Moving from individual roles to functional teams: A semester-long course in case-based decision making

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Abstract

Incorporating meaningful interprofessional education (IPE) into curricula to better equip students to enter and shape clinical practice can be challenging. Faculty from dentistry, medicine, nursing, pharmacy and social work taught a semester-long IPE course where interprofessional teams of students collaborated in case-based decision making to learn two IPE competencies: understanding professional roles and developing teamwork skills. Pre- and post-assessments measured students' knowledge and perceptions of professional roles, individual roles on a team, and overall team functioning. Pooled data from two years of students (n = 540) showed significant improvement in familiarity with the education and roles of each discipline (p < 0.05), improvement in individual communication and teamwork skills (p < 0.05), and improved team functioning (p = 0.006). The case-based pedagogy using interprofessional student teams effectively allowed students to learn about each profession's role on the team and gain teamwork skills.

Section snippets

Format

Team-Based Clinical Decision Making (TBCDM) is a large-scale, semester-long, active learning IPE course taught at the University of Michigan where there are several health-science schools on its local campus. Case-based discussions are used as a means for students to develop teamwork skills, learn about the roles each profession plays on the team, and gain experience in representing the role of their profession.

Target audience

TBCDM was launched in winter 2015 and has been offered for two consecutive years collectively enrolling 540 students (dentistry, 231; pharmacy, 156; social work, 87; medicine, 38; nursing, 28). It is required for all third year doctor of pharmacy and doctor of dental surgery students, and a subset of master of social work students. It has been offered as an elective for second through fourth year doctor of medicine and graduate advanced practice nursing students. In 2017, it will be required

Objectives

TBCDM focuses on two core competencies for interprofessional collaborative practice: understanding professional roles and responsibilities, and developing teamwork skills.5 Through weekly case-based discussions, students teach each other about their role and scope of practice so that all students gain an understanding of how each discipline contributes to the healthcare team. Working in fixed interprofessional teams over the course of the semester allows students to learn about the importance

Activity description

TBCDM is designed as a series of modules taught by an interdisciplinary faculty pair in order to model professional interactions and the collaborative nature of clinical patient care. Each module is focused on a specific theme, consists of a complex patient case, and is taught at a different health science school allowing students to rotate through the various buildings to see the didactic environments of their peers. An overview of the content for each module is shown in Table 1.

Enrolled

Assessment

For each class session students are required to complete a prework and in-class assignment, both of which are graded. These weekly assignments are designed to encourage student accountability and increase engagement with the material during class. Measurement of student learning was focused on the two core competencies, understanding professional roles and teamwork. For all measures, pre- and post-testing was used with baseline scores compared to end-of-semester scores. The results that follow

Evaluation

Measurement of success was based on student feedback regarding overall impressions and perceived value of the course. It was assessed using a survey instrument designed in conjunction with the University's Center for Research on Learning and Teaching (CRLT). This evaluation was completed during the final class session; for the first offering of the course (2015) it was followed by focused discussion directed by CRLT staff in order to identify the key strengths and opportunities for course

Impact

Student comments on the post-course reflections specific to lessons learned about team functioning are telling and focus on realization of their individual roles on the team (“I don't need to be an expert in all areas. I need to be an expert in my field and understand how to work with other disciplines on the team.”), team dynamics (“A problem between a small part of the team can affect the entire team.”, “One over-powering person, even if knowledgeable, can take over the team.”), and team

Required materials

The commitment of leadership from the health science schools was essential to allow for successful development of this large-scale course. In addition to providing staff support (0.3 FTE for the first year only), leadership agreed on several fundamental principles: offer the class at a set time in the schedule across programs; provide two faculty to teach from each school; provide sufficient teaching space; and, ensure a minimum number of enrolled students from each unit. Faculty designing the

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Funding: This work was supported by the University of Michigan, Center for Research on Learning and Teaching's Investigating Student Learning Grant, 2015–16.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

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