The UTMB Global Health Inter-Professional Core Course: Successes, Works in Progress, and Open Questions

1. The UTMB Global Health Inter-Professional Core Course: Successes, Works in Progress, and Open Questions Lexi Nolen, PhD, MPH and Caley Satterfield, MEd Laura Rudkin, PhD; Liz Reifsnider, PhD, RN; Carolyn Utsey PhD, PT; Gretchen Stone, PhD, OTR; Vicki Freeman, PhD, LeeAnn Bryant, MHS Janice Smith, MD, MPH

2. Objectives • Describe the context of UTMB in relation to IEGH • Present the process for creating the course • Outline some challenges • Describe future directions • Identify some key unanswered questions

3. Definitions • Inter-professional (IP) • “When two or more professions learn with, from, and about one another” • Inter-disciplinary • “collaboration within a single profession, e.g. among pediatricians, pediatric cardiologists and pediatric surgeions in the care of children with congenital heart defects” • Multidisciplinary • “other disciplines are invited to participate in an independent, discipline-specific team that conducts separate assessment, planning, and provision of services with little coordination”

4. The UTMB context • Health Professions campus • SOM (1st and 2nd yr students) • GSBS • *basic science and clinical science research students • public health students--not primary degree • SON • *Undergraduate • graduate • SHP • Occupational Therapy • Physical Therapy • Clinical Lab Sciences • *Physicians’ Assistant • *Respiratory Therapy • Growing GH Program • Fogarty Grant • Significant $ for students • Growing decentralization • Increasing coordination • Various opportunities • Field site experiences • Monthly potlucks • Lecture series • Global Grand Rounds • Major hurricane • Departure of key faculty • Funding disruptions • Planning disruptions

5. synergy and GHICC We used synergy’s momentum to support our GH goals • Steering Committee rep. • synergy support • Financial: tuition support for students (3 years) • Curricular: IP activity development, faculty development • Educational research: evaluation of educational experience, tracking • Benefits to synergy • Popular class with high and mixed participation • Early IP experience for students • Evaluation information

6. synergy Program Participation

7. Highlights of the GH Program at UTMB Global Health Track for medical students (2005) HABLE (2005), Spanish SOM curriculum to support training of bilingual providers Global Grand Rounds GH lecture series International field site electives Structured, inter-professional domestic field sites in Galveston and in 4 Texas colonias Active global health student interest group (chapters across the state) Monthly potlucks Fogarty International Research Fellowships, SOM Scholarships UT System Global Health Resource Center (2008- ) Global Health Interprofessional Core Course (2009- ) Coming year International Research Ethics Area of Concentration within the Master of Arts Program in Medical Humanities Global Health Concentration within the Master of Public Health (MPH) Certificates in GH in several programs (OT, PT, CLS) Mentoring Program Regional GHEC conference

8. Creation of GHICC • Began last spring • Inter-professional faculty (self-identified but broad) • Curriculum and Syllabus developed quickly • Goals for the course • Mapping of gh core competencies among programs, or program competencies when gh not available • Agreement on public health and systems focus • Complement to existing GH activities • Distance learning, repository

9. GHICC curricular structure • Wed 5-6:30, Sept-April • 16 Large group Inter-professional classes • 16 Small group professional classes (PT, OT, CLS, MPH)

10. Large Group Meeting Topics • Overview of Global Health and Introduction to Course • The Global Crisis in Human Resources for Health; Healthcare Teams in different Global Settings • Healthcare Systems • Introduction to Public Health and Epidemiology • Health Equity and Social Determinants of Health • Global Health Organizations; The Role of Civil Society and Universities in Global Health • Achieving the Millennium Development Goals • Human Rights and Social Justice; Ethical Issues in Global Health • Culturally Appropriate Healthcare; Health Promotion and Behavior Change • Women’s Health; Child Health • Nutrition and Malnutrition • Travel Safety and Health • Global Infectious Disease • Health Impacts of Disasters • Occupational and other Injuries in Developing Countries • Appropriate technology in low resource settings • Oral health in low income countries

11. Distance Learning • Tegrity • Records video, audio along with PowerPoint presentation • BlackBoard • Upload resources such as web links, readings, etc • Travel Safety lecture made available to all UT System campuses

12. The Usual Suspects… Schedules between schools, Curricular time, Credits and uniformity, Academic policies *Faculty time/compensation (resistance by administration) …plus some more Sustainable interprofessional enrollment Faculty development—dual skills in gh and interprofessional education Administrative Challenges

13. Curricular Challenges More suspects… *Learning modalities (PBL, sm groups, com based, etc) *Use of language (e.g. med students vs health professions students) *Breadth v. depth *Variations in students’ educational level …more more Global health and IP goals double the work! Developing or finding good IP/GH interactive activities The problems of serving two masters

14. Student Comments after 1st Semester • Lots of positive • Content—liked the gh competencies (unexpected for some) • Structure • Group activities • Info on careers, online resources and databases, etc • Liked having an IP faculty, esp when they worked together • Class on IP teams was the favorite • A few negative • More “field” talk, clinical skills building; didn’t get the gh competencies • More small group activities; fewer small group activities

15. Future Directions (administrative) Review of scheduling (student obligations) Improvement in physical educational environment Global Health Tracks/Certificates in the Health Professions programs Integration of SON, PA students *Secured faculty time/incentives *Faculty development Potential elective credit for SOM students

16. Proposed SOM Elective • *16 bi-weekly 90-minute inter-professional lecture/discussion sessions • 16 bi-weekly 60-minute medical student discussions • *Completion of the Welcome Trust Topics in Global Health learning modules on CD • *Participate in the global health mentoring program • Service learning experience: 2+ days • Development of class presentations, group projects, short research project • End of semester quiz and student evaluation by faculty • Could complete over 2 years (?)

17. Future Directions (curricular) • Clear introduction (emerging gh curriculum; not skills building, “field” talk; other opportunities on campus; career development) • Less lecture, more group and IP activities • Further development of online course delivery (req.) • Linked to service-learning experiences • Mainstreaming GH into schools’ curricula • Developing further opportunities to increase depth of knowledge in gh competency areas

18. Open questions…. • Sustaining broad student participation (tuition, distance education) • Inter-professional quality w/ increased distance education • Role of each faculty in the course • Your experiences? Other helpful literature? • Examples of inter-professional, global health class activities? • Should we be working and thinking together on a regular basis?

19. References • G Goelen, G de Clercq, L Huyghens, and E Kerckhofs. (2006). Measuring the effect of interprofessional problem-based learning on the attitudes of undergraduate health care students, Medical Education, 40, 555-561. • K McPherson, L Headrick, and F Moss. (2001). Working and learning togther: good quality care depnds on it, but how can we achieve it, Quality in Health Care, 10(Supp. II), ii46-ii53. • JA Dyer. (2003). Multidisciplinary, Interdisciplinary, and Transdisciplinary Educational Models and Nursing Education, Nursing Education Perspectives, 24(4), 186-188. • F Carpenter. (1995). Interprofessional education for medical and nursing students: Evaluation of a programme, Medical Education, 29, 265-272.