Major Public Health Issue as a Vehicle for Interprofessional Curriculum: A Simulated Obesity Module Involving Seven Disciplines
|Case, Tutorial||9317||1||January 22, 2013|
This resource seeks to continue the longitudinal development of a modular and portable curriculum in interprofessional health sciences education. This is a curriculum that prepares health sciences students for teamwork in treating patients with the leading public health problem in America: obesity. This curriculum involves a patient case, simulated patient training, faculty development for the case activity and associated learning resources. This module offers the opportunity to learn (a) from other healthcare professionals, (b) about health sciences disciples, and (c) teamwork and communication with peer health science learners. This module is portable and adaptable to most academic health centers; we have run this curriculum with up to 375 learners, utilizing 75 faculty members from all of the disciplines over a 4-day timeframe.
Wickham G, Gordon J, Kelly M, Weistroffer P, Valde J, Hosking J, Law L. Major Public Health Issue as a Vehicle for Interprofessional Curriculum: A Simulated Obesity Module Involving Seven Disciplines. MedEdPORTAL; 2013. Available from: www.mededportal.org/publication/9317
Contains Information Suitable for Patient Education
- To understand various health discipline perspectives about the societal impact of the obesity epidemic in the United States.
- To appreciate the roles of other professions in addressing obesity disease dynamics.
- To develop communication skills with the team members in pursuit of clarifying each member’s responsibility in executing components of an evaluation and treatment plan for obesity.
- To appreciate the value of working with an interprofessional team and the value of collaborative effort.
- To utilized the unique and complimentary abilities of all team members to optimize the assessment of obesity and develop a culturally competent, patient specific treatment plan.
- Obesity (MeSH), Interprofessional Education Collaboration (IPEC)
- Endocrinology, Diabetes & Metabolism
- Family Medicine
- Assessment, Diagnosis & Treatment
- Interpersonal & Communication Skills
- Interprofessional Collaboration
- Patient Care
- Practice-based Learning & Improvement
- Clinical Sciences
- Clinical Skills/Doctoring
- Communication Skills
- Community Health
- Curriculum Development/Evaluation
- Evidence Based Practice
- Public Health Sciences
- Cardiovascular system
- Endocrine system
- Gastrointestinal system
- Practicing Health Professional
- Allied Health
- Professional School
- Dental Student
- Medical Student
- Public Health Student
- Problem-based Learning
- Standardized Patient
Authors & Co-Authors
Gerald Wickham, EdD
Carver College of Medicine, University of Iowa
Joel Gordon, MD
Carver College of Medicine, University of Iowa
Paula Weistroffer, DDS, MS
College of Dentistry, University of Iowa
Janet Hosking, MSN, RN-BC
University of Iowa Hospitals and Clinics
Michael Kelly, PharmD, MS
Carver College of Medicine, University of Iowa
Jill Valde, PhD, RN
College of Nursing, University of Iowa
Laura Law, PhD
College of Medicine, University of Iowa
Sponsorship or Funding Source
Funded in part by the Josiah Macy Jr. Foundation in fulfillment of the AAMC/IPEC interprofessional education initiative.
Effectiveness and Significance
This interprofessional teaching curriculum is effective and significant for many reasons. From a knowledge standpoint, it offers state of the art scientifically proven facts about the biochemistry of obesity, the hormonal control of hunger and satiety, and the role that depression, stress, and sleep deprivation play in the generation and maintenance of obesity. It helps students understand the role of the life style changes of diet and exercise and how these impact obesity, or more correctly, how they fail to treat large populations of obese patients and highlights the challenges that lay ahead. As an alternative to life style changes, students learn about the surgical approach to obesity and how bariatric surgery is becoming more and more popular and effective in treating obesity and preventing the metabolic complications that accompany it. Students in this obesity curriculum begin to learn the skill of working with other health sciences students who will one day be their colleagues in a team-based health care delivery system. Students begin to learn the value of what other health disciplines “bring to the table” and begin to understand that not only is the perspective of other disciplines different than their own, their focus and approach to treatment, although different than their own, offers alternative approaches and opportunities for therapy that they were perhaps not aware of.
This curriculum allows students to learn about the other health sciences disciplines and thus gain a better understanding of the education and training someone from a different discipline goes through. Through this understanding, attitudes will hopefully change, and biases and prejudices will evaporate long before having a chance to coalesce and become ingrained in a students’ mind. The effectiveness of this curriculum in strengthened by the heterogeneous nature of it. The combination of large group plenary sessions, small group discussion groups, and team based and patient panels offer a variety of opportunities to learn about obesity in several different ways. The plenary sessions and Grand Rounds afford the most opportunity for gaining knowledge. The facilitated small group simulated case discussions offer students the opportunity to develop the skills needed when caring for patients with obesity both in the hospital and the ambulatory clinic. The patient panel is an especially effective way to help students perhaps change their attitudes towards the problem of obesity in this country. Hearing the success individuals have had in their struggle with obesity should offer the kind of optimistic outlook we would want our students to have as they begin their real world training in clinical care. The significance of this curriculum is that it represents ground breaking curriculum in interprofessional education at the University of Iowa. It demonstrates to Deans and other administrators that interprofessional education at the University of Iowa Health Sciences campus can work, does work, and should be expanded as new curricula in all of the health sciences is developed. Student Survey Results 2007 – 2011 Longitudinal tracking of student perceptions of the interdisciplinary cases demonstrates improvement over time, with a 2001 mean of 3.36 on a scale of 1 through 5.
