November 22, 2010
When a tennis player dropped out of a senior tournament complaining of shoulder pain, medical, nursing and allied health students from Indiana State and Indiana universities were called upon to examine him.
Dennis Rackett said the pain kept him awake and he blamed his performance on a lack of sleep. He said he had watched the U.S. Open on television and was reminded that he was a "pretty good" tennis player in high school so he decided to sign up for the tourney to "get out of the house."
From the beginning, students suspected it was more than aging muscles that sent the 60-year-old to the sidelines.
Nursing and allied health students from Indiana State and medical students from the Indiana University School of Medicine-Terre Haute had reason to be suspicious. Rackett is a fictional character whose scenario was created for an inter-professional education day designed to involve students from across the health care professions spectrum. In addition to IU medical and ISU nursing students, Indiana State students completing degrees in athletic training, public health administration, health education, dietetics and social work took part.
Michelle Kepp, a senior social work major from Elkhart, wondered if something occurred in Rackett's personal life. Was it more than his love of tennis, she asked, that prompted him to take to the court and play with the same intensity he demonstrated more than 40 years earlier, even though the pain had developed one week into his two weeks of training for the tourney?
Perhaps he hadn't been eating right, suggested Zara Reel of Vincennes, a senior dietetics major.
When the students later learned Rackett had been "eating out of a can" in recent weeks, they knew their hunches were right.
It turned out Rackett was the primary caregiver for his wife, who was in the early stages of Alzheimer's disease, and he didn't want to "bother" other family members and friends.
With all the pieces of the puzzle in place, the students developed a plan that went beyond a physician, nurses and an athletic trainer tending to Rackett's shoulder pain. It called for public health educators to educate the family about resources for treatment of Alzheimer's patients, social workers to refer the family to assistance with housekeeping and dietitians to assist with guidelines for nutritious meals. .
Kepp said the training "helped us appreciate each other's responsibilities and duties. That way we can communicate better."
Michael Riley, a senior nursing major from Terre Haute, said, "It's hard to teach how to communicate with others without having the experience first. This gave us the hands-on experience seeing how each profession has its role to play."
Second-year medical student Lauren Foulke of Chicago said she appreciated the opportunity to talk with students from other disciplines and suggested participants might benefit from more generalized discussions
"I don't know everything that they do and that was helpful. Sometimes going over cases makes you too specific. You have to focus on this case and then you can't just talk about your different areas, but this was definitely beneficial," she said.
In medicine, there have been cycles of inter-professional education and inter-professional practice about every 10 years since the 1940s and the climate is right to implement the approach, said Larry Lynn, M.D., keynote speaker for the event.
Health care professions have traditionally operated in silos, but Lynn, clinical coordinator of the physician assistant program at Butler University, said he wants "to bust these silos apart."
The goal, Lynn said, is relationship-centered care which emphasizes evidence-based medicine and is designed to serve not only the patient, but the patient's family and other caregivers.
Lynn told students they are fortunate to be at Indiana State because of the commitment the College of Nursing, Health, and Human Services has made to inter-professional education.
"As students and as employees coming into the job market, you're going to understand practicing medicine and your craft better than other students. This is cutting edge, high-tech medicine," he said. "If we're a team, if we're collaborating, if we're communicating well and we know what to expect from one another, we're much more likely to understand and utilize that information."
This time, Lynn said, the approach is here to stay because "we have an under-insured and unhealthy population" and an escalating national debt financed heavily by international investors. Those factors will help propel the expansion of inter-professional education and practice because the approach will result in long-term cost savings.
"One of the entities that is pushing for us to deliver more efficient medicine is China," he said, noting the Chinese hold a large portion of America's $15 trillion national debt and those investors are concerned about the ever-increasing cost of health care in the United States.
Rising costs have also resulted in support from the private sector for ways to control health care costs, he said, noting that such "buy-in" was not present when former President Bill Clinton last attempted an overhaul of the nation's health care system in the early 1990s.
"Everyone is asking for relief," he said. "We have employers who are saying ‘I can't afford benefits for our employees."
About 100 students from Indiana State and the IU Medical School took part in the inter-professional education day at Landsbaum Center for Health Education in Terre Haute and coordinated by West Central Indiana Area Health Education Center.
In addition to the tennis player, cases involved a 12-year-old boy from a rural area who had an asthma attack at football practice and a 54-year-old severely overweight woman from the inner city complaining of knee problems. Developers of the scenarios created situations where the 12-year-old had been bounced around from home to home and was being raised by a teen-age sister while the 54-year-old woman had diabetes and heart disease and yet hadn't seen a physician in five years.
Biff Williams, dean of the College of Nursing, Health, and Human Services, said "inter-professional education is the primary focus for the college. This was the founding event for a long and rich future of inter-professional activities at ISU."
Betsy Frank, professor of nursing, sparked the idea for the inter-professional learning program and chaired the planning committee for the event, a first for ISU and the IU Medical School-Terre Haute. She pronounced the day a success.
"They learned things they would not have learned had they just been educated in their own disciplines," Frank said.
Inter-professional education is vital for quality patient care and patient safety, she said, and it is important that future health care providers learn using scenarios that accurately reflect the often complex lives of persons they will be called upon to treat.
"If we don't learn how to work with other health care professionals, there are going to be pieces that are going to get missed," Frank said. "For example, if I don't know what services are available to help a man take care of his wife with Alzheimer's I'm not taking care of the whole person."
Photo: http://isuphoto.smugmug.com/Events/Inter-Professional-Learning/10968689133wpEP-L/1100469364_JyHxi-L.jpg - Nursing and allied health students at Indiana State University collaborated with students from the Indiana University School of Medicine-Terre Haute Nov. 19 for the first inter-professional education day involving the two institutions. (ISU/Bethany Baker)
http://isuphoto.smugmug.com/Events/Inter-Professional-Learning/008BSB1993/1096867665_iqzs9-L.jpg - Deli Stinnett, an athletic training major from Terre Haute, takes notes on a dry erase board as Indiana State University nursing and allied health students discuss patient treatment options with students from Indiana University School of Medicine-Terre Haute during an inter-professional education program Nov. 19. (ISU/Bethany Baker)
http://isuphoto.smugmug.com/Events/Inter-Professional-Learning/015BSB2003/1096868595_7QFHG-L.jpg - Savannah Cox of Dugger (right), a social work major at Indiana State University, researches options as she and health sciences major Mary Champion of Cannelton join other students in ISU's College of Nursing, Health, and Human Services and the Indiana University School of Medicine-Terre Haute during an inter-professional learning program. (ISU/Bethany Baker)
Contact: Betsy Frank, professor of nursing, College of Nursing, Health, and Human Services, Indiana State University, 812-237-3481 or email@example.com
Writer: Dave Taylor, media relations director, Office of Communications and Marketing, Indiana State University, 812-237-3743 or firstname.lastname@example.org
About 100 students from ISU's College of Nursing, Health, and Human Services and the IU School of Medicine-Terre Haute learned the importance of health care providers working together to improve patient care.