Journal of Interprofessional Care
ISSN: 1356-1820 (Print) 1469-9567 (Online) Journal homepage: http://www.tandfonline.com/loi/ijic20
Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study Mark Ryan, Allison A. Vanderbilt, Sallie D. Mayer & Allison Gregory To cite this article: Mark Ryan, Allison A. Vanderbilt, Sallie D. Mayer & Allison Gregory (2015): Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study, Journal of Interprofessional Care, DOI: 10.3109/13561820.2015.1020360 To link to this article: http://dx.doi.org/10.3109/13561820.2015.1020360
Published online: 14 May 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijic20 Download by: [Stockholm University Library]
Date: 16 September 2015, At: 13:04
http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, Early Online: 1–3 ! 2015 Informa UK Ltd. DOI: 10.3109/13561820.2015.1020360
SHORT REPORT
Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study Mark Ryan1, Allison A. Vanderbilt2, Sallie D. Mayer3, and Allison Gregory4
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
1
Department of Family Medicine and Population Health, School of Medicine, 2Center on Health Disparities, School of Medicine, 3Department of Pharmacotherapy & Outcomes Science, and 4Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, VA, USA Abstract
Keywords
The Hispanic population in and around Richmond, Virginia, USA, has grown rapidly since 2000. The Richmond City Latino Needs Assessment emphasized this growth and also reported concerns regarding healthcare access. Schools of medicine, pharmacy, and nursing at Virginia Commonwealth University have partnered together with community organizations to develop and implement an interprofessional student service learning pilot program to meet community needs and provide an opportunity for enhanced learning. Community events allowed students to work on interprofessional teams to provide healthcare screenings and education to the Hispanic community. The program was evaluated by the use of a community service survey. Results indicated improved perceptions of student comfort with working with diverse patients, working on teams, and patient-centered care, as well as statistically significant improvements in student understanding of health care access and barriers, community needs, and social determinants of health. Results suggest that this community-based service-learning interprofessional experience was critical in student learning.
Interprofessional care, interprofessional education, interprofessional collaboration
Introduction The Hispanic population in Richmond, Virginia, USA, has grown rapidly over the past 14 years, increasing from 2.6% to 6.3%, with surrounding counties experiencing similar growth (U.S. Census Bureau, 2010). A recent needs assessment report emphasized the strain on local service providers created by such rapid growth, and reported that 65.6% of respondents were ‘‘very worried’’ about healthcare access (Corona, Gonzalez, Cohen, Edwards, & Edmonds, 2006, p. 16). The report recommended ‘‘increase[d] access to and hours of medical services, exploring the use of mobile clinics and evening and weekend hours of existing services’’ and expanding lay health promotoras programs (Corona et al., 2006, p. 21). Increasingly, healthcare professional school curricula require or strongly encourage service-learning and exposure to interprofessional education (IPE). Service-learning combines student learning and reflection while meeting community needs. IPE competencies highlight key learning areas within the community and patient-centered care framework (Interprofessional Education Collaborative Expert Panel, 2011). Service-learning opportunities have the ability to provide a rich IPE learning environment, yet there are limited reports of IPE service-learning experiences in underserved populations involving students (De Los Santos, McFarlin, & Martin, 2014).
Correspondence: Mark Ryan, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, 410 N. 12th St., PO Box 980533, Richmond, 23298 VA, USA. E-mail: [email protected]
History Received 27 March 2014 Revised 24 November 2014 Accepted 13 February 2015 Published online 14 May 2015
Virginia Commonwealth University schools of medicine, pharmacy and nursing collaborated to engage with Richmond’s Hispanic population and establish an innovative model of servicelearning that embraced core components of IPE, provided outreach to marginalized communities, and assessed student learning. The ‘‘Una Vida Sana!’’ (UVS) partnership developed from the interest of collaborating faculty and students who realized the need for screening services in Richmond’s Hispanic community, and partnered with key community contacts, local providers and government agencies. UVS was proposed as a service-learning initiative to enhance students’ community learning opportunities and serve as a service activity for the school of medicine’s student family medicine association, a core activity for pharmacy students to meet required service-learning hours, and a community-based outreach opportunity for nursing students. Faculty members, CrossOver Healthcare Ministry promotoras, the health system’s Office of Language Services, and Richmond’s Office of Multicultural Affairs created a working group that established shared goals, identified key participants, and planned community-based health screenings. Consistent communication ensured cohesion, identification of impactful event sites, and future directions.
