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NYU Rory Meyers College of Nursing has been offering interprofessional education experiences for its nursing students since 2006. To explain how it works and why it’s essential for nursing education, we interviewed Judith Haber, PhD, APRN, FAAN, the Ursula Springer Leadership Professor in Nursing and Executive Director of the Oral Health Nursing Education and Practice (OHNEP) Program at NYU Rory Meyers College of Nursing, and Erin Hartnett, DNP, PPCNP-BC, CPNP, the Program Director of OHNEP and Teaching Oral-Systemic Health (TOSH) Programs at NYU Rory Meyers College of Nursing.
Haber and Hartnett took time to answer our questions. What follows is Part 1 of our interview. Keep on the lookout for Part 2 next week.
Why do you offer interprofessional education for nursing students? Why is it important?
Judi Haber: These experiences are an important component of the education of all students in the health professions. Historically, health education in the United States has been delivered in well-established silos. Yet patients come to primary and acute care health care settings with health problems that cross the boundaries of those disciplines. Student exposure to interprofessional education (IPE) experiences are designed to break down the traditional professional silos and prepare students to practice in teams that understand each other’s roles and responsibilities, value and respect the contributions of all team members, and communicate and function effectively on interprofessional health care teams. That is the health system model of the present and future!
Professional practice silos also have been documented in a series of reports by the Institute of Medicine (2001; 2003) to have a negative impact on the quality and safety of patient care. Fostering interdisciplinary team building and collaborative practice was proposed to improve patient outcomes; a call to action challenged faculty educating students in the health professions to educate them interprofessionally as members of collaborative teams who “learned from, with, and about each other.” Publication of the Interprofessional Education Competencies (IPEC) in 2011 propelled this interprofessional education agenda and soon accreditation standards for nursing, medicine, dentistry, pharmacy, and other professions required evidence that students were being exposed to interprofessional education experiences.
Essentially, these interprofessional education experiences are preparing students to “hit the ground running,” prepared to practice in high-performing teams following graduation.
What other students work with them? At what schools are they studying?
Judi Haber: The NYU interprofessional education experiences have always had a clinical focus and have always included dental and medical students and, more recently, pharmacy students.
What happens during this three-day study? How does it work?
Erin Hartnett: The TOSH–Teaching Oral Systemic Health event has been held every September for the past seven years. In 2013, we started with about 300 students from three schools–NYU Rory Meyers College of Nursing, NYU College of Dentistry, and NYU School of Medicine–and in 2019, our seventh year, we have almost 800 students from four schools–NYU Rory Meyers College of Nursing, NYU College of Dentistry, NYU School of Medicine, and Long Island University (LIU) Pharmacy.
TOSH brings together students from different health professions to participate in an interprofessional oral health simulation with a Standardized Patient and a case study discussion experience to learn from, with, and about each other. The goals of this experience are for the student to learn about oral health, specifically the oral health connection, and the oral exam; as well as to learn to work together as a team using the interprofessional educational competencies (IPEC competencies) to learn each other’s roles and responsibilities, values, and ethics and to learn to communicate and collaborate as a team for the good of the patient–to provide better, safer, more cost effective health care
Prior to the TOSH experience, all of the students are required to complete an assignment, which includes: two Smiles for Life Modules, read about the IPEC competencies, watch a video on the TeamSTEPPS® SBAR communication techniques, and read an article about prescribing for acute dental pain (Clark et al, 2010; Agency for Healthcare Research and Quality).
When students arrive at the Simulation Center, they take the Interprofessional Collaborative Competency Attainment Survey (ICCAS) on their phone (MacDonald, Archibald, Trumpower, Casimiro, Cragg, & Jelly, 2018). The ICCAS measures their interprofessional competencies prior to the experience. Students are then assigned to a team consisting of a nurse practitioner, midwifery, medical, dental, and pharmacy student. They work together as a team obtaining a focused history from the Standardized Patient– which should lead them to suspect Type 2 Diabetes, periodontal disease, and acute dental pain.
The dental student then demonstrates the oral exam on the Standardized Patient to the other students, and each student is then required to practice the oral exam on the Standardized Patient with the dental student as mentor.
The teams then all move to a case study discussion room where they meet with another team. The students introduce themselves to the other team and then each profession pairs with the member of their profession to develop a problem list. After completing the problem list, both groups meet back together to develop a care plan, which incorporates each profession.
Students then role-play calling each other on the phone using the TeamSTEPPS® SBAR technique to explain the Situation, Background, Assessment, and Recommendations for this patient.
At the end of the experience the students debrief with their facilitator on how the IPEC competencies were met.
Is participation required for nursing students or voluntary? Do the nursing students need to be in a particular semester in order to participate?
Erin Hartnett: All second-year NP and Midwifery students, fourth-year dental students, second-year medical students, and fourth-year pharmacy students are required to attend.