Introduction

1. Integrative roles for medical and nursing students in planning for a student-run free clinicTammy Wang, Hiren Bhakta, Nicole Cruver, Sarah Miano, Wanda Cruz-KnightCase Western Reserve University Schools of Medicine and Nursing Introduction Objective 2011 Timeline Student-run free clinics are uniquely poised to provide medical services to underserved populations, while improving professional student clinical education. While interdisciplinary health care teams are often seen in hospitals and community clinics, they are less common in student-run free clinics. Furthermore, medical schools typically provide limited opportunities for interdiscipinary collaborations. Here we present a model that relies on both medical and nursing students in the planning and implementation of a student-run free clinic. Students from both schools are thus mutually invested in all aspects of clinical care. From an administrative perspective, students will also work closely together on executive boards and planning committees. It is our hope that the insights and the perspectives gained from these collaborations will better prepare students for interdisciplinary health professional teams in their future health care practice. To improve medical and nursing collaboration early in professional student education through planning, management, and staffing of a student-run free clinic. Patient Flow Model Our patient flow model incorporates several important changes to the traditional student-run free clinic. In particular, the role of Case Manager (CM) is integrated into every aspect of patient care, from initial intake to final discharge. Once student teams and preceptors formulate a plan of care, CMs are responsible for subsequent implementation. This includes discussion of Patient Assistant Programs and prescription vouchers, non-medical determinants to care, and possible specialty referrals. The benefit of this model is such that patients can look to a single person to guide them through the visit and any necessary follow-up. In this way, CMs contribute to a more personalized and positive patient experience. Next Steps We are currently in the process of securing additional financial resources for medical supplies and pharmacy prescriptions. We are also setting the blueprint for a Quality Assurance and Improvement (QAI) team, which will evaluate clinic productivity and track health outcomes throughout clinic operations. To continue along the interdisciplinary nature of our work, we will invite students to join us from additional programs, such as Dentistry, Public Health, Social Work, Business, and Law. This will diversify the student learning experience as well as provide more comprehensive patient services. Medical and Nursing Collaborations A founding principle of the clinic is centered on productive partnerships between medical and nursing students early in their clinical education. We intend to draw upon the respective strengths from each school to provide a more comprehensive clinical care experience for patients, as well as unique clinical learning opportunities for students. Attending preceptors will also play a critical role in maintaining a dynamic educational environment centered on community care. Such an interdisciplinary team is well positioned to provide comprehensive patient care as complementary skill sets come together to improve overall team performance. Summary In collaboration with the Free Medical Clinic of Greater Cleveland, professional students at Case Western Reserve University are setting the foundation for a student-run free clinic that includes novel roles for medical and nursing students. By integrating medical and nursing students into every aspect of clinic planning and implementation, each discipline shares and builds upon the other’s strengths. This allows for unique learning opportunities as well as more sensitive and comprehensive medical care to in the setting of a community clinic. The second unique element of our patient flow model is the teamwork between medical and nursing students within each of the clinical care teams. Either preclinical medical students are paired with advanced graduate nursing students, or first-year graduate nursing students are paired with fourth-year medical students. These students see patients as a team, discuss and present cases together, and complete clinical notes for each patient. This system provides for greatly enhanced teaching and mentoring opportunities between disciplines and across years. Yet another element of cross-disciplinary educational opportunities is the incorporation of both physicians and nurse practitioners in the role of attending preceptor. This presents important opportunities to teach students from other disciplines about their respective field’s approach towards primary care. Faculty Support Dr Daniel Ornt, MD, FACP, Vice Dean for Education and Academic Affairs, CWRU School of Medicine Dr Wanda Cruz-Knight, MD, Assistant Professor, Dept of Family Medicine, University Hospitals & CWRU School of Medicine, Cleveland, Ohio Dr Patricia Underwood, PhD, RN, FAAN, Associate Dean for Academic Programs, Associate Professor, FPB School of Nursing Dr Carol Savrin, DNP, CPNP, FNP, Associate Professor, FPB School of Nursing