Interprofessional Healthcare Education Day 1
Roles and Responsibilities Script, Discussions and Presentation
12:15pm
Students arrive and are seated with their small group. If they wish, faculty facilitators can help greet the students as they arrive.
Start POWERPOINT PRESENTATION and Background Music while students find seats.
12:28-12:30pm
MUSIC Intro - TURN ON NEW POWERPOINT - Logo first slide
INTRODUCTION TO EVENT
12:30-12:35pm
Welcome Speech
12:35-12:45pm
IPE Curriculum Development Team
Introductions and Introduction to the Event
We are so excited to be here with you to officially mark the beginning of your interprofessional healthcare education experience! In this room today, there are ___first-year health professional students.
We have __students from the school of Dentistry! Will you please stand up?
Will the __ students from the school of Medicine stand?
Will the __students from the school Nursing stand?
Will the __students from the school of Pharmacy stand?
And finally, will the __Physical Therapy students stand?
We will now turn it over to the IPE Curriculum Student Development Team. Representing the School of Dentistry: ______Representing the School of Medicine: ______. Representing the School of Nursing, ______. Representing the School of Pharmacy, ______and representing Physical Therapy, ______.
Following intros:
(powerpoint should switch to objectives slide)
Nursing Student: Thank you all for being here for this important occasion. We have dedicated a lot of time to this curriculum because we really believe in the importance of advancing interprofessional relationships and teamwork. We are all so lucky to be studying at an institution that is committed to this cause- let’s make the most of it! The purpose of today’s event is to embrace the opportunity to make personal and professional connections across the various schools. Today is the first day of an ongoing yearlong curriculum. The objective is to engage all of you in understanding the importance of interprofessional collaboration in everyday practice, especially in the face of recent healthcare reform.
Medical Student: As you spend the next 3 hours getting to know each other a little better, remember that you are the face of your profession in the eyes of your teammates. This is your opportunity to positively shape people’s perceptions of your profession. Before you begin the Ice Breakers, we would like to acknowledge the work that the previous IPE teams have done to make these days a reality. We, the IPE Curriculum Development Team, are inspired by their dedication and passion for interprofessional collaboration. Let’s give them a round of applause.
Now on to the Ice Breakers. The Ice Breaker Questions and snacks are in the bag in the center of your group. We’ll also project the questions on the screens. So let’s get started!
12:45-12:58pm
(powerpoint switch to ice breakers slide)
Snacks and Ice Breakers in Small Groups
Ice Breaker Questions:
1.If you were going to be served your last meal, what would you order?
2. If you could ask an omnipotent being 1 question, what would it be?
3. If you could travel back in time, when and where would you go?
4. If you had to choose two words to describe yourself, what would they be and why?
12:58
(Switch from powerpoint to live video)
Introduction of Keynote Speaker
1:00-1:10pm
Keynote Speech
1:10-1:20pm
(Powerpoint projects logo and quote again)
Case Begins
[IPE MC-pharmacy student- takes the stage to introduce the next part of the event]
Pharmacy Student: “Thank you Dr. ______! And now we would like to take some time to have the Deans share with you a little about their roles as professionals. After that we will have some discussion time to talk about some relevant health policy issues.”
[Standardized patient (SP) wander onto stage, and MC acknowledges their presence and asks]
Pharmacy Student: “Sorry, can I help you?”
SP: “Umm, yes. Hi. I am here. I made an appointment to see a dentist. Am I in the right place? This place is so big and there are so many people! I just want to find where my doctor is. Can you help me?”
Pharmacy Student: “Oh ok, yes this can be a very confusing place. Have a seat right here, and I will get someone to come to help you. Can I get your name?”
SP: “Irene Eagan”
[Pharmacy student leaves to ‘go find dentist’]
SP Monologue
“I just moved here from Fresno. This is a great city, but I wasn’t planning on moving here. I recently lost my job, and I had to come to stay with my cousin while I look for work. I’m very worried about coming to this appointment today. How will I pay for this? I don’t have insurance anymore, and I can’t afford to use what little savings I have on medical visits!
I try to take care of myself, but between losing my job and house, I haven’t had the time or money to get regular check ups. I finally couldn’t put it off any longer because I’m in so much pain. I know I should be seeking care more often, especially since my diabetes sometimes gives me problems; but it’s so hard to keep track of everything. I’ve seen so many providers and had so many tests done over the years—it’s a lot to keep organized. I know there are things I could be doing to keep myself healthier—they always tell me to eat healthier because of my diabetes and my heart, but they don’t have to live on a tight budget like me. Sometimes McDonald’s is just easier and cheaper, you know what I mean? And giving up smoking is not as easy as it sounds either. I have tried so many times, but especially with all the stress I’m under, it is just too hard to stop. Life is hard enough without having to worry so much about my health and how I will take care of it. Why can’t this be easier? When my husband was alive he helped me take care of things... I miss that... I miss him. My family says I should see someone to talk about everything, but finding a therapist that is seeing new patients and is also affordable is impossible! Just another thing to worry about, I suppose. I just hope I can get some help today.”
