UCSF's Millberry Union gym took on the look of a political convention on Monday afternoon, with 500 first-year students packing the floor beneath signs indicating all 50 states. Rather than teaching the students about politics, however, the future health professionals gathered in the gym could probably teach a thing or two about collaboration and cooperation to the nation’s politicians.
Monday was "Interprofessional Education Day" — the kickoff event for UCSF's Center for Innovation in Interprofessional Education. In an effort to reflect the way health care is actually delivered today – by teams of professionals working together – UCSF is breaking down barriers between its various schools, and enabling students of dentistry, medicine, nursing, pharmacy and physical therapy to collaborate on projects.
“No one of us is going to have the competence to provide complete care. That’s why we’re going to have to work in teams,” said Kevin Grumbach, MD, chair of Family and Community Medicine in UCSF's School of Medicine. “You are not the most important person in the health care delivery system, which may come as a shock to some of you. The most important person is the patient.”
In emphasizing a model of patient-centric care – and in bringing all of its students together to work in that direction – UCSF aims to take a leadership role in the national movement toward interprofessional education, according to Elizabeth Watkins, PhD, dean of UCSF's Graduate Division and vice chancellor of Student Academic Affairs.
“We want to take advantage of having all five health professions represented here at UCSF,” Watkins said. “These team exercises will spark their enthusiasm and inform their role in what the new world of health care will look like.”
Although the practitioners of various specialties have worked together for many years, that concept has only expanded into the educational process of future health professionals relatively recently. Yet it’s swiftly becoming a vitally important part of a student’s training since research has demonstrated the benefits of teamwork, coordinated efforts and knowledge sharing to improve patient outcomes and provider satisfaction.
Learning from Peers Across Professions
At the very start of their training at UCSF, students learn from their peers across the professions what each brings to high-quality health care.
“All of our graduates need to be collaborative and practice-ready,” said Maria Wamsley, MD, a professor in UCSF’s School of Medicine and co-chair of the IPE curriculum development group. “Most of us in practice recognize that you can’t do anything without collaborating with other health care professionals. Having them graduate and get those skills on the job is too late. It's an essential skill. We wouldn’t dream of putting them into practice without it.”
Underscoring that point, San Francisco Fire Chief Joanne Hayes-White delivered a keynote address in which told how she has parlayed her involvement in team sports into a career in which teamwork is a necessity. When emergency workers respond to the scene of a crisis, they must be able to work together, she said.
When she became chief 10 years ago, she said, she assembled a team that was “diverse, with a lot of different qualifications, so that we could go in different directions. You will miss things if you are only getting one viewpoint.”
Hayes-White grieved in the aftermath of the July 6 airplane crash at San Francisco International Airport when three people died, including one struck by a fire engine at the scene. The incident offered lessons for the department. “When you have an outcome that is not what you want, it's very difficult to deal with,” she said. “You have to be supportive. You always have to be respectful of people’s feelings, not just the patients, but also one another.”
After her talk, the students split into small groups of 10 to 12 people, each group named for a state (hence the signs around the gym).
Each group included people studying in at least four different disciplines, and each was tasked with coming up with a proposal for a new initiative at UCSF. They were encouraged to think big; teams of faculty will evaluate the proposals, and the winning team will have an opportunity to pitch its idea to campus leadership, with the chance of receiving funding.
Best of all, the students said, the groups will continue to convene throughout their time at UCSF, deepening the connection between the different disciplines.
In the group meeting under the banner of Hawaii, students hatched a plan to send a team of health professionals from UCSF to schools into the community, helping urban school children with health care, teaching the children to care for each other, and inspiring them to pursue careers in the health professions.
The more the group discussed the idea, the more animated they became. UCSF students could use such a program to gain clinical experience, they said, while filling a gap left by the loss of school nurses to budget cuts.
“I think we should make this happen, one way or another,” said Gordon Goldstine, a dental student.
Other groups came up with a wealth of ideas, from developing health care apps for smartphones, to ensuring the health of UCSF students themselves (through a program they labeled “UCSF: U Can Stay Fit”). Some groups envisioned mobile health care clinics, while others developed mentorship programs.
Afterwards, students expressed enthusiasm at the power they unleashed in their new collaborations.
“It’s interesting to see what happens when we put our brains together,” said Lucy Hallajian of the School of Dentistry.
“This should be instituted worldwide,” said Chizoh Uzegbu, a nursing student. “It will make the health care system easier for us as colleagues and, most importantly, for the patients, so we’re all on the same page.”
UCSF graduate Tess Lang, MD, who was helping out as a group facilitator, recalled the start of her education at UCSF, when the program was new. “We all came into this room for a lecture, and the depth of the interaction was shaking the hand of the student next to you,” she said. “I remember I shook the hand of a dental student. It’s really come a long way since then.”
If some of the students have their way, the program will only continue to evolve, building even more sustained relationships between the schools. “I wish we had more of this,” said Jyesha Wren, a student nurse midwife in the School of Nursing. “These days are a good start, but they’re not deep enough to accomplish the goals the university wants us to accomplish. We should be doing it throughout our clinical experience. It’s too easy to get into our little silos.”
Photos by Susan Merrell