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Familiarity Breeds Better Care for Patients

A medical student and a nurse practitioner walk into a classroom...

Oladimeji Oki, M.D., an assistant professor and assistant clerkship director in the department of family and social medicine, facilitates an IPE class.

No, it’s not the start of a joke, but rather part of a trend in health professional training called interprofessional education (IPE). The goal is to prepare students for the increasingly collaborative healthcare environment that awaits them. In this classroom, 20 third-year Einstein medical students and Columbia University nurse practitioner (NP) students were split into four teams—each team a mix of both types of students—to discuss such questions as “What is the best indicator of high-quality diabetes care?” The idea is for future doctors and future NPs to learn more about real-life issues they will soon be dealing with, and to get to know one another in the process

Medical students should learn early that reaching across professions isn’t just a ‘feel-good’ exercise but actually helps them to learn and to become better doctors.”

Med students and NPs will be working together when they graduate, so each should have a clear idea of the other’s training and better understand each other’s roles,” says Maria Teresa Santos, M.D., the director of Einstein’s family medicine clerkship, an assistant professor of family and social medicine at Einstein and an attending physician at Montefiore. “NPs are trained and licensed to do many of the things doctors can, including prescribe medication.”

NPs are registered nurses whose graduate education allows them to specialize in different areas of medicine, much as doctors do. Thanks to their time spent as registered nurses, second-year NP students arrive in the IPE classroom with extensive clinical knowledge and experience. They usually know more about interacting with patients than do their third-year medical school IPE classmates, who may just be starting their clerkships.

“Medical students should learn early that reaching across professions isn’t just a ‘feel-good’ exercise but actually helps them to learn and to become better doctors,” says Pablo Joo, M.D., associate dean for medical education at Einstein and an attending physician in family and social medicine at Montefiore. “We hope they’ll realize that some of their greatest allies on the wards and in the clinic are members of other professions.”

Dr. Joo, Dr. Santos and their longtime colleague Marlene McHugh, D.N.P., developed the IPE team-based learning sessions as part of the clerkship. Dr. McHugh, the program coordinator, is an assistant professor of nursing at Columbia University’s School of Nursing and a family nurse practitioner in clinical practice at Montefiore.

The family medicine clerkship’s dual-profession IPE classes debuted in 2014, and consist of three team-based learning sessions. “They read about clinical cases in advance, and then evaluate and discuss in class realistic scenarios involving patients with diabetes, hypertension and elevated cholesterol,” explains Dr. Santos.

The sessions are popular with students. “Once we’re on the wards, we’re expected to work seamlessly with social workers, nurses, therapists and other providers,” says Mollie Nisen, a fourth-year Einstein medical student, who participated in the IPE. “This class gives us some exposure to the realities of how hospitals and clinics actually function and also a better understanding of what other members of the healthcare team are expected to do.”

Meredith Peeke, a doctoral family nurse practitioner student at Columbia, says that participating in the IPE sessions made her feel more confident professionally. “I get a little intimidated working with M.D.s,” she admits, “so it was really nice to work with M.D. students and meet them in a more approachable environment.”

Third-year medical student Kayla Applebaum, left, confers with Stephanie Chambers, D.N.P. Left, Oladimeji Oki, M.D., an assistant professor and assistant clerkship director in the department of family and social medicine, facilitates an IPE class.
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