Q: What do you get when you cross a pharmacy student, a medical student and a nursing student?
A: An interprofessional rotation that helps students learn to communicate and collaborate with other health professionals!
Kate Johnson, a registered nurse, is the interprofessional care coordinator at the college’s Medication Management Center. She coordinates an interprofessional education (IPE) rotation at the MMC for health professions students. Johnson recently received a College of Pharmacy Award for Excellence in recognition of her outstanding work at MMC.
Through the interprofessional rotation, students in pharmacy, medicine and nursing bring their specialized skills to the table to serve high-risk patients together, with the added benefit of learning to value the contributions of other professions.
“The IPE rotation came about with the goal of providing students with more interprofessional opportunities, as this has become something that many colleges are aiming to improve,” says Johnson. “We felt that the MMC would be the perfect fit for an interprofessional rotation due to all of the work we do with pharmacy students.”
The rotation made its debut with a pilot in October 2015, and the third rotation is underway now.
Each IPE rotation includes six students – two from each of the three health professions. Pharmacy students are recruited for the IPE rotation through a few routes. If there are students already scheduled for an APPE (Advanced Pharmacy Practice Experience) rotation at the MMC, they are included by default. Otherwise, students from another APPE rotation site are incorporated, or pharmacy students on a break from their APPE rotations may volunteer. Medical students volunteer for the IPE rotation through their Commitment to Underserved People program. Nursing students are selected by professors in their required community health course, because the MMC is one of several clinical sites for the course.
Each rotation has the students work one 8 a.m.-3 p.m. day per week for three weeks with patients in various programs such as the Transitions of Care program. In the Transitions of Care program, high-risk patients are referred to the MMC after being discharged from Tucson Medical Center. The goal is to prevent hospital readmissions. Through the program, each patient receives two phone medication therapy management consultations – the first, one week after their discharge and the second, three weeks after their discharge.
The heart of the rotation consists of small groups of three students, one from each profession, completing these phone consultations with patients. Each group prepares before the calls by reviewing the patient case together, then presenting it to Johnson and a pharmacy preceptor for feedback. Johnson describes how the tasks are allocated on a typical call:
“Once on the phone with the patient, the nursing student starts by identifying the patient’s current concerns, completing a medication reconciliation, and answering any nursing-related questions. The medicine student then addresses the patient’s questions and concerns related to the disease states and treatment goals and provides any necessary education related to these concerns. The pharmacy student then wraps up the call by addressing medication-related concerns, identifying any safety concerns or gaps in adherence to treatment guidelines, and summarizing the main takeaway points from the call.”
Students’ comments on the IPE rotation reflect that they agree with Johnson that it has been “incredibly successful” so far.
- A nursing student says, “I really enjoyed being able to work with students from the school of pharmacy and feel that I have gained a better understanding of their role in patient care.”
- A medical student adds, “I loved the opportunity to interact with patients and to work with an interprofessional team. It was an incredible learning experience to get to defer to others and to provide my own input so that we could all come to good conclusions in the interprofessional team. It was also nice to be involved with real patients because it showed an applicable way of working interprofessionally.”
- A pharmacy APPE student lists the best things about the rotation: “helping to understand other professionals,” “patients are more satisfied,” and “more enthusiasm and cooperation among team members.”
Johnson shares a “success story” from the most recent rotation:
“The students spoke with the daughter of a patient newly diagnosed with type 2 diabetes. The patient had just been started on insulin therapy in the hospital and the daughter was overwhelmed by the stress of monitoring her father’s blood glucose. The students were able to successfully educate the patient’s daughter about blood glucose goals, the signs and symptoms of hypoglycemia, and typical trends in blood glucose during the initiation of insulin treatment. By the end of the consultation, the patient’s daughter was reassured and seemed immensely grateful for the education provided. In addition, the students identified that the patient’s medication regimen was missing a statin and a diuretic, both of which are recommended by national guidelines due to the patient’s diagnoses of diabetes and heart failure, respectively. The interprofessional rotation students were able to coordinate the care of this patient, resulting in comprehensive care to improve diabetes control, prevent cardiovascular complications from diabetes with the addition of a statin, and reduce the likelihood of future hospital readmissions.”
Johnson concludes, “I’ve been so impressed by all of the students’ enthusiasm regarding interprofessional collaboration and patient care. They have all done such an amazing job working as a team and providing professional and comprehensive consultations for these patients. I feel that this experience provides them with a valuable opportunity to practice interprofessional collaboration skills and to have a very real impact on patients at high-risk for complications and readmissions.”
First photo caption: Kate Johnson
Second photo caption: Johnson (far left) presents a case study to students in the rotation
Third photo caption: Aaron Leyba, PharmD Class of 2016, considers a case study
Story by Elizabeth Harris, communications assistant