With cautious, deliberate steps, Chris Jones slowly entered the interprofessional clinic, one hand tightly wrapped around the handle of a wobbly cane. Ever since a car accident three years ago, the 58-year-old woman’s back pain has become unbearable. The oxycodone her doctor prescribed helped — for a while. Now she needs more of it to have the same effect. As a result, she is abusing her prescription medication.
Patricia Howard, left, playing the role of patient "Chris Jones," talks with students about her addiction to prescription opioids during IPE Day 2020.
This was the scenario that played out for students across the University of Maryland, Baltimore’s (UMB) seven schools at the 8th Annual IPE (Interprofessional Education) Day, held Feb. 26 at several locations on the UMB campus. Interprofessional education helps students put teamwork into practice. (See video below).
Students attending IPE Day enhanced their knowledge of using a team-based approach to health care, law, and social work as they assisted actors playing the role of patients addicted to prescription opioids.
The 220 students came from UMB as well as the University of Maryland, College Park, which was represented by participants who study audiology or speech language pathology. The day began with a welcome from UMB Interim President Bruce E. Jarrell, MD, FACS, and UMB Center for Interprofessional Education (CIPE) director Jane M. Kirschling, PhD, RN, FAAN, dean of the University of Maryland School of Nursing (UMSON).
“I can say without a moment’s hesitation that he is deeply, deeply committed to all of the students who are here on the campus,” Kirschling said as she introduced Jarrell. “And he believes in the importance of being able to learn how to work in teams, to be able to meet the social and health care needs of the folks that you all will be working with as you complete your degree programs.”
Jarrell told the students, “I hold a very special place for interprofessional education because I think it leads to interprofessional care. And I will tell you, in the early days of organ transplantation, it was not just a surgeon deal, it was a surgeon with about five, six, seven other people who actually knew how to take care of a patient, get the patient well, and get him back in a good environment. So, I’m a deep believer in this. I started out my career with this type of training, and I’m pleased to see it happening here.”
Participants discovered how to effectively work and communicate with professionals outside of their areas of study, what specialist skills they can share with other professionals, and how interprofessional communication can improve quality of care. To bring those lessons home, CIPE enlisted faculty members to facilitate discussions and actors to play the role of patients suffering from chronic pain and addicted to opioids. Students also heard from retired emergency room physician Tom Fioretti, MD, who overcame an opioid addiction thanks to a multidisciplinary approach from his care team.
“IPE Day gives students an opportunity to learn from each other about ways in which the different disciplines here interact,” said Donald B. Tobin, JD, dean of the University of Maryland Francis King Carey School of Law, who sat in on one of the breakout sessions and listened to students’ discussions about the best way to care for the standardized patient. “But it also gives them an opportunity to appreciate each other and appreciate what each discipline can bring to making the lives of people better.”
“I think it’s important for all the students to know, especially today, that the goal is to understand that each member of the team is important no matter what that diagnosis might be, and to learn from each other and with each other about the different disciplines,” added Elsie Stines, DNP, MS, CRNP, assistant vice president of special projects and initiatives for the Office of the President.
At the start of one of numerous breakout sessions, Margaret Martin, RN, BSN, told the students gathered in a UMSON classroom, the location of a mock interprofessional clinic, “This is a training situation. We want you to think outside the box and take risks. We want you to be able to say, ‘Hey, look what I can achieve as a team member versus what I can achieve alone.’ ”
With cane in hand, actress Patricia Howard, playing the role of “Chris Jones,” took a seat among the interprofessional team assigned to her care. As a team of students asked her questions about her situation and her medical history, the remaining students craned their necks to watch, eagerly jotting down notes about her answers.
The patient showed surprise when University of Maryland School of Dentistry dental hygiene student Hailey Ebue asked how long it had been since she’d seen a dentist.
“I thought I was here because of my issue with medication,” Howard responded. Due to having an interdisciplinary care team, she later learned that an over-the-counter oral rinse will help dry mouth and thrush being caused by her medications, that a lawyer could help navigate a disability claim that was denied without explanation, that a physical therapist could help to reduce her anxiety of falling, and that she likely would benefit from aquatic therapy. UMSON student Sonia Max also suggested that because of the patient’s limited transportation options, she should seek an online support group to help with depression. University of Maryland School of Pharmacy student Hannah Kim suggested switching to ibuprofen to manage the patient’s pain.
“All of these sound like good ideas,” the patient said. Later, in providing feedback on the students’ communications skills, Howard added. “There was a lot of good eye contact. I felt cared for.”
At the end of the day, participating students convened for a debriefing session in the Southern Management Corporation Campus Center.
University of Maryland School of Social Work student Victoria Robles said she was pleasantly surprised at the reception she received from her interdisciplinary teammates.
“I thought I would be an afterthought,” she said, but instead her teammates turned to her for advice on case management and therapy needs.
Jasper Mok, a student at the University of Maryland School of Medicine, noted that working on a team can sometimes have its challenges.
“I think we could have summarized the information better” to be sure the care plan was understood by the patient, he said. “It was a complex case. You have all these things thrown at you” from different disciplines, which can confuse a patient, he said.
Kirschling closed the day by reminding the students that addiction to opioids “goes beyond the homeless,” adding, “there are a lot of people who are around us who need love and care.”