2022-23 Progress Report from the University of Michigan Center for Interprofessional Education

2022-2023 PROGRESS REPORT

INNOVATING AND IMPLEMENTING INTERPROFESSIONAL EDUCATION to Improve the Quadruple Aims of Health

MICHIGAN CENTER FOR INTERPROFESSIONAL EDUCATION Why do great teams matter?

This question is at the center of our work at the Michigan Center for Interprofessional Education (C-IPE). I find myself thinking about the answer every day, and have realized this simple question actually has a simple answer. Great teams matter because great teams can improve health. Period.

Many saw this on display at Health Professions Education Day through the story of a patient who had a stroke and the strides he’d made through collaborative teamwork with the HEART program at UM-Flint. I was touched by their story, but unaware of how much it would affect me personally.

Ten days later, I suffered a stroke of my own.

I felt panic, anxiety, anger and fear as I was taken to the hospital emergency room and later admitted to the University of Michigan stroke unit and rehabilitation hospital.

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But through this personal journey, my emotions changed as I met the 125 members of my different care teams, each of whom treated me with respect, courtesy and love. I felt included in all decisions and was a true partner on their teams. Together, they came from 24 different professions and each contributed immensely to the care I received. I was so moved and inspired by my experience that I kept track of each and every one of their names. I want to remember and recognize every one of them.

The care and love I felt from my teams may be the most inspiring part of this chapter of my life. And it reflects what I experience from the teams who work on this mission at C-IPE. Everyone is so dedicated and caring in the work they do to advance interprofessional teamwork to improve health.

Rajesh Mangrulkar speaks with Craig and Cindy Hawkins about how a stroke impacted their family at HPE Day 2023.

Throughout this report, you will read about five interconnected strategies that support a single goal: innovating and implementing IPE at U-M to improve the Quadruple Aims of Health.

Collaboration and teamwork are at the heart of this goal, and everything we do.

I know that by training our students to work together from day one with the goal of improving health, we are setting them up for success.

I now deeply and personally understand the potential impact of our mission.

With gratitude for all of our teams and for your interest, Rajesh S. Mangrulkar, M.D. Director, Michigan Center for Interprofessional Education (C-IPE)

COLLABORATING U-M SCHOOLS AND COLLEGES School of Dentistry College of Education, Health & Human Services (UM-Dearborn) College of Health Sciences (UM-Flint) School of Kinesiology Medical School School of Nursing School of Nursing (UM-Flint) College of Pharmacy School of Public Health School of Social Work

MISSION Innovating and transforming interprofessional education, collaborative practice and research to achieve the Quadruple Aims of Health.

VISION The University of Michigan Center for Interprofessional Education and its partners bring faculty, staff and students together to design and implement innovative interprofessional education experiences in didactic and experiential settings so that learners are effective team members and can lead the development of new models of collaboration. The Center partners with university and community units in developing and educating learners in these new models of interprofessional collaboration in the practice and community settings. Collectively, we strive to measure the impact of IPE on learning, practice and the Quadruple Aims of Health.

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OUR PARTNERS We are grateful for our collaborating partners who help support our mission.

University of Michigan

Michigan Medicine

Center for Academic Innovation (CAI)

Office for Health Equity and Inclusion (OHEI)

Center for Educational Outreach (CEO) Center for Research on Learning and Teaching (CRLT) Department of Learning Health Sciences (DLHS) Edward Ginsberg Center for Community Service and Learning Health Equity. Action. Research.

Teaching. (HEART) at UM-Flint Information and Technology Services (ITS) Institute for Healthcare Policy and Innovation (IHPI) Taubman Health Sciences Library (THSL) University of Michigan Student-Run Free Clinic (UMSRFC)

Office of Patient Experience (OPE) Health Information and Technology Services (HITS) Quality Department Research. Innovation. Scholarship.

Education. (RISE) University of Michigan Medical Group (UMMG) Wellness Office

Community Cranbrook Tower Detroit Public Schools Community District Hamilton Community Health Network Parkway Meadows

National and International “I really, truly believe that the University of Michigan is the

American Interprofessional Health Collaborative (AIHC)

right place to move forward

Big Ten IPE Academic Alliance

this incredibly important initiative. It has an incredible

Canadian Interprofessional Health Collaborative (CIHC)

history and an incredible

Institute for Healthcare Improvement (IHI)

group of deans that are leading the different schools that can really make us a world leader in

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The Marteney Group National Academies of Practice (NAP)

interprofessional education.”