Special Implementation Guidelines or Requirements
To implement something as ambitious as is this obesity curriculum requires organization and commitment from all of the stakeholders involved. Tips on some of the strategies that we have followed, that could be used elsewhere, are shown below:
- Assemble an interprofessional planning or steering committee. Representatives from all of the health science disciplines on a particular campus/academic health center should have a seat at the table.
- Elect/Select a chair who is going to be the leader and champion of this effort. Having a planning committee is essential; having a champion or chair assures the best chance for success.
- Decide on a topic/health issue that cuts across all disciplines that can be used a focus for instruction. Obesity is just one example. There are others that could likely be identified as well.
- Design a curriculum that is not only heterogeneous, but also includes topics/problems from all of the disciplines represented on the planning/steering committee. A combination of large group presentations, small group discussions, and panel discussions has worked well here at Iowa and could be implemented at any academic health center devoted to interprofessional education.
- Case development takes time and it takes input from a variety of experts. Make certain that all perspectives and views are incorporated into the case such that it has “something” for all health science students, regardless of discipline.
- Recruit faculty to serve as facilitators who are like-minded. That is, they are good team players, value interprofessional collaboration, model interprofessional collaboration in their own practice, are good communicators, and understand how a good facilitator operates.
- Meetings held to discuss curriculum should be done on a regular basis, and to create an atmosphere of maximal collegiality, the meeting place should rotate form month to month so that each and every discipline gets a chance to host the meeting on their own territory. This serves as yet another way to familiarize not just students, but faculty as well with the other health science disciplines on any given health sciences campus.
- To expand the scope of something like this, that is to make this a longitudinal learning experience, convincing curricular planners that the time is right and the time is now for this kind of pedagogy to take place is essential. Demonstrating success in such an undertaking as this is an excellent way to demonstrate to those planning curriculum that it is time to exit the silos of health sciences education and move into a collaborative educational effort to better educate and prepare health sciences students for the team based practice models that they are likely to encounter when they leave school and enter practice in whatever their chosen field of endeavor is.
The single most important lesson that has been learned has been that interprofessional education through collaboration and cooperation is possible and that the siloed approach to health sciences education is not the only way we can successfully prepare our students for practice in the 21st century. Representation in the steering committee of members from 6 other health sciences disciplines has resulted in a portable, creative, heterogeneous, and vibrant teaching module on the topic of obesity, the number one public health problem in America. There are several lessons that we have learned in developing and delivering this curriculum. First question to ask was whether or not obesity had been well received as a topic worthy of discussion? That question has been posed to the faculty when we first introduced the theme of obesity 2 years ago to our interprofessional teaching module. The overwhelming response from the faculty was that obesity as a central theme for this interprofessional module was an excellent choice for a topic that is not only vitally important and relevant, but one that “cuts” across all health science disciplines. Following the introduction of obesity as a central theme for this interprofessional module, we then asked the faculty if this theme should be maintained in future years. For the last 2 years the faculty responded in a very favorable manner by indicating that yes it should be maintained and used again for future renditions because it was relevant to all of the health sciences disciplines, and no one involved in health care would not be involved in the evaluation and care of obese individuals. Even in Pediatrics, the epidemic of childhood obesity is startling and we now recognize that children as well as adults are afflicted with this disorder. Thus, we plan to continue with obesity as a central theme for our one-week course in June of 2012. Another valuable lesson learned is that of how important feedback is. We survey both students and faculty after each rendition of this interprofessional course. We have paid a great deal of attention to the feedback we have gotten from students in particular and from faculty. This has allowed us to modify our entire interprofessional curriculum in each and every year it has been presented. Curriculum needs to be constantly modified, updated, and changed to be successful. For an interprofessional curriculum such as this one, feedback, modification, and revision is the rule rather than the exception. In 2010 we surveyed faculty who facilitated the interdisciplinary case, and 44 responded. Their responses were overwhelmingly positive (on a scale of 1-5) with means over 4.1: The topic of obesity as a central theme was a positive addition Mean 4.43/5 SD 0.66 The obesity theme should be maintained for future years Mean 4.18/5 SD 0.87 Being trained on only one case is optimal Mean 4.2/5 SD 0.73
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