Experiential Learning
in
Interprofessional Education
Joe Schwenkler, MD
Medical Director
Physician Assistant Program
School of Health Related Professions
Rutgers Biomedical & Health Sciences
Experiential Learning
• Reflection, critical analysis and synthesis
• Opportunities for students to take initiative, make
decisions, and be accountable for the results
• Opportunities for students to engage intellectually,
creatively, emotionally, socially, or physically
• A designed learning experience that includes the
possibility to learn from natural consequences,
mistakes, and successes
Source: Experiential Learning Center
University of Colorado
• Established on February 12, 2013
• Representatives from four schools:
– Rutgers PA Program
• Joe Schwenkler, MD- chair
• Lori Palfreyman, PA-C
– RWJ Medical school
• Rob Zachow, Ph.D.
• Joyce Afran, MD
– Rutgers College of Nursing
• Maureen Esteves, Ph.D., R.N.
– Ernest Mario School of Pharmacy
• Rolee Pathak Das, Pharm. D.
• Students from each program participated in the planning
sessions
Principles of Interprofessional
Education
• Longitudinal training, developing relationships
with peers
• Opportunities for collaborative problem solving
• Explore how to function effectively on teams
• Ensure that graduating students have the
foundation for collaborative practice
• On-going program evaluation
Rutgers/RWJ InterProfessional Education
Initiative Website
Moodle Course
utilized for
central storage
of case info and
suggested
readings
http://moodle.rutgers.edu/course/view.php?id=4289
#
2013/2014 IPE Seminars (students)
• IPE Patient Centered Medicine run by RWJMS
– Geriatrics (250)
– Caring for patients with limited English proficiency (180)
• IPE Physiology Small Groups run by RWJMS
– Asthma (250)
– Nephrotic Syndrome (180)
– Uncontrolled Hypertension (180)
• IPE Case Conferences
– CVA run by PA Program (350)
– Medical Errors run by Pharmacy, Scheduled on 3/19/14 (400)
• IPE Simulation Sessions run by the College of Nursing
– To start with asthma case scenario April 3, 2014
– Plan to expand to 48 students every other week
New IPE seminars
planned for 2014/2015
• IPE Case Conference: The Hospice Team
– To be coordinated by the School of Social Work
– Modeled after the CVA Case Conference with the
addition of New Brunswick Seminary students
• PCM Shadow Experience
• Nurse/PA Cadaver Lab
• New simulation scenarios emphasizing IPE
IPE Case Conference: CVA (11/25/13)
• Seven programs participated (# students):
– Robert Wood Johnson Medical School (130)
– School of Health Related Professions:
• Physician Assistant (45)
• Dietetics (18)
• Physical Therapy (30)
– Rutgers College of Nursing (70)
– Ernest Mario School of Pharmacy (25)
– Rutgers School of Social Work (40)
Case Conference Goals
– Realize the importance of patient care being provided
by Interprofessional (IP) teams in the real world
– Learning to work as a collaborative unit
– Skill-building to be able to function as part of an IP
collaborative team
– Understanding the roles, strengths of IP colleagues
and what each individual and discipline can bring to
patient care
– Develop relationships with colleagues outside of the
student’s own discipline
Research Initiative
• Collected pre- and post-activity data using validated
instrument (about 300 surveys completed)
– Readiness for Interprofessional Learning Scale (RILS)
– Paper-based, will use Qualtrics* for future activities
• Looking at attitudes and perceptions about other
disciplines and IPE
– Assesses value of cooperative learning, trust, respect,
professional limitations and professional identity
– First step toward developing a comprehensive IPE curriculum
• Identify real and perceived barriers to IPE
*Qualtrics is a web-based survey design and collection program
Major Challenges
• Scheduling
– Several programs had limited student availability due
to scheduling conflicts
– Need to plan further in advance
•
•
•
•
•
Logistics
Case presentation
Facilitator training
Reflection
Data Collection and analysis
Logistical Challenges
• Getting over 350 students and 50 facilitators to the
right place at the right time
• Creating 30 small groups and finding enough
rooms
– About a dozen students did not show
– Created an imbalance in several groups
• Balance student representation in each small
group
• Ensure student educational levels are similar
Logistical Solutions
• Utilized Access Database to store data
– This relational database allows for instantaneous
queries and reports
– Easy to create mailing lists
• Each participant picked up a place card
– Name, Program (color coded), and breakout room
• Also received a list of students & facilitators in
their small group
PA students served as the “hosts”
• Enlisted PA students to organize the traffic flow, greet
participants, and stand in the aisles
• Red carnation identified the 45 students hosting the event
Case Discussion Challenges
• Need to utilize a case that encourages
collaboration
• Need to have aspects of care that
relate to all the disciplines involved
• Need to present the case in a manner
that promotes group problem solving
• Need to emphasize the process taking
place within the small group
Case Discussion Solutions
• Build on a CVA case used by the PA faculty for
2nd year students
• Utilize a comprehensive appendix for
facilitators
• Role-play the ER entrance of a “stroke patient”
in front of the entire audience
– Let the students take the history and ask for
physical exam findings
Case Discussion Solutions (cont.)
• Break out into thirty small groups with a mix of twelve
students and one or two facilitators
– Groups with the best balance “performed” the best
• This “stroke team” follows the patient from the
entrance to the ER until they return home
• Build in challenges the team needs to deal with (i.e.
acute delirium, dysphagia, falls, family issues)
Facilitator Training Challenges
• Bringing a heterogeneous group of about fifty
clinicians up to speed on the case
• Getting the information to the facilitators ahead of
time
• Getting the facilitators to preview the material
• Getting all facilitators to attend a training session
in advance of the case conference
Facilitator Training Solutions
•
•
•
•
Distribute case discussion in advance
Comprehensive appendix
Postings on website
Train the facilitators via mailings
– Working in an Interprofessional (IP) Group
• Dr. Afran’s document distributed in advance
• One hour case review over lunch
• Debriefing for facilitators at the end of session
Student Reflection at the end
• What do you feel you learned about the role of other
professionals in the care of older patients in particular?
• Were there any challenges to working as an IP group
today?
• Do you think these challenges come up when providing
interdisciplinary care in the actual clinical setting?
• What are some of the key factors in making IP care
work?
• How has IP communication and dialogue been
facilitated?
Ways to improve?
• Goal is to have equal # students per program
– Ensure that all who sign up participate
• Students should have similar level of education
• Goal to have two facilitators per small group
– Each program to supply at least 1 facilitator per 10
students
– Enlist practicing clinicians:
• speech therapy and occupational therapy
– Invite top senior students from each program
• Develop a webinar for facilitator training
Any Questions/Comments/Suggestions?