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 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 UTMB has a 20-year history of providing students early global health learning opportunities, guided by preparation and long-term relationships with international field sites. UTMB has a 20-year history of providing students early global health learning opportunities, guided by preparation and long-term relationships with international field sites.

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. Administrative Challenges 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 Faculty unevenly compensated (variations in leadership�s attitudes, priorities, needs re GH among schools) �credits� vs. track requirementsFaculty unevenly compensated (variations in leadership�s attitudes, priorities, needs re GH among schools) �credits� vs. track requirements

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

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.