Background The training and screening events emphasized IPE. Training sessions allowed interprofessional teams of students to be trained and perform health screenings, work with interpreters, learn about area community resources, and provide cardiometabolic risk and healthy lifestyles information. Students guided by interprofessional faculty and community clinicians formed interprofessional
2
M. Ryan et al.
J Interprof Care, Early Online: 1–3
Table I. Mann–Whitney U on student attitudes toward community service. Survey item
Mann–Whitney U
My knowledge/understanding of: The types of community resources available for the population with whom I worked. How health care delivery systems (e.g. managed care) impact my work in the community. The health care needs of the community in which I served. The responsibilities of other professionals in a multidisciplinary team. The barriers to receiving health care in the community that I served. The impact of socioeconomic status on health and illness How my placement site is perceived in the community How to work with clients/patients who have various levels of health care knowledge. What the terms ‘‘community resources’’ and ‘‘community service’’ mean.
0.000* 0.015* 0.000* 0.001* 0.004* 0.024* 0.002* 0.001* 0.007*
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
N ¼ 17. The scale ranged from 1 (no knowledge or understanding) to 5 (extensive knowledge or understanding). SD ¼ Standard Deviation. *p5.05.
teams at events to lead these screenings and education stations, as previously described (Cox, Fugit, Ryan, Gregory, & Mayer, 2014). Teams referred patients to the partnering free clinic if indicated, and to on-site peer-to-peer education with the promotoras.
Methods A pre/post intervention design was employed to gather student perceptions about their interprofessional experience. Data collection The Students Attitudes Toward Community Service survey developed by Wall, Brown, and Heaton (2007) was used with permission. The pre-survey was administered electronically to students prior to volunteering with UVS. At the end of the academic year, after all of the events were complete, all students who had participated in at least one event during the year received the post-survey to assess student perceptions of learning related to service-learning, community service and resources, and working with health care professionals (Table I). The survey was anonymous, did not include information about the students’ prior experience or school affiliation, and asked specifically about the learning experiences gained during events Data analysis Frequency data and a Mann–Whitney U analysis were conducted in SPSS 21.0 (Chicago, IL). Our analysis used the subset of questions that focused on students’ retrospective assessments of their learning experiences. Ethical considerations Ethical approval for this study was obtained from the VCU Institutional Review Board before work commenced.
Results Approximately 50 students, nearly evenly divided between the three participating schools, volunteered at the events; and 17 (34%) completed the post-survey. Nine survey items, which assessed students’ perceptions about what they gained by participating in these events, were found to be statistically significant, suggesting the experience at UVS had an impact on the students’ learning experience via exposure to the population. Table I demonstrates the Mann–Whitney U-data and the statistically significant findings. Participants had significant increases in their understanding of community resources and health needs, barriers to accessing healthcare, the roles of health care delivery systems, and the impact of socioeconomic status on health. Students also reported that they were more comfortable
working with diverse communities and patients, working in interprofessional teams, and incorporating patients’ beliefs and personal beliefs into medical care.
Discussion This pilot study’s findings underscore the perceived impact of service-learning experiences that involve healthcare professional students working on teams to meet a community need. Results indicate that students had improvements in learning surrounding core interprofessional competencies involving team work, communication, roles and responsibilities, and values/ethics, specifically relating to barriers to care and comfort working on interprofessional teams. Although this study’s limitations include its retrospective nature and small sample size, it suggests that well-designed IPE service-learning projects focused on providing community-based opportunities to work with underserved populations may help prepare health professions students for their future careers in our increasingly diverse nation. Student gains are likely due to the fact that UVS emphasizes IPE collaboration, teamwork, and patient centered care in a community setting that allowed students to experience working alongside other professions and community partners to achieve a common goal of meeting a health need in the local Hispanic community. This model also may help meet the need for health professional schools to prepare graduates for a health system which is looking to interprofessional teams to improve safety and quality of care (Interprofessional Education Collaborative Expert Panel, 2011). The success of this project is most likely due to its careful development, including identifying relevant community needs, engaging multiple stakeholders to develop shared goals, meeting schools’ learning and accreditation requirements, developing community-based partnerships, providing relevant, patient-centered screening services, and engaging students in participation and leadership.
