A new effort by the University of Virginia’s schools of Nursing and Medicine and the Claude Moore Health Sciences Library has them rallying for a common cause: Nurturing 21st-century physicians and nurses who are compassionate with patients, respectful of one another and who provide coordinated, collaborative team-based care.
The new interprofessional effort – dubbed “ASPIRE,” for Academic Strategic Partnerships for Interprofessional Research and Education – is a formalization of an already years-old partnership among the schools and the library to practice and promote collaboration among nurses- and physicians-to-be. Each of the three entities will commit funding, time and energy to the Center for ASPIRE’s cultivation, which will offer a central point from which to organize, assess and expand interprofessional opportunities on Grounds.
“This is a chance to fortify and expand what we’re already doing so well,” said Dr. Tina Brashers, Woodard Clinical Scholar and a nursing and internal medicine professor who oversees the schools’ interprofessional efforts. “My hope is that our already robust partnership will enable us to continue and expand this important work.”
Though the center’s formation is new, U.Va.’s interprofessional efforts are not. Nearly two dozen interprofessional activities are routinely offered to U.Va. medical and nursing students, some of which have been in place for decades but, until recently, were optional and ungraded.
The Center for ASPIRE changes that. Supported with a $750,000 grant from the Josiah Macy Foundation from 2011, Brashers and her interprofessional faculty team developed courses and simulated scenario exercises to boost the teamwork experience and abilities of all nursing and medical students. Before and after the mock scenarios, which employ actors who simulate real medical situations, students are evaluated for their ability to demonstrate specific teamwork skills and interprofessional competencies.
One simulated scenario involves students reacting quickly and in unison to an emergency sepsis situation, while other scenarios enable students to practice difficult discussions, such as talking with families about a child’s chronic illness, end-of-life care for a dying patient and dealing with patients with dementia and their caregivers.
Since the Macy grant, more than 300 nursing and medical students have participated in interprofessional simulation exercises, now a required part of their education. New experiences in development will involve graduate nursing students and residents as well as expanded interprofessional continuing education opportunities for faculty and clinicians.
The Center for ASPIRE is changing the way nursing and medical education is taught at U.Va. Research has repeatedly proven that, with the challenges Americans face in health care – with growing populations of elderly patients, patients with multiple chronic conditions, coupled with dramatic changes in the way hospitals and clinics are reimbursed for their care – team-based health care is required for 21st-century medicine. Effective team-based care should improve patient safety and outcomes and reduce costs, Brashers said.
Governing bodies in nursing and medicine have already taken note. A 2011 Institute of Medicine report acknowledged the critical importance of interprofessional collaborative practice to develop effective teams that offer patient-centered, safe, timely care in a professional environment that’s effective, efficient and equitable. The Institute of Medicine also noted that equipping health care workers with new skills and “new ways of relating to patients and each other” demands both retraining of the current health professions workforce and interprofessional learning approaches for preparing future practitioners.
When the American Academy of Colleges of Nursing released its “Essentials of Baccalaureate Education” in 2010, it identified interprofessional care as an “essential competency.” The American Association of Colleges of Medicine has also identified teamwork skills as essential to medical education. The numerous interprofessional activities already in place have made U.Va. a nationally recognized leader in interprofessional education.
“There is a sense of, ‘Why hasn’t this been going on for a very long time?’” School of Medicine Dean Steven DeKosky said. “It’s a legitimate topic, not just for scholarship, but also for modeling the most efficient ways to train doctors and nurses to work together. It’s absolutely critical that these two very important groups charged with direct oversight of the patient understand each other’s roles, and get along well, and model those behaviors for others.”
“The library’s mission is to support the entire Health System, so being involved with ASPIRE just makes sense,” said Gretchen Arnold, director and associate dean of the Claude Moore Health Sciences Library. “We work with learners throughout their careers and interprofessional learning is another way that the library can ensure that our students and clinicians have access to critical health knowledge.”
“There are about 63 steps between the Med School and the Nursing School,” added Dorrie Fontaine, dean of the School of Nursing, “and there was a time when it was a gap not regularly trod. These days, though, we’re blazing a trail between the schools because we understand how important it is for nurses and doctors to work together seamlessly. Time and time again it’s been found that learning to work well together in school translates to the professional environment – and that ultimately boosts our nation’s hospital quality and safety, and improves the patient experience.”
With the Center for ASPIRE’sformation, the schools are aligning their academic goals with the practice-oriented ones of the Health System and the University at large: that care be of the highest quality, seamless, organized, team-based, patient-centered and compassionate.