical officer of the Colorado Department of Public Health and
Environment. “This innovative partnership will help address these
shortages by supporting the recruitment and retention of new
health profession graduates in currently underserved
communities.”
http://www.cufund.org/2009/06/11/students-may-be-solution-to-shortage-of-medical-professionals-in-rural-colorado/
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IRTS Publicity: 9 News
… the Colorado Area Health Education Center system is working with the
University of Colorado-Denver Medical School on the Anschutz Campus in
Aurora to get more students interested in working along the Eastern Plains.
More than 20 students from the school of medicine, school of nursing, and
school of pharmacy are taking part in the Interdisciplinary Rural Training and
Service Program, led by Dr. Mark Deutchman.
"The goal is to immerse students in rural life," said Deutchman, director of the rural track at
the University of Colorado Denver Anschutz Medical Campus. "It's really a lifestyle
choice. It's a different kind of life. It's also a family choice and so that's why we've invited
spouses along with these students."
Most of the students in the immersion program are no strangers to rural life. Deutchman says
they target people from rural backgrounds to foster their feelings of giving back to
communities they can relate to. "They know rural life, but they don't necessarily know
rural health care,"
Deutchman said. "Targeting students all the way from the elementary level to get them
thinking about health care careers,“ Deutchman said.
The program is funded by The Colorado Trust, a grant-making foundation. It's also paid for by
a $2.4 million grant from Kaiser Permanente
http://www.9news.com/news/education/article.aspx?storyid=117472&catid=129
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IRTS Publicity:
Aurora Sentinel
According to the Colorado Rural Health Center, seven counties in Colorado
have no dentists. Along with a grant from the Colorado Trust that funds
the track, the Interdisciplinary Rural Training and Service Program at CU
Denver started with a $2.4 million grant from Kaiser Permanente Colorado
in the spring 2009. The program will mingle students from other
disciplines to prepare them to work together in rural areas. Dr. Jandel
Allen-Davis, MD, the vice president of government and external relations
for Kaiser Permanente Colorado said the health care provider invests
money where it’s needed and will help make a difference. “The goal of the
(IRTS) program is to help duplicate what we’ve done in the School of
Medicine rural track program in the other areas – pharmacy, dentistry,
nursing, etc,” Deutchman said. “It’s to get the students to learn together
because they’re going to have to work together once they get out in the
real world.”
http://aurorasentinel.com/articles/2009/06/25/news/metro_aurora/doc4a43d05c847002171... 6/26/2009
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Professional School
Admissions Issues
 Many urban applicants have impressive portfolios
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International travel
Extensive extracurricular activities
Experiences made possible by having grown up in large
metropolitan areas
Professional parents who have above average
resources.
 This may put rural applicants at a competitive
disadvantage unless their unique experiences are
recognized
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Rural applicant experiences to be
recognized in the application
process
 Consistent history of working on the family farm
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or ranch
Significant amounts of time devoted to helping
care for siblings or other relatives
Consistent history of working away from home to
add to family income
Being first in the family to attend college or apply
to professional school
Extracurricular activities and leadership in
organizations such as FFA or 4-H
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IPE Relationships
AHEC
HSC
MD, PA,
SODM,
SOPH, SON
Rural Colorado
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