A foundation of collaboration
Tucked away in an Olin Hall conference room on the Vanderbilt University campus, 36 adults huddle over Lego pieces. Eleven teams have been assigned to assemble multicolored Legos using the written directions included in the packet. The result should be a Frankenstein figure. Each team must time their progress.
Hands fly up as teams complete the task. Once a monitor approves the completed model, the team disassembles the figure and rebuilds it in hopes of improving their time. Just as they are becoming comfortable with their process, the teams are thrown a twist — additional multicolored pieces. Can teams rebuild AND beat their best prerecorded times?
The exercise, meant to simulate the growing challenge of providing health care in a more efficient and effective manner, creates much discussion, whispers and even laughter as the groups figure out how best to complete the task efficiently. This assignment is one of several team-building exercises for the newest members of the Vanderbilt Program in Interprofessional Learning (VPIL).
The two-year interprofessional program draws students from multiple disciplines — medicine, nursing, pharmacy, social work, divinity and counseling — to work together in a collaborative method to treat patients. The teams of students are assigned to the same clinical setting for the duration of the program. The goal is learning from each other in an effort to improve health care delivery and outcomes.
Intensive and immersive
Before the VPIL program officially begins, each student participates in a weeklong orientation known as Immersion, an intensive introduction to VPIL that sets the tone for the teamwork-themed health care model.
The concept was a perfect fit for Brooke Hazen, who is enrolled in the nurse practitioner adult gerontology primary care program at the Vanderbilt University School of Nursing and is a Lettie Pate Whitehead Scholar (see story).
For as long as Hazen can remember, Vanderbilt University Medical Center has been a part of her life, becoming the standard of excellence in her family.
Her parents were longtime patients at VUMC and she grew accustomed to interacting with the various specialties that provided care.
Once she was accepted into the School of Nursing, she learned about VPIL and she knew it was a track she had to follow.
“The interdisciplinary aspect of the program is what attracted me,” Hazen said. “I researched it and saw the relevance and importance of this in my own family.
“I remember how important it was to have all of my dad’s care team, which included many specialties, on the same page. Having this intense introduction to this approach to health care is invaluable.”
Immersion is designed to create healthy team dynamics. Students participate in team building exercises to help in the development of communication and shared decision-making.
Team-based patient care
The Lego building exercise is just one activity during the week to engage the various team members. The class is divided into 11 teams, each assigned to a different clinic in which they will work during the two-year VPIL program.
VPIL program directors are eager for the Immersion week of activities. It’s the perfect entry to the many disciplines of health care. Immersion week introduces students to the essential theme of health care before they venture into their separate clinical pathways — a team-based style of caring for patients.
“We want to get the students before they step into their individual programs,” said Shannon Cole, DNP, MSN’94, instructor of Nursing at VUSN and co-director of VPIL. “They are already thinking about what it will be like as an advanced practice nurse, as a doctor, as a pharmacist, so before they get into those silos, we want to introduce them to this concept of learning and treating patients before they establish their professional identities.”
“We want our students to practice at the top level of their professions while realizing the important pieces of the puzzle that the other professions are bringing to the table,” Cole said.
Cole and Melissa Hilmes, MD’00, BS’96, associate professor of Radiology and Radiological Sciences at Vanderbilt University School of Medicine, are tasked with overseeing the unique teaching experience that results in clinicians who are versed in a collaborative clinical work environment.
“Medical teams care best for patients with medically and/or socially complex problems,” Hilmes said. “One single professional or discipline cannot address the many facets of patients, and teams can help. We should train our professional students to approach health care as a team.”
VPIL started with four disciplines — medical, nursing, pharmacy and social work — and schools in and outside of Vanderbilt when it launched in 2010. It has grown to include counseling and divinity for the patient-focused health care teams that work together to think about the health care experience.
Rebekah Finley, a pharmacy student at Lipscomb University, sees VPIL’s collaborative focus as the foundation of how medical teams should operate.
“It is the vision of medicine and puts the patient in the forefront,” Finley said. “Collaborative care is 21st century care — placing pharmacy in combination with medicine, nursing and social work. It’s the holistic approach to care.
“During the Immersion week, we really learned about the other disciplines and their roles. We are learning how to use not only our strengths but also discovering our weaknesses and how best to improve on them to provide the best care to patients, which will only make our health care teams stronger,” she said. “It was great starting off learning these concepts. Not everyone is on the same page and I think during Immersion, we saw that four brains working together had a much better outcome.”
A broad framework
Those realizations are what Immersion week organizers hope for as students from different specialties connect prior to starting in their individual programs. Inspiring them is the premise behind the Lego activity led by Rebecca Lofton, PharmD, instructor and clinic coordinator.
“The Lego exercise allowed the teams to work together in a respectful manner,” Lofton said. “It provided a platform for the teams to get to know each other, observe each other’s styles and personalities. It was a fun and nonthreatening way for the members to learn how each member of their group approaches problem-solving. It’s a practice that reaches far beyond what they are doing in the classroom and in clinic rotations while in school.”
During the Immersion week, not only are students introduced to various concepts of interprofessional learning but they are also given a tour of the Nashville community and experience an additional learning module.
Students saw firsthand the importance of approaching health care from a holistic perspective when they were tasked with meal preparation for a family on a reduced budget. The activity showed students barriers to healthy living and many other factors that affect a patient’s decision-making and ability to follow through with specific treatment plans.
“There are a lot of things that impact a person’s health, which is not just genetics or family history,” said Meredith Huszagh, a first-year medical student at VUSM. “Immersion gave me a good broad framework on how to think about things. It was invaluable to learn what skillsets others can offer so that we can collaboratively enhance the patient experience. There are so many other factors outside of the molecular things we focus on in medical school. Through this experience I have a better perspective of how many other factors affect disease and patients.”
Students prepared a budget-friendly meal for the entire class using only items available at the neighborhood stores within communities that are typically labeled as disadvantaged. Student teams then cooked their meals in a community center or church.
“Immersion was an incredible way to learn more about approaching patients from different sides,” Hazen said. “We are all engaging the patient in different facets, but this really taught me to consider the different factors impacting a patient. I feel so much better prepared going into my classes.
“It also re-emphasized the importance of community and the role it plays in a person’s health. The interdisciplinary, team atmosphere goes hand in hand with the future of health care. We got our first dose of that during Immersion.”