Declaration of interest The authors are faculty at Virginia Commonwealth University. They report no declarations of interest.
Funding This project was supported by a VCU Division of Community Engagement grant.
References Corona, R., Gonzalez, T., Cohen, R., Edwards, C., & Edmonds, T. (2006). Latino needs assessment: Health and safety needs of Latino children and families living in Richmond, Virginia. Retrieved from http://www. ci.richmond.va.us/HispanicLiaison/documents/LatinoNeedsAssessment.pdf.
DOI: 10.3109/13561820.2015.1020360
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
Cox, L., Fugit, A.M., Ryan, M., Gregory, A. & Mayer, S. (2014). Una Vida Sana! An interprofessional service-learning outreach project in an underserved Latino population. Currents in Pharmacy Teaching and Learning, 6, 577–584. De Los Santos, M., McFarlin, C.D., & Martin, L. (2014). Interprofessional education and service learning: A model for the future of health professions education. Journal of Interprofessional Care, 28, 274–275. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of
Improving health status through IPE
3
an expert panel. Washington, DC: Interprofessional Education Collaborative. Retrieved from http://www.aacn.nche.edu/educationresources/ipecreport.pdf. U.S. Census Bureau. (2010). Richmond, Virginia population. Census 2000 and 2010 interactive map, demographics, statistics, quick facts. Retrieved from: http://censusviewer.com/city/VA/Richmond. Wall, A., Brown, B., & Heaton, P. (2007). A Service-Learning elective to promote enhanced understanding of civic, cultural, and social issues and health disparities in pharmacy. American Journal of Pharmaceutical Education, 71, 1–7.
ISSN: 1356-1820 (Print) 1469-9567 (Online) Journal homepage: http://www.tandfonline.com/loi/ijic20
Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study Mark Ryan, Allison A. Vanderbilt, Sallie D. Mayer & Allison Gregory To cite this article: Mark Ryan, Allison A. Vanderbilt, Sallie D. Mayer & Allison Gregory (2015): Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study, Journal of Interprofessional Care, DOI: 10.3109/13561820.2015.1020360 To link to this article: http://dx.doi.org/10.3109/13561820.2015.1020360
Published online: 14 May 2015.
Submit your article to this journal
Article views: 48
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijic20 Download by: [Stockholm University Library]
Date: 16 September 2015, At: 13:04
http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, Early Online: 1–3 ! 2015 Informa UK Ltd. DOI: 10.3109/13561820.2015.1020360
SHORT REPORT
Interprofessional education as a method to address health needs in a Hispanic community setting: A pilot study Mark Ryan1, Allison A. Vanderbilt2, Sallie D. Mayer3, and Allison Gregory4
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
1
Department of Family Medicine and Population Health, School of Medicine, 2Center on Health Disparities, School of Medicine, 3Department of Pharmacotherapy & Outcomes Science, and 4Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, VA, USA Abstract
Keywords
The Hispanic population in and around Richmond, Virginia, USA, has grown rapidly since 2000. The Richmond City Latino Needs Assessment emphasized this growth and also reported concerns regarding healthcare access. Schools of medicine, pharmacy, and nursing at Virginia Commonwealth University have partnered together with community organizations to develop and implement an interprofessional student service learning pilot program to meet community needs and provide an opportunity for enhanced learning. Community events allowed students to work on interprofessional teams to provide healthcare screenings and education to the Hispanic community. The program was evaluated by the use of a community service survey. Results indicated improved perceptions of student comfort with working with diverse patients, working on teams, and patient-centered care, as well as statistically significant improvements in student understanding of health care access and barriers, community needs, and social determinants of health. Results suggest that this community-based service-learning interprofessional experience was critical in student learning.
