Training Future Nurses With Future Doctors Boosts Teamwork and Collaboration
By Carol Davis
Future nurses work with future doctors in clinical rotations for an entire school year as part of a new collaborative model for nursing education by NYU Rory Meyers College of Nursing.
“We operate on the premise of teamwork and collaboration because there’s not just one individual that is responsible for the care of the patient,” says Selena Gilles, DNP, ANP-BC, CNEcl, CCRN, associate dean of the undergraduate program at NYU Meyers.
The program, based at NYU Langone Hospital-Long Island, is an example of interprofessional education (IPE), designed to develop effective working relationships between different types of healthcare students and practitioners to support health outcomes.
Research shows that interprofessional healthcare has many benefits, such as improving patient care, fewer preventable errors, reduced healthcare costs, and improved working relationships.
“To my knowledge, there isn’t another structured interprofessional education program like this at other nursing schools,” Gilles says. “Some schools do one-off interprofessional simulations or experiences, but our program at NYU Langone Hospital-Long Island is unique.”
Creating healthcare teams
The program, which began in fall 2021, paired 12 students in their first year of the nursing program with second-year medical students.
“We pair them into a dyad and when the students are in the clinical setting, they are working together on the unit to care for the same patient,” Gilles says. “They are doing health histories and physical assessments together, which involves them working as a team, which is meeting one our objectives—teamwork and collaboration.”
The student teams also complete a social determinants of health (SDoH) assessment on their patient to ascertain how social factors—conditions such as housing, education level, income, and access to healthy foods—may affect that patient’s outcomes, she says.
“And then they’re able to collaborate and develop a plan of care for that individual, based on the information they have,” she says.
Each team attends and participates in interdisciplinary rounds, where they meet with other care team members—the attending physician, residents, social worker, and occasionally physical therapists and pharmacy students.
“They are able to bring back the information they gained from doing that social determinants of health assessment and present to the team the concerns that they might have regarding that patient meeting their outcomes and also recommend who on the healthcare team can help this patient meet their outcomes,” she says.
“It’s not just about them being able to take care of the patient together,” Gilles says, “but also going back to the larger team and being a part of that.”
Developing the program
The interprofessional education program, funded by a $7 million gift from Howard Meyers and his late wife Rory, began with its own collaboration among nursing and medical teams and faculty members. This work group met frequently to develop program objectives and operations, Gilles says.
“We wanted to involve other members of the healthcare team—like physical therapy, occupational therapy, pharmacy—and make sure that we designed an experience where our students are also able to interact with those professionals,” she says.
Coordinating those different curriculums required intense planning, Gilles says.
“What our students learn, when they learn it, and how it’s taught are very different in the different healthcare professions, though ultimately, we all have the same goal of finding safe and effective care for our patients, and helping them to have good outcomes,” she says. “Because these program structures and timetables are different, and the curriculum is very different, we had to pay very close attention to where they might align and at what point in the program the students could best interact in order for us to meet the program goals.”
Those goals include improving quality of teamwork, collaboration, and communication among healthcare team members, she says.
Creating ‘true understanding’
A school survey of participating students indicated that the program is doing what it was intended to accomplish.
“Overall, the students are really enjoying the experience,” Gilles says. “It allows them to have a different level of appreciation for one another.”
That’s crucial in a changing healthcare landscape, she says.
“There are increasingly complex patient health needs, and it requires us to be innovative when it comes to patient care. We’re often working alongside individuals without having a true understanding or appreciation of each other’s role and what each other does,” she says.
“Based on survey results and anecdotal data from students and their instructors, they have a different level of appreciation for each others’ roles, and it’s been able to show them how they might differ but are also the same, and that they have the same goal of ensuring good patient outcomes,” she says.
In fact, students are requesting more team-based experiences, so the nursing school is developing other clinical-setting collaborations for them.
“Just two weeks ago, the nursing students went out to the School of Medicine and participated in an interprofessional experience with the same medical students and with pharmacy students,” Gilles says.
“We put them in groups of six and we gave them a case. Some groups had a case study on geriatric rotation while other groups had a case study on a pediatric patient,” she says. “We allowed them to work together to identify the patient concerns and identify the role that the different team members play in caring for that patient and ensuring that they meet their outcome.”
Better patient outcomes
Students aren’t the only ones who recognize the benefits of the IPE program; it’s obvious to Gilles, as well.
“IPE promotes better team dynamics, which can ultimately end up resulting in things like healthier work environments or more positive attitudes toward each other,” she says.
“Better understanding about each other’s competencies, skills, and experiences allows us to share knowledge and skills and improve that team, because that team is responsible for the care of patients,” she says. “There’s evidence to show that IPE directly translates to improve patient outcomes, whether that’s decreasing patients’ length of stay or reducing the number of medical errors, so we certainly have evidence to support why IPE would be beneficial and at the very top of that list is teamwork and collaboration.”
“I’m really glad to be a part of this program,” she says, “and in the long run our students and our patients are going to have a huge benefit from it.”
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.