On my first day at work after physician assistant school, my boss asked me to discharge a patient. After thinking “ok, how hard could this be?,” and getting advice from the nurses on the floor to make sure the patient was ready to be discharged, I spoke with the patient and asked: “are you ready to go home?” When the patient responded “yes,” I wrote up the paperwork for the patient to be discharged.
I can still hear my boss yelling at me: “Has the patient worked with nutrition and speech and language pathology after having a tracheotomy? Have they been cleared by physical and occupational therapy after being in a car accident? Have case management and social work made sure the patient has home healthcare and is safe at home yet?”
I sat there in awe, that here I was letting a patient out on the street without considering any of these things. That is when I learned medicine is not only an art, it is about logistics and team work, too.
Now, as an instructor with the Yale Physician Assistant (PA) Online program, I have the opportunity to help ensure future physician assistants don’t repeat my mistake. By bringing them together with students from other professions in an impactful online interprofessional program, I’m training them how to work effectively as team members.
Building an Online IPE Program
In 2017, when I first started working with the Yale PA Online program, I was very excited for many reasons, but chiefly because it was the first program I had come across that had almost all of the didactic content for teaching physician assistant students online, using a highly interactive curriculum.
Collaborating with the education technology company, 2U, Yale Physician Assistant Online transports remote students into lecture halls, exam rooms, food banks, nursing homes, and many other locations. It does the same for faculty—which means we have experts from all over the country contributing to our curriculum.
As I became more involved with Yale PA Online, I was struck by the question of: How do you create an environment where students from different professions can learn from each other? And, how do you create interprofessional education (IPE) in an online setting?
I set out to create a virtual interprofessional education (VIPE) environment for trainee physician assistants, nurse practitioners, occupational therapists, physical therapists, social workers, speech therapists, public health experts, and other members of the health care team.
I reached out to faculty and staff at the following health professions schools across the country:
- Georgetown University School of Nursing & Health Studies, Family Nurse Practitioner Program
- NYU Steinhardt School of Culture, Education, and Human Development, Master of Science in Communicative Sciences and Disorders Program
- NYU Steinhardt School of Culture, Education, and Human Development, Doctor of Occupational Therapy Program
- University of Southern California Division of Biokinesiology and Physical Therapy, hybrid Doctor of Physical Therapy Program
- University of Southern California Suzanne Dworak-Peck School of Social Work, Master of Social Work Program
I let everyone I spoke with know that I wanted to form a committee, have meetings, and host a large VIPE in November of 2018. The idea took off, and with the assistance of 2U, we began planning.
The VIPE Content
The VIPE uses a simple stroke case to teach students about team work.
Students are assigned to read
background material on the case study patient, a 72-year-old woman in Kentucky.
The materials include information about her symptoms when she arrived at a
primary care office on an urgent basis, and other data such as her past medical
history, family medical history, psychosocial/personal history, and lab
Students also watch a video in which Diana Burden MSN, FNP-BC, RN, family nurse practitioner/ clinical faculty director with Georgetown’s online FNP program, interviews the patient and her husband—who are really actors working off a script we wrote.
VIPE participants then separated into 18 virtual break-out rooms with a faculty mentor. Each group spent an hour working through the patient’s case. In reviewing the case, the students discussed the roles of different team members, and also noted where there is overlap and similarities among the different professions. The video was referenced often—sometimes through direct quotes—demonstrating that it helped the students feel connected to the patient and her husband, and helped them understand the patient more.
Each breakout group then delivered a presentation for the broader group on how to handle the case, and when to bring in other health care team members to assist with treatment.
We launched the first VIPE in November 2018 and data from our pre- and post-surveys of the VIPE experience, as well as assessments of student knowledge of other professions before and after the VIPE, indicate that it was an effective and easy-to-use experience.
Expanding the VIPE
Since the first VIPE event, we’ve been able to incorporate more organizations, schools, and students into the VIPE—including The Centre for the Advancement of Interprofessional Education (CAIPE) and Concordia University, which conducts an amazing in-person IPE experience with law, theology, law enforcement, and nursing students.
We’ve also added new content. Working
with Barbara Maxwell PT, DPT, MSc, Cert THE, FNAP, professor and university
director of interprofessional education and collaboration at A.T. Still
University of Health Sciences, we’ve expanded our VIPE with new IPE cases.
One day I hope to expand this
globally, and, for example, teach those in the Philippines what a physician
assistant is, and help others understand the role of clinical associates in
Africa and the role of PAs in Saudi Arabia, so that health care teams around
the world are performing at the top of their game.
Read more about the innovative November 2018 VIPE, in this article on the Yale PA Online website.
Mary Showstark is a physician assistant who works as an instructor with the Yale Online Physician Assistant Program. Her background is in trauma surgery, emergency, urgent care, & disaster medicine; and her interests are in interprofessional education, disaster relief work, and event & mass gathering medicine as well as technology and medicine to include AR/AI/VR.