Al Brandt lit up with a smile when Jami Jackson walked into the room. Now that his knee surgery was behind him, he was ready to begin physical therapy.
“I’m just excited about getting up, learning to walk again, and getting back out on the pickleball court,” he said.
Jackson, a second-year physical therapy doctoral student at University of Lynchburg, took Brandt’s vitals and talked about his recovery so far — all was well, he reported. But after Jackson helped him stand up and grasp a walker, Brandt started trembling. Pain and fear swept over his face. He clutched his chest.
Jackson helped him lie down, took his vitals again, and called for a nurse. Rachel Edwards ’18, a senior nursing major, assessed the situation and called for Caitlin Pickeral, a first-year physician assistant medicine student.
“I’ve never had this kind of pain before,” Brandt said. “Am I having a heart attack?”
Pickeral comforted Brandt; she didn’t know whether he was having a heart attack, but they were there to take care of him. She talked with Edwards and Jackson about what to do next.
Then a knock on the door signaled that the simulation was over. It was all an act.
Brandt, who acts as a patient in simulations at the Central Virginia Center for Simulation and Virtual Learning, complimented Jackson, Edwards, and Pickeral for communicating well with him and each other. If he had been an actual patient in a real emergency, he would have felt comforted by them and confident in their teamwork. “Not only do I feel like I have a good person to take care of me, but I’ve got a good team,” he said.
That’s exactly how health care providers hope their patients will feel, which is why University of Lynchburg professors who teach students in health-related fields —nurses, PAs, physical therapists, special education teachers, mental health counselors, and athletic trainers — are working together to make sure their students are ready to communicate and collaborate when it matters most. About a year ago, a dozen professors created the University of Lynchburg Health Interprofessional Education Task Force.
“They’ve been charged to develop and grow a culture of interprofessionalism in our graduate and undergraduate programs,” said Dr. Rusty Smith, a DPT professor and dean of the School of Graduate Health Sciences.
“Schools often teach these students in silos — someone who is studying nursing might never see a physical therapist, or a physical therapy student might never see a PA. When they go out into the world they have to work with someone who has a different skill set and perspective.”
Those differences are more serious than different jargon or ideas about best practices. Studies have shown patients are more likely to survive, recover quickly, and be satisfied with their care when provider teams function like a well-oiled machine. As University of Lynchburg becomes the University of Lynchburg and the health professional programs become a part of the College of Health Sciences, the faculty members see more opportunities to help students be prepared for the interprofessional atmosphere of hospitals and other medical settings.
“We need to educate clinicians in a collaborative fashion,” he said.
Efforts to educate healthcare professionals alongside each other predate the official task force. A couple of years ago, faculty members from DPT, PA, and nursing programs started planning simulations in collaboration with Centra, a local healthcare organization that operates the simulation center. After a successful pilot last year involving three students from each program, they expanded it to involve more students this year.
“We were excited to be able to use this as a bridge to clinical practice,” said DPT professor Dr. Garretson Gellert, a member of the task force who helped initiate the collaborative simulations. “In clinical practice, it’s not often you work as a sole provider. You have to have a good team.”
Nursing faculty saw benefits in the arrangement, too. “Learning to communicate with the other members of the team is critical for positive patient outcomes,” said Jill Foster, a nursing professor who helped launch the interprofessional simulations. “This really allows them the opportunity to learn how to communicate with and collaborate with other members of the team.”
After Jackson, Edwards, and Pickeral finished their simulation with Brandt, they met with Dr. Allen Moore, a Lynchburg DPT professor, to assess their performance. “Each of you did your professions proud,” Dr. Moore said.
Rather than rattle off a list of things the team did well or needed to improve, he asked questions to help them reflect on the experience and teach each other. They talked about the different ways they approached the patient and the different tests they might use to diagnose the problem.
Edwards said Jackson had handed off the patient perfectly. Pickeral had a similar experience. “I feel like I got a really good story” about the patient’s background and his symptoms, she said. “You two were able to get that to me effectively and efficiently.”
Jackson said Pickeral had done a great job comforting the patient and had taken control of the situation well, without making the physical therapist in the room feel unnecessary.
Having completed her first clinical rotation this past summer, Jackson said she sees the value that will come from interprofessional education. “I think it’s awesome that they are doing this,” she said. “This is really helpful in building communication skills and practicing them now, in a more relaxed way.”
Pickeral added, “I think this is really helpful to find that we can work together.”
Now that interprofessional simulations have started, the task force is working on other opportunities. Faculty are planning seminars where students from different health care disciplines would hear speakers discuss topics that all providers must be familiar with — such as medical ethics, conflict resolution, and teambuilding — so they have more common ground.
Other opportunities include possibly working together on community service, including international medical mission trips, and in the University of Lynchburg Community Health Clinic, where DPT students treat community members who do not have insurance to cover the physical therapy they need.
“As our students receive more opportunities to learn alongside their peers who are going into other professions, we will prepare graduates to work with modern, diverse health care teams to reach the best patient outcomes possible,” Dr. Smith said.