(l to r: Kaspar Ng, Zoraida DeCastro Beekhoo, Keyur Shah, Patricia Galata, Leigha Saunders, Elisa Simpson, and Christopher Siu)
The direction of effective patient/client care continues to grow and support health care providers working in collaborative teams. Students from the University of Toronto, through the IPE curriculum coordinated by the Centre for Interprofessional Education (IPE), demonstrated this collaborative approach and claimed top honours at the 2013 National Health Care Team Challenge (HCTC). Comprised of students from various health care professions, Elisa Simpson (Bloomberg Nursing), Christopher Siu (Leslie Dan Faculty of Pharmacy), Keyur Shah (Leslie Dan Faculty of Pharmacy), Kaspar Ng (Faculty of Medicine) Leigha Saunders (Canadian College of Naturopathic Medicine) and Patricia Galata (Canadian Memorial Chiropractic College) had one week, one hour and one minute to prepare and address a predetermined patient case study. Presenting in front of a live audience in Vancouver, B.C. at the Collaborating Across Borders North American IPE conference, the U of T team impressed judges, mentors and attendees alike with their commitment to patient/client/family care.
“Our group from Toronto was definitely a unique representation of the different professions within health care, with great collaborative ideas when we combined our profession specific input,” says Elisa Simpson who is nearing the end of her term as Co-President, Interprofessional Healthcare Students’ Association. “To win the local challenge in February, and then at the national level in June, really showcased what health care teams can accomplish, and how students are embracing interprofessional delivery of care.”
Initiated by the University of British Columbia (UBC) over 25 years ago, the HCTC grew from a local student event to a national one developed by the National Health Sciences Students’ Association. The idea to harness interprofessional education at the student level, by bringing them together from different health care professions to work on a management plan for a clinical case has even gone global. Now students from around the world participate in their local HCTC to present their recommendations for a complex case and showcase the future of health care teamwork. The Canadian Challenge for 2013 brought teams from Queen’s, Western, UBC, The Michener Institute, the University of Ottawa, and the University of Alberta— but it was U of T who demonstrated the strongest level of collaboration.
“As interprofessional education continues to have more of an impact, I’m seeing the next generation of our health care practitioners fully embrace this teamwork-based model of delivering health care,” says Susan Wagner, inaugural Faculty Lead-Curriculum, Centre for IPE from 2007-2012, initiator of the UT HCTC and student mentor. “The Health Care Team Challenge provides meaningful learning opportunities for students and really fosters the skills and desire for teamwork in a practice setting.”
Wagner, also a Senior Lecturer, Department of Speech-Language Pathology in the Faculty of Medicine, was the lead in developing the IPE curriculum for what was then the Office of Interprofessional Education after it opened its doors at the University of Toronto in 2006. Incorporating 11 of the health sciences programs at the University, the now Centre for IPE provides a competency-based curriculum to health professional students so they can deliver patient/client care as a collaborative team. Ranked as a world leader in IPE, the University of Toronto is reshaping the future of health care at the practice and policy level too, through its curriculum and activities such as the HCTC.
“U of T has really taught me, and the whole team, to look at the big picture and I feel that really gave us an edge when presenting our answers,” says Simpson. “We recognized that presenting our patient management plan meant addressing more than just the patient’s individual symptoms; this was a case that required touching on how policy needs to change as well.”
Their case study – an Aboriginal man presenting with a foot infection and other chronic conditions – asked the team to present a management plan providing optimum patient/client care. “As a group we met with our faculty advisors to see how we could get an edge on the competition,” says Simpson. “We knew all of the teams would discuss straightforward approaches, like prescribing antibiotics, and we wondered how we could stand out.”
The answer was clear to Faculty Mentors Zoraida DeCastro Beekhoo, Senior Lecturer at Bloomberg Nursing and Chadwick Chung, a faculty member at the Canadian Memorial Chiropractic College. They saw how well the group worked together and encouraged them to continue focusing on building trust within the team.
“Every level of interaction between the team shone through and set them apart from the competition,” says Beekhoo, who has mentored HCTC teams since 2012. “Watching each of the teams present in Vancouver, I saw how they addressed the case study in terms of their own profession, but when U of T took to the stage, our team viewed everything as one unit working together; using their strengths to collaborate, not set themselves apart.”
The team also provided more of a visual impact and incorporated a North American Aboriginal medicine wheel. Not only was this out of respect for the patient’s beliefs, but also to focus on the four healing elements of the wheel. Each team member dressed in the colour of the medicine wheel, with Keyur in white for the Physical aspect, Patricia in red for the Mental aspect, Leighain black for the Spiritual aspect and Elisa in Yellow for the Emotional aspect. Team ideas were presented based on the four aspects of the medicine wheel, and addressing the needs of the patient as a whole person and as part of a community. At the end, the team joined hands with each other and the patient to visualize the holistic benefits of the medicine wheel.
The judges, Tania Dick, Family Nurse Practitioner, Andrea Burton, Government Relations/Policy/Communications Consultant and Sebastien Tessier, Respiratory Therapist were also duly impressed, both with the presentation and the responses to the final two questions. The teams were given one hour on the day of the challenge to prepare an answer to an additional question addressing the patient/client situation six weeks after the initial visit, where the patient came back with complications and was unhappy with his care plan. Then the teams were given one minute to provide another solution to the same concerns. The repetition of questions indicated to the group that while management plans were solid, there was more to this case than just physical symptoms.
“From the moment we received the case study, we were cognizant of the fact that our patient was Aboriginal and we wanted to address the social, environmental and political factors involved,” says Simpson. “It was in that final minute when everything stood out to us that this scenario went beyond the frontlines and we needed to address the bigger picture. This is an important lesson to take forward as advocates of patient care in our future careers.”
With minimal time to prepare, and fully trusting each other’s judgment, the team spoke about the challenges the patient faced accessing the health care he needed. Location and resources made it difficult for him to follow the management plan and the team acknowledged that health care providers need to advocate for their patients/clients at the system and policy level so they can get equal care, as mandated by the Health Care Act. They were the only team to address these issues. Their response impacted the judges; especially Tania Dick who is Aboriginal and congratulated the team on addressing how, at the end of the day, the patient is a Canadian citizen who should have the same access to health care as every other Canadian.
“Our students are showcasing the impact of the IPE curriculum, but this extends far beyond the university,” says Wagner, who is a member of the international HCTC group. “We’re very conscious of working with our clinical partners to integrate interprofessional education into the practice settings so students can continue to expand on what they’ve learned at the university into the workplace.”
“This experience really showed me that, ultimately, while health care providers have their expertise based in their our particular scope of practice., it is only when we all come together as a team that we are truly able to create the best solutions for our patients,” says Simpson. “As I’ve grown in the nursing profession, I’ve participated in and witnessed the value of teamwork, especially in this competition. It’s made me recognize that these professional relationships begin when we’re students and hopefully continue well into our health care careers. This relationship building has a strong foundation in the interprofessional education curriculum delivered to all healthcare students at the University of Toronto in conjunction with the Centre for Interprofessional Education.”