[Pharmacy student reenters stage]
Pharmacy student: Thanks for your patience, your dentist will be right with you. [Turns to audience] While our patient waits here, let’s take a few minutes to break into your groups to talk about some of the health policy issues that you have prepared for today. We have included some fact sheets and discussion questions in your packets to guide your conversation. We would like you to think about how some of these issues could affect this patient or your future practice as professionals.
1:20-1:40pm
Small Group Discussion I: Small Group Discussion: Health Policy “Hot Topics” - Introduced by IPE Curriculum Student Development Team Member
[Please see attached “Hot Topic” sheets to be used by learners to prepare for and guide discussion]
Pharmacy Student: “I hope you all were able to have some good discussion about these health policy issues. These are complicated issues and many of these topics will continue to change as reform progresses. It looks like the dentist is ready to meet with our patient, so let’s all come back together and follow Mrs. Eagan as she initiates care here at ______[walks stage to introduce deans] with Dean ______as the dentist, Dean ______as the physician, Dean ______as the nurse, Dean ______as the pharmacist, and Dean ______as the physical therapist.
1:40pm
IPE Day 1: Deans’ Skit
Characters
Dentist: Dean of Dentistry
Patient: Standardized Patient
Physician: Dean of Medicine
Nurse: Dean of Nursing
Pharmacist:Dean of Pharmacy
Physical Therapist: Professor and Chair of Physical Therapy
Act 1 ( Patient, Dentist)
Dentist: Welcome to the UCSF dental clinic, My name is ______, what would you prefer to be called? [Shakes hands with patient]
Patient: Hi! Mrs. Eagan is fine.
Dentist: Okay Mrs. Eagan, what brings you in today?
Patient: My tooth has been killing me this week. I can’t even eat on the right side of my mouth. Also, my back started hurting around the same time. Do you think that could be related?
Dentist: I’m so sorry to hear that, it sounds like you’re having a really tough time. We’ll see what we can do. Let me take a look here. [Starts to perform extraoral exam, palpating soft tissues around the jaw and neck]It looks like you are a little swollen right there. Also, I don’t think that your back pain is related to your tooth pain, but it may be a good idea to see a physical therapist about that. [Begin looking at pt chart] I see you wrote here that you have diabetes and your blood glucose level is sometimes high. How do you think your diabetes has been controlled lately?
Patient: Well, my blood sugar is a little high sometimes, but I do take my medications.
Dentist: OK, let’s go ahead and look at the x-rays we took earlier to see if I can get a better idea of what’s going on with your tooth, but I do think that before I would feel comfortable initiating any major treatments, it would be a good idea to see a primary provider to talk about your diabetes control. Diabetes can affect the tissues surrounding your teeth and make them more prone to infection and inflammation. Therefore if your blood sugar has not been well controlled, we have to take care of that first before beginning treatment.
Dentist: Here are your x-rays; lets take a look. You see this big shadow right here? And the swelling of the tissue here? Based on your symptoms and after seeing your x-rays, I’m afraid we’re going to have to extract the infected tooth.
Patient: Oh really? [Pause] Is there anything I can do to save my tooth?
Dentist: I’m sorry it’s just too far gone. I can’t save the tooth, but we’re going to work with you into the future to save the rest of your teeth, which is very important. But as I mentioned, it’s going to be a few days before we can extract it because we need to treat the infection I’m seeing and get your glucose levels controlled. Tell me Mrs. Eagan, do you consume sugary snacks throughout the day?
Patient: Well, I do like to drink soda throughout the day; it helps pick me up when I get tired.
Dentist: Considering the condition your teeth are in now and your diabetes, it is in your best interest to cut down on drinking soda. If you must absolutely drink soda, consider drinking the diet forms because the bacteria in your mouth can’t metabolize sugar substitute.
Patient: That’s a great suggestion! I can try to do that; I don’t want the rest of my teeth to fall out too.
Dentist: That’s good to hear Mrs. Eagan. I’m going to call the primary care clinic I’m affiliated with to see if we can, as a health care team, figure out the best treatment option for you.
Patient: Ok, so no dental work today?
Dentist: I’m afraid not. Let’s go ahead and schedule your next appointment in a few days at the front desk on your way out. For now, I am going to prescribe a prescription mouthwash to treat your abscess and 600mg ibuprofen for your tooth pain, which should also help your back. [Write on the prescription pad] Here’s a referral with all the information you need. Please give me a call if your pain gets worse.
Patient: Thanks so much, Dr. Featherstone.
Dentist: Oh, before you go I wanted to ask you about your smoking: are you interested in getting resources to help you stop?
