Interdisciplinary Training for Medical and Nursing Students: Learning to Collaborate in the Care of Geriatric Patients

Abstract

A medicine clerkship for students at the Albert Einstein College of Medicine provided the setting for a pilot program in interdisciplinary geriatric training with nursing students from the College of Mount Saint Vincent. The program's objectives were to provide opportunities for interdisciplinary collaboration and to increase appreciation for the role of each discipline in caring for the aged. Additionally, it sought to foster a holistic approach to the aging and a recognition of the psychosocial influences on their lives. Teams of one medical and two nursing students conducted patient work-ups and presented cases to an interdisciplinary group of health care professionals. Analysis of pretest-posttest responses of ten medical and ten nursing students to a Role Assessment Questionnaire (RAQ) found that the program significantly increased medical students' perceptions of the nurse's role in caring for hospitalized elderly patients (P less than 0.05). Despite this gain, however, there continued to be substantial discrepancies between medical and nursing students' perceptions of the extent to which nurses are "essential" in caring for the elderly. In evaluating the program, all participants concurred that working with students in another health profession was a valuable learning experience. While nursing students felt that the program achieved all its goals, responses of medical students were more variable, with volunteers having more positive perceptions of program impact than those who were assigned. The program demonstrated both the need for and the effect of interdisciplinary training, and that teaching and clinical experiences centering around the hospitalized older person can provide a natural setting for such training.

Evaluation of Evidence for Interprofessional Education

“…On inspection by the second reviewer, 6 of these were subsequently excluded, resulting in 13 articles included in the final review (Table 1). [23][24][25][26][27][28][29][30][31][32][33][34][35] Two studies from the same group employed the same intervention and evaluation methods to medical and social work students, and medical and nursing students, respectively. 27,28 Two other studies did not report results but were included to provide a more complete description of study designs, interventions, and measurement methods.…”

“…Five studies developed their own questionnaires and described some of their features (eg, number of items, response scales). 25,30,32,33,35 Of these 5, 2 studies reported measurements of survey reliability or validity. 32,35 The instruments used in the remaining 4 studies 26,28,34 were not described.…”

“…35 The interventions chosen for the 13 trials were mainly a combination of didactic instruction with clinical training. [23][24][25]30,32,34,35 Two studies from the same research group utilized an intervention consisting of didactic instruction only, including a fictitious case for students to evaluate and report on. 27,28 Three trials apparently consisted only of clinical interventions.…”

“…Most studies employed a pre-test/post-test design to measure and compare their chosen outcomes. [23][24][25][26][27][28][29][30][31][32][33][34] Only 3 trials used a parallel group comparison 23,30,35 and only 1 of these employed random assignment of teams to an active or control group. 35 The interventions chosen for the 13 trials were mainly a combination of didactic instruction with clinical training.…”

“…While some were discrete experiences, 27,28,32,35 others were weeks or months long and were set in actual clinical practices. [23][24][25][26][29][30][31]33,34 Many included didactic educational experiences about participating on teams. 23,27,28,31,32 Despite most interventions being conducted as part of educational curricula for health professions students, participation in the studies was often voluntary.…”