Rebecca Cowan, Interprofessional Curriculum

1. Interprofessional
Curriculum
Rebecca G. Cowan, PhD, LPC, NCC
Eastern Virginia Medical School

2. Project Mentors
 Dr. Daniel Bluestein- Content Mentor
 Dr. Pamela Parsons-Content Mentor
 Lewis Hackett-Evaluation Mentor

3. Objectives
 Implement an interprofessional curriculum for family
medicine residents built around our SCCs, which
involves a team approach to tx, at both Portsmouth
Family Medicine and Ghent Family Medicine.
 Implement July 1, 2014
 18 residents per year
 Enhance resident’s geriatric rotation experience
 Familiarize residents with interdisciplinary team
approach to geriatric population

4. Methods
 Pre-test
 Attitudes and Knowledge
 Self-study materials posted to Blackboard
 Readings
 Video
 Case Study
 Discussion Questions
 Senior care clinic
 Post-test
 Attitudes and Knowledge
 Curriculum Evaluation Survey

5. Senior Care Clinic
 Focus on problems specific to elderly population
 Interdisciplinary team:
 Geriatrician
 Nurse Practitioner
 PhD Behavioral Science
 Resident
 Master of Social Work Student
 Psychology Intern

8. Pre-Assessment: Knowledge
 Question bank developed from assigned readings and
standards of care for the geriatric population
 Evaluate initial knowledge base:
 Interdisciplinary teams
 Pharmacology
 Geriatric syndromes (incontinence, falls, dementia, etc.)
 Advance directives
 Guide education based on the individual resident’s
needs

11. Pre-Assessment: Attitudes
 Attitudes Towards Health Care Teams Scale
 21 items
 strongly agree=5, moderately agree=4, somewhat
agree=3, somewhat disagree=2, moderately disagree=1,
to strongly disagree=0
 Some items must be reverse scored
 scores = better attitudes (score range 0-105)

12. Pre-Assessment: Attitudes

14. Week 1: Stages of Interprofessional
Team Development
 Week 1 Reading:
 Farrell, Schmitt, & Heinmann (2001) Informal roles and
the stages of interdisciplinary team development,
Journal of Interprofessional Care, 15(3), 281-295.
 Week 1 Discussion Board:
 Please discuss your experience being a part of a team.
What were some of the benefits of working together as
a team? Challenges? What do you hope to gain this
month by being a member of an interdisciplinary team?

15. Week 1: Geriatric Rotation Assigned
Readings
 Gaddey, H. L. (2014). Unintentional weight loss in older adults.
American Family Physician, 89(9), 718-722.
 Hesh, L. & Salzman, B. (2013). Clinical management of urinary
incontinence in women. American Academy of Family Physician,
87(9), 634-640.
 Simmons, B.B., Hartmann, B, & DeJoseph, D. (2011). Evaluation
of suspected dementia. American Academy of Family Physician,
84(8), 895-902.
 Spoelhof, G.D. & Elliott, B. (2012). Implementing advance
directives in office practice. American Family Physician, 85(5),
461-466.
 Tinetti, M. E. (2010). The patient who falls: It’s Always a Tradeoff.
JAMA, 303(3), 258-266.

16. Week 2: Team Roles and Functions
 Week 2 Video:
 Week 2 Discussion Board:
 After viewing the team meeting video, please discuss
how this team’s communication could be improved.
What are some issues with the way they are currently
interacting/communication? According to the Farrell et
al. (2001) article posted in Week 1, what stage is this
team likely in? How do you know?

17. Week 3: Barriers to Interprofessional
Teamwork
 Week 3 Reading:
 American Geriatrics Society Core Writing Group of the
Task Force on the Future of Geriatric (2005)
MedicineCaring for Older Americans: The Future of
Geriatric Medicine

18. Week 3: Case Study
Louise White is a 78 yo woman who was found to have a lump in her breast 6 years ago
during a visit to her PCP. Needle biopsy revealed malignant cells and, after talking with
the surgeon as well as her PCP, Louise underwent surgery to remove the tumor.
Unfortunately, her disease recurred. She now has widespread metastases. Her prognosis
for living more than two years is poor.
Louise has two sons, Marc age 56 and William age 58. William lives out of state but
checks on his mother about one time per week via telephone. Marc lives a few miles
away from Louise. He is an alcoholic who can sometimes be very irritable and angry.
Louise fully relies on Marc to transport her to her medical appointments but in recent
months he has failed to show up. He recently took over the management of Louise's
finances. She is worried he could be mismanaging them because last month $1,000 was
missing from her bank account. She is too afraid to confront Marc about the money.
Louise is still living independently. She takes codeine for fairly severe pain. She is very
weak, sleeps much of the day, and needs the help of her son, Marc, for shopping and
preparing meals; however, he is unreliable. She has lost 45 lbs from an already small
frame since her diagnosis. She comes to the office today with concerns about her health
and future. She scores an 18 on the MOCA.
 What team members need to be involved in this case? How should they obtain
and share information?
 What services need to be arranged for Louise?
 What are the legal/ethical issues in this case?
 What barriers to effective interprofessional teamwork may exist in this case?

19. Week 4: Interprofessional Team
Communication
 Week 4 Reading:
 Bokhour, B. G. (2006). Communication in interdisciplinary
team meetings: What are we talking about? Journal of
Interprofessional Care, 20(4), 349-363.
 Week 4 Discussion:
 Discuss how communication affects a team and team
member’s ability to work together. Provide an example of a
miscommunication that occurred during your work with the
team this month or during a time when you worked with a
team in the past. Overall, what can you do to improve your
communication with team members?

20. Post Test
 Knowledge Question bank
 Assess knowledge after completion of rotation
 A score of 80% or better is required
 Attitudes Towards Healthcare Teams Scale

21. Evaluation
 Supervising faculty will evaluate residents electronically
via NI.
 Residents will evaluate supervising faculty and rotation
electronically via NI.
 The evaluation is part of resident files and is incorporated
into semi-annual performance reviews for directed
resident feedback.
 Curriculum Evaluation Survey
 Utilize feedback to improve experience for residents

22. Curriculum Evaluation Survey
1. Curriculum materials were up to date and useful (handouts,
articles, etc.)
2. The amount of work I had to do for this curriculum with time
allotted was reasonable.
3. What I learned is important and will be useful to me.
4. This curriculum helped me to develop my skills in working
as a member of a team.
5. Overall, I was satisfied with the quality of this curriculum.
6. What did you like most about this curriculum?
7. What did you dislike most about this curriculum?
8. What suggestions do you have to improve this curriculum?

24. Next Steps
 Submit to IRB so that we can analyze:
 Quantitative data from
 pre/post test knowledge assessment
 attitudes questionnaire
 Qualitative data from:
 discussion boards/case study
 focus groups/individual interviews
 Quantitative and Qualitative data from:
 New Innovations
 Faculty evaluation of resident
 Resident evaluation of geriatric rotation
 Curriculum evaluation survey