Interprofessional care, interprofessional education, interprofessional collaboration
Introduction The Hispanic population in Richmond, Virginia, USA, has grown rapidly over the past 14 years, increasing from 2.6% to 6.3%, with surrounding counties experiencing similar growth (U.S. Census Bureau, 2010). A recent needs assessment report emphasized the strain on local service providers created by such rapid growth, and reported that 65.6% of respondents were ‘‘very worried’’ about healthcare access (Corona, Gonzalez, Cohen, Edwards, & Edmonds, 2006, p. 16). The report recommended ‘‘increase[d] access to and hours of medical services, exploring the use of mobile clinics and evening and weekend hours of existing services’’ and expanding lay health promotoras programs (Corona et al., 2006, p. 21). Increasingly, healthcare professional school curricula require or strongly encourage service-learning and exposure to interprofessional education (IPE). Service-learning combines student learning and reflection while meeting community needs. IPE competencies highlight key learning areas within the community and patient-centered care framework (Interprofessional Education Collaborative Expert Panel, 2011). Service-learning opportunities have the ability to provide a rich IPE learning environment, yet there are limited reports of IPE service-learning experiences in underserved populations involving students (De Los Santos, McFarlin, & Martin, 2014).
Correspondence: Mark Ryan, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, 410 N. 12th St., PO Box 980533, Richmond, 23298 VA, USA. E-mail: [email protected]
History Received 27 March 2014 Revised 24 November 2014 Accepted 13 February 2015 Published online 14 May 2015
Virginia Commonwealth University schools of medicine, pharmacy and nursing collaborated to engage with Richmond’s Hispanic population and establish an innovative model of servicelearning that embraced core components of IPE, provided outreach to marginalized communities, and assessed student learning. The ‘‘Una Vida Sana!’’ (UVS) partnership developed from the interest of collaborating faculty and students who realized the need for screening services in Richmond’s Hispanic community, and partnered with key community contacts, local providers and government agencies. UVS was proposed as a service-learning initiative to enhance students’ community learning opportunities and serve as a service activity for the school of medicine’s student family medicine association, a core activity for pharmacy students to meet required service-learning hours, and a community-based outreach opportunity for nursing students. Faculty members, CrossOver Healthcare Ministry promotoras, the health system’s Office of Language Services, and Richmond’s Office of Multicultural Affairs created a working group that established shared goals, identified key participants, and planned community-based health screenings. Consistent communication ensured cohesion, identification of impactful event sites, and future directions.
Background The training and screening events emphasized IPE. Training sessions allowed interprofessional teams of students to be trained and perform health screenings, work with interpreters, learn about area community resources, and provide cardiometabolic risk and healthy lifestyles information. Students guided by interprofessional faculty and community clinicians formed interprofessional
2
M. Ryan et al.
J Interprof Care, Early Online: 1–3
Table I. Mann–Whitney U on student attitudes toward community service. Survey item
Mann–Whitney U
My knowledge/understanding of: The types of community resources available for the population with whom I worked. How health care delivery systems (e.g. managed care) impact my work in the community. The health care needs of the community in which I served. The responsibilities of other professionals in a multidisciplinary team. The barriers to receiving health care in the community that I served. The impact of socioeconomic status on health and illness How my placement site is perceived in the community How to work with clients/patients who have various levels of health care knowledge. What the terms ‘‘community resources’’ and ‘‘community service’’ mean.
0.000* 0.015* 0.000* 0.001* 0.004* 0.024* 0.002* 0.001* 0.007*
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
N ¼ 17. The scale ranged from 1 (no knowledge or understanding) to 5 (extensive knowledge or understanding). SD ¼ Standard Deviation. *p5.05.
teams at events to lead these screenings and education stations, as previously described (Cox, Fugit, Ryan, Gregory, & Mayer, 2014). Teams referred patients to the partnering free clinic if indicated, and to on-site peer-to-peer education with the promotoras.