National Center for Interprofessional Practice and Education

~ U-M President Santa J. Ono, Ph.D., opening remarks at 2023 Health Professions Education Day

University of Toronto Centre for Advancing Collaborative Healthcare & Education (CACHE)

STUDENT ADVISORY COMMITTEE (SAC) SAC works collaboratively with C-IPE to ensure students are part of the driving force towards the future of interprofessional education and collaborative care at the University of Michigan. Co-chairs act as liaisons between health science students, health science school faculty and leaders, and C-IPE.

From left: SAC co-chairs Tommy Lau (School of Dentistry), Nikki Trupiano (Medical School) and Natalya Salganik (College of Pharmacy) participated in HPE Day through planning and presentations.

Highlights from this past year include: •

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Working with the Interprofessional Community Health Collaborative and organizing IPE events for students.

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Participating on the Health Professions Education (HPE) Day planning committee and organizing a student-led panel featuring UM-Flint’s HEART program.

Presenting scholarly work at conferences and events including Nexus, Collaborating Across Borders and HPE Day.

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Developing the Longitudinal Interprofessional Family-Based Experience (LIFE) offering and collaborating on the revamping of the Introduction to IPE module.

Organizing an in-person trivia social for members of Team-Based Clinical Decision Making to reinforce relationships between students from multiple disciplines.

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Published Trupiano N, Lau T, Gururaj A. Restructuring interprofessional education: a student-driven strategic plan. Acad Med. 2022;97(8):1106-1107.

SAC co-chair, Nikki Trupiano, received the AIHC Student Award for Interprofessional Collaborative Practice, the highest national IPE award for a student.

Health Science Deans

Provost

Leadership Team

Curriculum Committee * Core Curriculum Workgroup *

Experiential Innovation Workgroup *

Executive Committee *

Student Advisory Committee *

Chair: Director

Intentional Measurement Workgroup *

Educator Development Workgroup *

Systems-Based Problem Solving Workgroup

* Indicates Student Participation

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FIVE STRATEGIES FOR IMPROVING THE QUADRUPLE AIMS OF HEALTH

STRATEGY 1: THE CORE CURRICULUM GOAL:

WHY:

Strategically review, enhance and scale the IPE “Core” for students at the University of Michigan.

To prepare a broad base of students with consistent, foundational knowledge of and attitudes toward IPE so they can engage effectively in interprofessional learning and practice in experiential settings.

Introduction to IPE Teams and Teamwork

Team-Based Clinical Decision Making

Didactic

INTRODUCE

REINFORCE

Experiential

INTRODUCE

REINFORCE

Patient/Community Interaction

PRACTICE

Longitudinal Interprofessional Family-based Experience (LIFE)

The Core Curriculum: By the Numbers LIFE:

Intro to IPE:

Teams and Teamwork:

Team-Based Clinical Decision Making:

237 students 1,597students 884 students 518 students 25 faculty 41 faculty 14 faculty 10 faculty 28 patient advisors “This experience taught me to appreciate working in interprofessional teams and groups with diverse backgrounds and perspectives.” ~ Blake Hardin, medical student and participant in LIFE 6

Partner Highlight: Center for Research on Learning and Teaching (CRLT) C-IPE partners with CRLT to utilize their expertise in teaching and learning to support the work being done as part of the core curriculum, intentional measurement and research, and educator development strategy areas.

BUILDING MOMENTUM Longitudinal Interprofessional Family-Based Experience (LIFE) In partnership with the Office of Patient Experience, LIFE partners interprofessional teams of students with a patient to support students in learning about the experiences and challenges that patients face when navigating the healthcare system. Students also learn from and collaborate with students across the health sciences. For the first time in its three years, LIFE was embedded into health professional programs. It was added to the Bachelor of Science in Nursing and the Doctor of Physical Therapy programs, leading to a final enrollment of 237 students. Next year, the team is hoping to double participation by embedding it into the curriculum for even more health professional students. Additionally, the online modality — a course innovation arising out of the pandemic — has helped reduce barriers to participation and offers greater diversity of perspectives than would be available by meeting in person.

