It has been well established that interprofessional (IP) teams improve quality, safety, and efficiency.1,2 When taught consistently, IP education (IPE) can challenge students to problem-solve collaboratively, impart attitudinal changes, and reduce stereotypes between health professionals.3,4 As a result, there has been an impetus to provide more IP learning experiences for students in the health affairs schools. The World Health Organization defines IPE as "learning about, learning from, and learning with other professions."5 This definition, along with the identified barriers to implementation of IP courses, challenges faculty to think about how to develop these courses successfully. Research has shown that having well-trained prevention and population health professionals outside the traditional public health field is important because of the focus on prevention across health settings. Because health professionals work in IP teams clinically, training and educating all health professionals within IP models are a fundamental first step in preparing these health providers.6
However, preparing practitioners to work collaboratively in teams and IP practice requires new models to train and socialize health care professionals and current students. Many health professional educational programs have created IPE learning to support this team-based care approach, and accrediting bodies reflect this change.7 Despite the promise of IP collaboration, education and practice implementation challenges exist.2,4,6
Specifically, IPE has many barriers, including lack of resources, student and classroom scheduling, faculty workload distribution, varying requirements by educational accrediting bodies, and challenges associated with expectations and faculty development.3 To address these barriers and create strategies for the implementation of IP learning experiences, more dissemination of faculty "success" stories is needed. The purpose of this educational brief is to describe an innovative learning experience where IP groups of graduate students worked together with faculty, during a 1-credit independent study in the spring semester, to design and develop content for a 3-credit IPE course focused on population health management offered the following fall.
Models to implementing IPE have focused on course development through extensive planning with IP faculty and community experts, but no models exist where students have been used as key collaborators in course development.8-10 The following example describes an innovative way to use students from 6 health professions (nursing, medicine, pharmacy, social work, nutrition, and public health) to assist in the creation of a blended learning graduate-level IPE population health management course. These students, in conjunction with faculty from each of the health professions, worked together to construct the course-an effort that resulted in IPE interactions at various points of course design, construction, and implementation.
Content Development
The idea for an IPE course on population health management germinated from a nursing faculty member who recognized the need for such a course based on conversations with clinical partners and national trends. As a university, IPE efforts were occurring, but efforts were sporadic and not always communicated efficiently as there lacked a central coordinating body across campus to help disseminate efforts and invite members from each profession. Fortuitously, several health affairs schools were undergoing curricular revision and also recognized the need for more IP collaboration. The deans of each health professions school collaborated with the lead nursing faculty to identify representatives from each school to develop and implement an IP population health course.
Faculty resources and time were limited for the development of the IP population health management course, with only 1 year from project conception to course implementation. To reach this ambitious goal, only 1 semester was allotted to develop the course objectives, content, and evaluation measures. Therefore, key faculty from each of the professional schools were asked to identify 1 to 2 graduate students from their program who might be interested in assisting with content development of the final product-the IPE course on population health management. These students were selected by each faculty member based on previous relationships as advisees or those who expressed an interest in IPE. The selected graduate students enrolled in a 1-credit independent study during the spring semester to receive academic credit for their efforts developing the course.
Content Outline
Before the start of this experience, faculty from each of the professional schools created a curriculum guide with specific content goals and overall objectives for the 3-credit IP course. This guide served as the foundation for the students to work with the faculty designing the course. The purpose of the course was to prepare health care professionals with the foundational skills needed to work effectively in teams when collaborating and coordinating care in population health management. Six modules were created that focused on (1) defining population health in a changing care system, (2) understanding and defining quality, (3) conducting a needs assessment to target interventions for populations, (4) patient and community engagement, (5) care coordination, and (6) understanding populations at risk and the impact of care decisions on cost. Key themes throughout the course focused on IP communication, collaboration, leadership, and professionalism. Because of the complexity with scheduling across the health affairs campus, it was determined that a blended learning approach, with a mix of online modules and monthly face-to-face meetings, would be the best implementation approach for the course.
