March 2023

Students Try Hands at Team-Based Health Care

March 30, 2023    |  

About five years ago, John Dignam was retired and spending his free time participating in local community theater.

Students participate in the 11th Annual Interprofessional Education Day.

Students participate in the 11th Annual Interprofessional Education Day.

It’s there where he learned about Standardized Patients (SPs), actors who are hired to help train medical professionals in simulated scenarios. But to Dignam, the work he does with the University of Maryland, Baltimore (UMB), as well as Johns Hopkins Hospital, is much more than just another acting gig.

“I applied, and five years later, I’m still doing it,” he said. “And I love it.”

Dignam was one of multiple SPs on UMB’s campus March 29 helping roughly 400 students from disciplines across the University work collaboratively at the 11th Annual Interprofessional Education (IPE) Day. The event is hosted by UMB’s Center for Interprofessional Education.

The center began under former UMB President Jay A. Perman, MD, now chancellor of the University System of Maryland, and was announced at the first IPE Day in April 2013. Perman, a pediatric gastroenterologist who continues his practice in the weekly President’s Clinic that includes students from various schools, has continued to be an avid supporter of interprofessional education and the center. 

Jane M. Kirschling, PhD, RN, FAAN, the Bill and Joanne Conway Dean of the University of Maryland School of Nursing (UMSON), has led the center as its director since its founding. This was Kirschling’s last IPE Day as director, as she will retire at the end of the academic year. 

“What Dean Kirschling has stood up here — what she has sustained and grown and nourished — is really something special,” Perman said to the students at the start of event. “She has advanced the practice of team-based care. She's grown the scholarship and the evidence base to demonstrate that team-based care is better care. She's encouraged us and enabled us to develop students to be capable contributing members of a team.” 

Each year, the all-day event includes hands-on practice with the SPs on scenarios where students in nursing, pharmacy, medicine, public health, social work, law, and dentistry are required to work in a team-based model to provide a wraparound care approach.

“It does feel like we’re really helping in our way to help the future doctors, nurses, pharmacists, lawyers, and social workers of tomorrow to improve their skills in a setting that is safe,” Dignam said.

A Lesson in Collaborative Care

Before each IPE Day, SPs like Dignam are trained on the year’s patient assignment. It prepares them for what the patient symptoms are, what their demeanor is, what their backstory is, and more, he said.

And it helps them be prepared for what types of questions students may ask the patient actor.

“On the day of the actual event, there are one to several encounters with different students … and it’s a difficult job in the encounter, because you have to kind of do two things at once,” Dignam said. “You have to portray the patient, the way it’s written in the script. But you also have to, in the back of your mind, think of what the student is doing well, or what the student could do a little better if they had an opportunity.”

The focus is less on who can get a correct answer, but rather how the students work together, and how their interactions made the patient feel, he added.

Second-year social work student Priya Bhayana said Wednesday’s event and interaction with the SP taught her a lot and has motivated her to approach her practice a bit differently.

It even made her think more about her future career because she’s focused her time more on social work in the school systems, as opposed to in the medical field, but after IPE Day, she realized all she could learn in and offer to the medical field.

Getting to work with multiple disciplines was especially rewarding, she said.

“I feel often really siloed as a social worker. I think part of that is just people not understanding what a social worker is, what the profession is supposed to do. Even a lot of social workers have difficulty articulating that. And it also looks very different in different settings,” Bhayana said.

“So I learned a lot about what the social worker’s role is in that kind of setting and how it can really support the other medical professionals. So it made me feel less siloed, because I felt like I was actually contributing something really meaningful to the team.”

Treating the Whole Patient

IPE Day doesn’t just provide students with an educational experience, it also helps people from different programs get to know each other and gets them out of their silos, said Nancy Culpepper, director of the Standardized Patient Program, which is housed at UMSON. They learn what it’s like to work on a health care team, she said.

“They all learn so much about what each other does in their professions. And it really focuses on the importance of a collaborative approach to health care and treating patients,” Culpepper added.

That type of approach to health care is instrumental because it’s important for patients to not only have a clinician tend to their medical needs, but also to understand their social situations to understand what could be impacting their health, she said.

The patient profile for the IPE event that Dignam participated in is a person who is struggling with diabetes and recent high blood pressure and arm weakness, but there’s much more to the patient’s story. Lifestyle factors like smoking impact the overall health. A spouse’s recent job loss and battle with long COVID, plus family financial challenges, played a major role in whether the patient can afford medication and doctor’s appointments.

When you are able to “dissect a person’s life and understand what they’re going through,” Culpepper said, and you can bring in multiple medical and social disciplines, it allows the care team to learn about the whole patient to immediately assist and coordinate.

“We hope that there are lessons learned that they can take into the clinical environment and know that there are other disciplines that can assist them in treating their patients as they move into their professions outside of school,” Culpepper said.