Methods A pre/post intervention design was employed to gather student perceptions about their interprofessional experience. Data collection The Students Attitudes Toward Community Service survey developed by Wall, Brown, and Heaton (2007) was used with permission. The pre-survey was administered electronically to students prior to volunteering with UVS. At the end of the academic year, after all of the events were complete, all students who had participated in at least one event during the year received the post-survey to assess student perceptions of learning related to service-learning, community service and resources, and working with health care professionals (Table I). The survey was anonymous, did not include information about the students’ prior experience or school affiliation, and asked specifically about the learning experiences gained during events Data analysis Frequency data and a Mann–Whitney U analysis were conducted in SPSS 21.0 (Chicago, IL). Our analysis used the subset of questions that focused on students’ retrospective assessments of their learning experiences. Ethical considerations Ethical approval for this study was obtained from the VCU Institutional Review Board before work commenced.
Results Approximately 50 students, nearly evenly divided between the three participating schools, volunteered at the events; and 17 (34%) completed the post-survey. Nine survey items, which assessed students’ perceptions about what they gained by participating in these events, were found to be statistically significant, suggesting the experience at UVS had an impact on the students’ learning experience via exposure to the population. Table I demonstrates the Mann–Whitney U-data and the statistically significant findings. Participants had significant increases in their understanding of community resources and health needs, barriers to accessing healthcare, the roles of health care delivery systems, and the impact of socioeconomic status on health. Students also reported that they were more comfortable
working with diverse communities and patients, working in interprofessional teams, and incorporating patients’ beliefs and personal beliefs into medical care.
Discussion This pilot study’s findings underscore the perceived impact of service-learning experiences that involve healthcare professional students working on teams to meet a community need. Results indicate that students had improvements in learning surrounding core interprofessional competencies involving team work, communication, roles and responsibilities, and values/ethics, specifically relating to barriers to care and comfort working on interprofessional teams. Although this study’s limitations include its retrospective nature and small sample size, it suggests that well-designed IPE service-learning projects focused on providing community-based opportunities to work with underserved populations may help prepare health professions students for their future careers in our increasingly diverse nation. Student gains are likely due to the fact that UVS emphasizes IPE collaboration, teamwork, and patient centered care in a community setting that allowed students to experience working alongside other professions and community partners to achieve a common goal of meeting a health need in the local Hispanic community. This model also may help meet the need for health professional schools to prepare graduates for a health system which is looking to interprofessional teams to improve safety and quality of care (Interprofessional Education Collaborative Expert Panel, 2011). The success of this project is most likely due to its careful development, including identifying relevant community needs, engaging multiple stakeholders to develop shared goals, meeting schools’ learning and accreditation requirements, developing community-based partnerships, providing relevant, patient-centered screening services, and engaging students in participation and leadership.
Declaration of interest The authors are faculty at Virginia Commonwealth University. They report no declarations of interest.
Funding This project was supported by a VCU Division of Community Engagement grant.
References Corona, R., Gonzalez, T., Cohen, R., Edwards, C., & Edmonds, T. (2006). Latino needs assessment: Health and safety needs of Latino children and families living in Richmond, Virginia. Retrieved from http://www. ci.richmond.va.us/HispanicLiaison/documents/LatinoNeedsAssessment.pdf.
DOI: 10.3109/13561820.2015.1020360
Downloaded by [Stockholm University Library] at 13:04 16 September 2015
Cox, L., Fugit, A.M., Ryan, M., Gregory, A. & Mayer, S. (2014). Una Vida Sana! An interprofessional service-learning outreach project in an underserved Latino population. Currents in Pharmacy Teaching and Learning, 6, 577–584. De Los Santos, M., McFarlin, C.D., & Martin, L. (2014). Interprofessional education and service learning: A model for the future of health professions education. Journal of Interprofessional Care, 28, 274–275. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of
Improving health status through IPE
3
an expert panel. Washington, DC: Interprofessional Education Collaborative. Retrieved from http://www.aacn.nche.edu/educationresources/ipecreport.pdf. U.S. Census Bureau. (2010). Richmond, Virginia population. Census 2000 and 2010 interactive map, demographics, statistics, quick facts. Retrieved from: http://censusviewer.com/city/VA/Richmond. Wall, A., Brown, B., & Heaton, P. (2007). A Service-Learning elective to promote enhanced understanding of civic, cultural, and social issues and health disparities in pharmacy. American Journal of Pharmaceutical Education, 71, 1–7.