Student Assistants
Eight graduate students representing nursing, pharmacy, medicine, social work, and public health (nutrition and health behavior) participated in the independent study to develop the course, coordinated by 4 faculty representatives from nursing, social work, and public health. Students also were paired with consulting faculty from their own profession to discuss discipline-specific content as part of class preparation. Students and the faculty representatives met weekly to discuss the content outline, identify current resources and didactic content, and brainstorm IPE learning activities. In addition, students met monthly with their consulting faculty to ensure adequate representation from all the health professions.
Ideally, a more thorough orientation to course development and blending learning involving traditional and online education would have been offered, but because of time constraints, this was not formally done. However, involving students in the creation of this population health course served a dual purpose. First, because students were from nursing, pharmacy, medicine, social work, and public health, it helped ensure that various perspectives were included. Second, because students were engaged in course content and development, their opinions allowed faculty to assess whether the material was clear, engaging, and relevant to students.
In the initial course development sessions, students discussed the need for IP learning in each of their programs and brainstormed learning activities to address IP engagement. Subsequent class sessions were focused on creation of 1 of the 6 modules, with students presenting papers, didactic content, and videos relevant to each of the modules. Finally, the students as a group discussed teaching and evaluation methods that would not only engage their peers but also assess knowledge, attitude, and skill changes in IP population health management. The students found this component of the sessions the most engaging as they were able to create a course that blended multiple professional views and teaching strategies. As a result, the modules were developed in a true IP manner, by students and for students, with each profession sharing their perspective and interpretation of the content.
After course development discussions, each student was responsible for creating an outline of module content, complete with objectives, relevant articles, IPE activities, discussion board questions, and links to videos or other relevant technology. Students chose content topics that were most interesting to them. Several students worked collaboratively, providing an additional IPE experience. Students then presented their content to the development team faculty and consulting faculty. Open dialogue from the team allowed for additional perspectives and changes. Once the students made final revisions to the module content, the modules were ready for faculty for assessment of validity. The content was then reviewed by the consulting faculty from each of the health professions programs, using a rubric for determining content validity. After feedback, the modules were revised and formatted for online learning by the course faculty using a learning management system. The 3-credit population health course was then offered the following fall with students from the 6 disciplines.
Outcomes
Many outcomes were achieved from this experience, some expected and some unanticipated. As a result of this innovative approach, the deadline to complete the modules by the beginning of the fall semester was achieved. This approach proved to be symbiotic in nature, in that the students were able to learn how to develop IP curricular content with faculty support, and the faculty were able to focus on larger organizational tasks such as completing syllabi and getting approval for the coursework through the respective school's executive curricular committees.
Because the course was developed primarily by students from multiple professions, the IP nature and valued student perspective were achieved. The students who engaged in the independent study to develop the course did not enroll in the IP population health management course but recruited many of their fellow students into the course.
The faculty and graduate students who participated in developing the course reported positive outcomes with the experience, as evidenced through course evaluation data and reflection during the final class session. One strength of this model was verifying the content validity by faculty experts after completion of the student-developed modules. This approach allowed for the students to work alongside a faculty to learn the steps of IP curriculum development while also having the faculty expertise to determine that the course and module objectives were met. In addition, although most IP courses are developed by well-meaning experts, the lack of collaboration across all professions can unintentionally leave out the perspective of disciplines that are not represented through course development. By involving students and faculty from multiple disciplines, we were able to create a course that was conceptualized, designed, and evaluated from multiple perspectives from the beginning.
Student feedback from this experience was positive, and all of the students reported a deeper appreciation for IP collaboration. The faculty involved in the effort reviewed the final assignments, which had a reflective component, and also course evaluation data to assess success of this IPE curriculum initiative. A quote from a participating graduate student summarizes the experience:
Being a part of the cohort of student developers instilled a firm understanding of the various facets of interdisciplinary health care and provided a one-of-a-kind opportunity to be on the forefront of innovation in my field. By addressing gaps in the literature and recognizing our different opinions among the represented disciplines, this process provided a rare and unique look inside the crux of research and education.
Future work will focus on implementing and evaluating this IP population health course and creating a sustainability plan as all of the health professions schools are invested in the success of this course. Although evaluation is ongoing, preliminary results from the course indicate that engaging students in course development is a unique approach to IP course development.
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