Narrative Medicine Program and Macy Foundation Launch Seminar on Interprofessional Teamwork
The Program in Narrative Medicine is launching a first-of-its-kind seminar in interprofessional teamwork at Columbia University Medical Center (CUMC) beginning in January 2012. Supported by a $1,000,000 grant from the Josiah Macy Jr. Foundation, the seminar will be comprised of four students from each of the schools of CUMC: College of Dental Medicine, College of Physicians & Surgeons, Mailman School of Public Health, and School of Nursing. The sixteen students for this inaugural seminar will be hand selected by the faculty of their schools and will be honored as inaugural scholars in this ground-breaking program.
The credited seminar, titled “The Cultures of Health, Illness and Health Care,” will be co-taught by senior faculty from the four CUMC schools, and will aim to equip health professions students to function effectively in interprofessional health care teams. Hosted by Dr. Rita Charon, Executive Director of the Narrative Medicine Program, the seminar will look at illness and health care from social sciences, populations sciences, and the arts to get a wide and sharp viewpoint on the events of health, illness, and care. By adopting highly collaborative methods, the seminar will model and practice transparency, respect, and discovery.
For more information: Building Mutual Respect and Teamwork Among the Healthcare Professions
Reframing the Academic Medical Center through Interprofessional Effectiveness:
Toward Justice, Safety, and Kindness
The Josiah Macy, Jr. Foundation funded a group of Columbia University Medical Center (CUMC) faculty for a planning year to investigate the basic and applied sciences of health care team development. Throughout 2010, senior faculty members from the dental school, medical school, nursing school, and school of public health—including associate deans, senior vice presidents, center directors, and full-time clinicians—convened in bimonthly two-hour seminar sessions over a full year. We chose the conceptual frameworks of narrative medicine and participatory action research as the foundations of our work together. The methods of narrative practice (building skills in attentive listening, close reading, expressive writing, and sharing of what is learned through narrative work) and participatory action research (allowing research questions to emerge from and influence those who are engaged in the subject of research) promoted authentic, consequential, and demonstrable contact among the faculty. The result of these meetings is the development of a community of practice which fosters open dialogue and exploratory interdisciplinary work. We made path-breaking progress in dismantling the walls that have divided this particularly fractious medical center for decades.
Our goals were: to create trust and transparency among an interprofessional group of senior faculty, to analyze the forces preventing and permitting effective health care team work at CUMC, to perform a diagnostic inventory of effective and dysfunctional health care teams at CUMC, to architect a strategy to strengthen health care team function at CUMC, and to win the investment in our plans from the highest levels of power of all four health care professional schools of Columbia. This proposal describes how we did all this and how we plan to move ahead into a team-building top-down and bottom-up revolution in our medical center.
Specific Aims and Objectives:
-Maintain the Macy Foundation-initiated Executive Core for Interprofessional Education and Practice at CUMC as the planning and executing board overseeing strategic development and funding of health care team-related initiatives.
-Inaugurate the process to provide IPE for all students at CUMC.
-Support and oversee a suite of innovative and collaborative radiating projects, arising from one or more than one of the individual schools and intersecting at the Core, that contribute to the research in and overall growth of health care team effectiveness.
-Identify effective interdisciplinary teams at CUMC, integrate them into the training of students, and promote these models in each of the four schools.
-Aggressively disseminate replicable methods to others.
1. Interprofessional Education Seminars: The primary outgrowth of the planning year is the design, execution, and evaluation of pilot Interprofessional Education seminars available for enrollment by students of all four health professions schools on campus. These seminars will be credit-bearing courses that will fulfill a course requirement for the student's school. They will be team-taught by faculty from two or three of the health professions schools. Enrollment will maintain equal numbers of students from each of the four schools. The seminars will convey content salient to effective health care teams and will enact the community of practice processes that the senior faculty developed for themselves in the planning year. Topics will include Cultural Competence in Health Care, Patients' Lived Experience of Chronic Illness, and Communities of Practice in Health Care Settings. The inaugural impetus is that all four schools will commit themselves to growing the seminars and, upon completion of Macy funding, will maintain support of the faculty to teach them so all CUMC students will participate as part of their professional training.
In addition to the IPE seminars, a suite of projects, arising from the individual schools singly or in groups, radiate from this center. The projects are chosen to maximize the inter-project richness and cross-fertilization. During the Macy funding period, two radiating projects are proposed, both of which originate from one of the schools but rely on faculty and students from all of the health sciences schools.
2. The Interprofessional Certificate in Public Health Sciences: As part of the curriculum reform of the Mailman School of Public Health now underway, a number of intensive Certificate Programs are in planning. Most of these Certificates are available only to students enrolled in the 2-year Master of Public Health degree program. With Macy funding, we propose to partner in the development of the Interprofessional Certificate in Public Health Sciences. This Certificate will be available to all students at the CUMC campus and not just the public health students. The goals of the Certificate Program are to train health professionals particularly committed to interprofessional sciences in the theories, methods, and practices of health care team development, evaluation, and dissemination. Students completing this Certificate Program will be equipped with specialty knowledge and skills in leading the development of IPE and IPP nationwide. This project is possible only by virtue of collaboration with the Macy Interprofessional Education and Practice Project, both the leadership of the Executive Core and the IPE Seminars being offered under its aegis.
3. Redefining Dentistry within an Interprofessional Primary Health Care Environment: Health care reform and the aging population dictate rapid expansion of the primary health care delivery work force. One possible strategy is to increase the number of contact points where patients can access the health care system, including among dentists. Dental professionals are responsible for oral health and treating patients with diseases and disorders of the oral cavity. Emerging scientific knowledge about inflammatory pathways suggest that oral cavity diseases like periodontal disease either presage or contribute to inflammatory conditions elsewhere in the body. For too long, the dental profession has been on the periphery of the health care system, generally excluded from discussions about health care policy and preventive health care. Dentists are now poised to change or expand the services they provide, including a greater role in the basic health care for their patients, “scoping up” their professional responsibilities to provide dental services in the context of overall health care. This project will prepare and pilot a feasibility project of health screening and surveillance in the dental clinic for such medical conditions as diabetes, need for smoking cessation, or response to overweight/obesity conditions. High-level consultation with dental leaders and primary care leaders will be sought. Ground-level planning will be accomplished in the “laboratory” at the CUMC Vanderbilt Clinic, where both dental and primary care medical clinics are housed. This pilot will establish the need and feasibility for including medical screening in the dental routine visit while developing and testing educational methods to prepare dentists and physicians and advance practice nurses for their new collaborating relationships in their shared primary care practices.