Breaking Down the Silos: Interprofessional Education Comes to Columbia Nursing

Collaborative practice and a team-based approach to care are rapidly becoming hallmarks of America’s changing health care system.  The Affordable Care Act and recommendations by such prestigious organizations as the Institute of Medicine are ensuring that providers from diverse professional backgrounds address the increasingly complex needs of their patients by practicing in coordinated health care teams to help improve outcomes and streamline health care services.

“Historically, health care education was conducted in silos,” said Jeffrey Kwong, DNP, MPH, ANP-BC and Assistant Professor of Nursing at Columbia School of Nursing.  “Only after graduation from their respective professional schools did providers from various disciplines learn to work together.” But by that time, each profession — whether nursing, medicine, dentistry, physical therapy, social work or pharmacy — communicated using a specialized vocabulary and didn’t have a clear idea what each of the other caregivers could contribute.  “That silo mentality could lead to poor patient care,” says Kwong. “So today the trend is toward educating providers together.  Coordinating language and training helps increase understanding among the various health care disciplines for the benefit of the patient.”

Laurel Daniels Abbruzzese, PT, EdD and Director of Clinical Education at Columbia University Medical Center (CUMC), agrees: “Interprofessional education is being driven by the recognition that patient care can be improved by changing the way we teach and organize health education.  Twenty years ago, we had no interprofessional education in class, only in clinic.  But the idea has been percolating for a long time, and today interprofessional education is finally starting to catch fire.”

Last summer, Kwong and Abruzzese brought together seventy-five of Columbia’s Nurse Practitioner, Physical Therapy and Medical students for a joint clinical seminar focused on geriatric care.  The students worked in collaborative teams to discuss and review two clinical scenarios.  While the seminar focused on enhancing caregiver competency with geriatric patients, the skills students gained are applicable across disciplines with other patient groups. 

“This was the first time we’ve done something like this at Columbia,” Kwong said. “The seminar’s goal was to allow students to work as a team and be as comprehensive as possible in their approach to patient care.”    

Comments by students provided at the end of the seminar indicated that they grasped the benefit of interprofessional education. 

“Eventually we will be working and collaborating together after we graduate,” wrote one student, “but it’s a lot less intimidating to learn how to collaborate while we’re still students before we work together in the field.” Many student comments reflected an enhanced appreciation of the various responsibilities and contributions by different members of the care team and how they can work more effectively as a whole.  As one student wrote, “It was eye-opening to witness the thought processes of another profession.”

Given the seminar’s success, Kwong and Abbruzzese hope to create a new interprofessional collaborative practice course for the Fall 2015 curriculum.  In addition, the Adult-Gerontology Primary Care NP program is starting a new interprofessional education project in September with the College of Dental Medicine that will include AGNP students seeing patients alongside dental students.

“Going forward, we are looking forward to developing didactic and academic course content with clinical experience emphasizing interprofessional care,” Abbruzzese said.  “We want to coordinate more experience between disciplines early in our programs.”