Assistant Professor of Medicine, Division of General Internal Medicine and Geriatrics, Oregon Health & Science University School of Medicine.
Adjunct Associate Professor of BioEngineering and Therapeutic Sciences, University of California, San Francisco, School of Pharmacy.
MedEdPORTAL. 2020 Dec 24;16:11059. doi: 10.15766/mep_2374-8265.11059.
Interprofessional (IP) clinical care is ideally taught in authentic environments; however, training programs often lack authentic opportunities for health professions students to practice IP patient care. Skilled nursing facilities (SNFs) can offer such opportunities, particularly for geriatric patient care, but are underutilized as training sites. We present an IP nursing facility rotation (IP-SNF) in which medical, pharmacy, and physical therapy students provided collaborative geriatric patient care.
Our 10-day immersion rotation focused on four geriatric competencies common to all three professions: appropriate/hazardous medications, patient self-care capacity, evaluating and treating falls, and IP collaboration. Activities included conducting medication reviews, quarterly care planning, evaluating functional status/fall risk, and presenting team recommendations at SNF meetings. Facility faculty/staff provided preceptorship and assessed team presentations. Course evaluations included students' pre/post objective-based self-assessment, as well as facility faculty/staff evaluations of interactions with students.
Thirty-two students (15 medical, 12 pharmacy, five physical therapy) participated in the first 2 years. Evaluations ( = 31) suggested IP-SNF filled gaps in students' geriatrics and IP education. Pre/post self-assessment showed significant improvement ( < .001) in self-confidence related to course objectives. Faculty/staff indicated students added value to SNF patient care. Challenges included maximizing patient care experiences while allowing adequate team work time.
IP-SNF showcases the feasibility of, and potential for, engaging learners in real-world IP geriatric patient care in a SNF. Activities and materials must be carefully designed and implemented to engage all levels/types of IP learners and ensure valuable learning experiences.
理想情况下，跨专业（IP）临床护理是在真实环境中教授的；然而，培训计划通常缺乏让卫生专业学生实践跨专业患者护理的真实机会。熟练护理机构（SNF）可以提供这样的机会，特别是对于老年患者护理，但作为培训场所的利用率不高。我们提出了一个跨专业护理机构轮转（IP-SNF），其中医学、药学和物理治疗学生提供协作性老年患者护理。
我们为期 10 天的沉浸式轮转侧重于所有三个专业共有的四项老年护理能力：适当/危险药物、患者自理能力、评估和治疗跌倒以及跨专业合作。活动包括进行药物审查、季度护理计划、评估功能状态/跌倒风险以及在 SNF 会议上提出团队建议。机构教师/工作人员提供指导并评估团队演示。课程评估包括学生基于目标的自我评估，以及教师/工作人员对与学生互动的评估。
在头 2 年，有 32 名学生（15 名医学、12 名药学、5 名物理治疗）参加了该轮转。评估（n=31）表明，IP-SNF 填补了学生在老年病学和跨专业教育方面的空白。自我评估表明，与课程目标相关的自我信心有显著提高（<0.001）。教师/工作人员表示，学生为 SNF 患者护理增加了价值。挑战包括在允许足够团队工作时间的同时，最大限度地增加患者护理体验。
IP-SNF 展示了在 SNF 中让学习者参与真实世界的跨专业老年患者护理的可行性和潜力。活动和材料必须精心设计和实施，以吸引各级/各类跨专业学习者，并确保有价值的学习体验。