Patient: I don’t think I’m ready at this point, but thank you.
Dentist: Okay, let us know if you change your mind. See you soon.
[Dentist exit stage]
1:50pm
Act 2 (Doctor, Patient)
Physician: Hi Mrs. Eagan, I see that you are new to our clinic. Just to get you up to speed with our clinic, we operate as a medical home. We use an interprofessional team including myself, a nurse, a physical therapist, and a pharmacist working together to provide you with the best possible care. Is there anything else you would like to know about the medical home or what it means?
Patient: Is it sort of like a nursing home? I didn’t think I was that old yet!
Physician: No, no. We’re not a nursing home. It’s like “home” as in your main medical care resource where all your health and wellness needs are met and concerns are addressed.
Patient: Oh, ok, got it!
Physician: Great. So, our team met this morning and we discussed a few things. First of all, the dentist wanted me to check in with you about your tooth pain - how would you rate the pain on a scale of 1 to 10?
Patient: I’d say it’s a 7.
Physician: Wow, that doesn’t sound great. That’s still a lot of pain. Have you ever taken Vicodin or morphine before?
Patient: Just once when I got my wisdom teeth taken out in high school.
Physician: And that wasn’t a problem? Any vomiting at all?
[Patient shakes head “no.”]
Physician: Ok, I think that Vicodin every 6 hours could help. I’ll write you the prescription. I also wanted to remind you about Dr. Featherstone’s referral to physical therapy because that’s the best person to treat your back pain.
Patient: Oh right, can you help me get in touch with them?
Physician: Sure, I can have you check in with them today before you leave. We should also have you talk about your diabetes with the pharmacist who can review your medications with you. Before the pharmacist comes in, do you have any other questions for me?
Patient: No. I’m just looking forward to getting this all coordinated and taken care of.
Physician: We are too. We will meet back as a team and discuss your care. I’ll ask the pharmacist to come in now. Take care, Mrs. Eagan.
1:57-2:05pm
Small Group Discussion 2:Diversity and Teamwork Exercise
Physical Therapy Student: It looks like it will be a few minutes before the pharmacist, Dr. ______, can come see you, Mrs. Eagan.
In the mean time, let’s get to know each other a little better while also taking the opportunity to at least stand up and stretch your legs! One of the issues we have identified as a potential barrier to collaborative work is a lack of understanding of people’s backgrounds, which could lead to a misunderstanding of their potential strengths and contributions. We are going to perform a short activity to demonstrate the differences and similarities in our backgrounds. We’ll have you standing up at certain points, so make sure the floor is clear of backpacks! Please stand if:
· You were not born in California
· You speak more than one language fluently
· You come from a family of more than four children
· You engage in physical exercise regularly
· You are the first person in your family to be educated as a health professional
· You have played on an organized sports team
· You have never broken a bone
· You considered entering a health profession different from the one you’re in now
Now let’s just take a short stretch break; everyone stand up and do some gentle stretches for a few moments. (1 min)
It looks like Dr. Koda-Kimble is ready to see Mrs. Eagan. Let’s all take a seat, please!
2:05-2:11pm
Act 3 (Pharmacist, Patient)
Pharmacist: Hi, Mrs. Eagan, I am Dr. ______, the Pharmacist. [They shake hands]I have reviewed your list of prescribed medications, which include metformin for diabetes, and lisinopril and hydrochlorothiazide both for high blood pressure. Are there any other vitamins, herbs, supplements, or over the counter medications that you are taking?
Patient: Well I’ve been taking ibuprofen from the dentist for my pain and I just started a mouthwash that the dentist gave me.
Pharmacist: Ok. I see you just started on the chlorhexidine mouthwash. Rinse your mouth with this after each time you brush and floss your teeth. Do not use before brushing, eating, or drinking. Swish the medicine in your mouth for at least 30 seconds then spit it out. Do not swallow the mouthwash. Avoid eating, drinking, or brushing your teeth just after using this medication. Can you tell me how you have been taking your Metformin?
Patient: Umm. Which one is that one again?
Pharmacist: It’s the drug to treat your diabetes—the round white one.
Patient: When I do take it, I’m taking one and a half pills in the morning and one and a half at night. I try to take them as regularly as I can, but sometimes I forget.
Pharmacist: Are you cutting your pills in half? I understand that it can be difficult for you to remember how to take all of your medications. Try keeping your pills in a place that might help you remember to take them, like on your nightstand or by your toothbrush. I can also give you a pill box that might help you remember as well. Some people even find it helpful to set an alarm to prompt them to take their medications. How do these techniques sound to you?
Patient: I’ll try keeping a pillbox on my nightstand; I think that could help. Thank you.
Pharmacist: I also wanted to check in to see if you’ve noticed any side effects from the medications you are taking. Have you experienced a dry cough, light-headedness when standing? Frequent urination?