Columbia Commons IPE brings together faculty and students from all nine professional health schools to learn how to support effective health care teams here at the medical center. The Commons is the breeding ground for interprofessional work amongst students and faculty from Dentistry, Medicine, Nursing, Nutrition, Occupational Therapy, Pastoral Care, Physical Therapy, Public Health and Social Work.
Columbia Commons IPE was founded in 2016, and was preceded by a grant from the Josiah Macy, Jr. Foundation that initiated collaborative study, training, and social action among students and faculty of the disciplines. In a recognition of the importance of interprofessional work, the deans of CUIMC agreed to fund the group to continue this work upon the end of the grant. It is recognized as the campus interprofessional educational group at Columbia University Irving Medical Center.
Over the course of this project, Columbia diverged from the mainstream national currents in IPE. Through our involvement with IPEC and the National Center for Interprofessional Practice and Education at the University of Minnesota, we are well aware of the skills-based approaches often adopted elsewhere. Through a ten-year collaboration with colleague schools in a broad NIH-funded grant program in enhancing social science and behavioral science curricula in medical schools, we have worked closely with an IPE sub-group of health professionals at Oregon Health Sciences University, University of California at San Diego, UCLA, Indiana University, University of Texas at San Antonio, and Brown University. Some if not many of the programs at other institutions in the US emphasize joint learning of concrete interprofessional skills: learning each profession’s specific role in clinical situations, training for courtesy toward members of other professions, and check-listing approved behaviors in clinical simulations.
In contrast, the emerging philosophy and approach to IPE at Columbia is focused less on specific tasks completed by each role, and more on shared values and ways to work together to produce better healthcare for the patient. Our narrative approach results in individual-to-individual contact within the context of health care teams. We don’t gather to discuss operating room checklists or who does what at the cardiac arrest code. Instead, whether with faculty groups or student groups, we invite participants to grapple with fundamental issues of the human condition. Each of our courses and seminars devotes some time to intensive close reading and creative writing, in addition to more conventional seminar discussions. Through rigorous and guided examination of cultural works—literary texts, visual images, or performative arts—groups of participants can meet within a shared confrontation with powerful carriers of meaning. This is not as obscure as it sounds: together, a group will read a poem or a paragraph from a great novel or watch a clip of a movie or look slowly at a painting. They talk about it; they work at what it says or shows; they learn how diverse are their individual perspectives on the work. They are invited to write—spontaneously, in just a few minutes—about their trains of thought released by the work. When they read aloud or tell about what they’ve written, they achieve privileged views of their own and one another’s subjectivity. Within a half-hour, they’ve enjoyed intimate contact with their own and their colleagues’ deep ways of knowing of the world.
The project began with monthly gatherings of leadership and faculty from the eight programs to think about and discuss the silos that divided them. Through narrative methods, the group began to recognize that ultimately more aspects of their respective professions united them rather than divided them. After exploring the commonalities of care the sick, the faculty designed and executed credit-bearing seminars for mixed groups of students from all these disciplines.
The Spring 2018 semester marks the seventh year of this campus-wide seminar. Knowing how critical well-functioning teams are in the care of the sick and the improvement of the health of the public, these seminars help to develop the wherewithal to work seamlessly, effectively, and respectfully together. The seminar opens up urgent questions about health, illness, and care while absorbing each of the multitude of perspectives on these topics. Pictures from the 2017 Seminar Graduation can be viewed here >>.
The Commons also sponsors various events across CUIMC’s campus for students from all the disciplines. For the 2017-18 academic year, the Commons sponsored the Columbia Hotspotting Initiative. Hotspotting is an innovative approach to primary care combining data-driven selection of high-utilizing patients with interprofessional delivery of personalized care. The project joins together twelve students from medicine, nursing, public health, and social work. Over six months, the students participate in the Camden Coalition’s curriculum emphasizing teamwork, leadership, and patient advocacy skills, while simultaneously helping a group of patients at Columbia’s Associates in Internal Medicine Clinic better navigate their illnesses, treatments, and the healthcare system.
In 2017, the Commons co-sponsored Implicit Bias in the Academy along with the School of Nursing at Columbia University, and several other entities. The Commons also co-sponsored May’s Narrative Medicine Rounds with Ruth Messinger and Randy Cohen.
In March 2016, the group hosted a film screening and panel discussion with Grace Dammann, an HIV/AIDS physician, Buddhist, and member of the LGBT community, who shared her experience and reflections on being a patient after a life-threatening car accident. In June 2016, The Commons co-sponsored Narrative Medicine Rounds with Elisabeth Rosenthal who gave a public lecture on CUMC campus regarding her career long devotion to researching and reframing inequities of our current healthcare system.
The Commons has resulted in several other interprofessional initiatives, such as Nursing faculty teaching in a core course in the Medicine curriculum, Social Workers having appointments among the Dental faculty, Nursing faculty attending Dental rounds, and an interprofessional collaborative for the aging LGBTQ population, e-linc.
In addition to the recognition of interprofessional work, Columbia Commons has become a breeding ground for junior faculty in all disciplines, both a nurturing mentoring program and a creator of opportunities for junior investigators committed to scholarly and research careers. Research efforts are currently underway between junior and senior faculty members of all disciplines. Most recently, Sharon Akabas, Rebekah Ruppe, Michael Devlin, Carol Kunzel, Moneek Madra and Rita Charon submitted a Phase I CaMPR grant proposal to the Irving Institute for Clinical and Translational Research titled “Using Narrative Medicine Weight Bias Across the Health Professions: Toward Improved Health Care for Persons with Obesity.”