Awards for IPE Innovation and Excellence For the fifth year, C-IPE recognized those who have made outstanding contributions in advancing interprofessional education and practice with the Awards for IPE Innovation and Excellence. This year’s recipients included both an individual and team honoree.

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Nikki Trupiano, Student Award • for IPE Innovation and Excellence This award encompasses the breadth and depth of IPE work that Trupiano (Medical School) participated in while a student at U-M. Notable contributions included helping create and implement LIFE, working with staff and faculty on two IPE introductory modules, and participating in numerous conferences, presentations, posters and publications.

Health and Disabilities Team, Faculty/Staff Award for IPE Innovation and Excellence This team designed and created a new set of innovative and experiential interprofessional (IP) activities within the elective course Health and Disabilities, with the goal of creating an IP healthcare workforce capable of providing a person-centered approach to patients with disabilities. Team members included: Steven Erickson (College of Pharmacy), Jillian Woodworth (College of Health Sciences, UM-Flint), Laura Smith (College of Health Sciences, UM-Flint) and Jeanne Andreoli (Center for Research on Learning and Teaching).

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FIVE STRATEGIES FOR IMPROVING THE QUADRUPLE AIMS OF HEALTH

STRATEGY 2: EXPERIENTIAL INNOVATION GOAL:

WHY:

Launch a suite of experiential IPE pilots that can scale and, as a whole, will address key needs for learning in the practice and community setting for students of the health professional schools and colleges.

To prepare learners to be “team-ready,” which requires education that moves from theory to practice. Students must be able to function effectively in collaborative teams to serve patients and populations.

“These events allow

Partner Highlight: Edward Ginsberg Center for Community Service and Learning

students to meet people in the communities where they live, which helps them to understand how social determinants of health act

C-IPE collaborated with the Ginsberg Center to support the Interprofessional Community Health Collaborative, a team dedicated to expanding interprofessional education in community health settings.

as facilitators and barriers to good health.” ~ Sarah Vordenberg, Pharm.D., M.P.H., clinical associate professor of pharmacy

Experiential Innovations: By the Numbers Cranbrook Tower participation

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students

5

preceptors

34

community residents

TEAMS participation Activity 1: Observe

15

students Activity 2: Analyze

22

students

8

3

faculty

4

faculty

BUILDING MOMENTUM Interprofessional Community Health Collaborative (ICHC) The ICHC is dedicated to expanding IPE to community health settings to mutually benefit both students and the local community. Their first event at Cranbrook Tower included students from medicine, pharmacy and nursing, who worked together to educate residents about nutrition, exercise and healthy blood pressure. The events are intentionally designed to be flexible so that participants from other disciplines can be included in the future. The team plans to expand to more community sites over the next year, including an upcoming event with residents of Parkway Meadows.

Teams Engaging to Acquire Meaningful Skills (TEAMS) Adapted from the Flexible Activities created by the Centre for Advancing Collaborative Healthcare & Education (CACHE) at the University of Toronto, TEAMS activities provide experiential learning opportunities for students in early, mid and advanced learning stages following a scaffolded learning continuum of 1) Observe, 2) Analyze and 3) Collaborate.

The School of Nursing integrated the first two TEAMS activities into their winter 2023 B.S.N. rotations, with more programs hoping to integrate them moving into 2023-24.

Supporting the Design of Experiential IPE This year, C-IPE updated the criteria for experiential interactions to support the design of experiential IPE and to reduce the barriers to capturing IPE that is happening in real time. To be considered “experiential,” participants must include a balanced mix of individuals (students, practitioners and faculty) from two or more disciplines who are engaged in learning about, from and with each other.

Content should include intentional teaching of one or more of the five IPE core competencies with a specific IPE learning focus or discussion.

The activities may include a variety of interaction types, determined by learning objectives and learner competencies.

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FIVE STRATEGIES FOR IMPROVING THE QUADRUPLE AIMS OF HEALTH

STRATEGY 3: INTENTIONAL MEASUREMENT & RESEARCH GOAL:

WHY:

Implement a portfolio of valid assessment tools in our IPE experiences that measure outcomes reliably and consistently.

Learners need to be given information from measurements that will help them develop into effective real-world teammates in the healthcare practice and community settings.

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We need to generate evidence that IPE impacts learning, practice and health outcomes (aligned with the Quadruple Aims of Health).

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The scholarship should inform how IPE is implemented both at U-M and nationally.

Scholarship: By the Numbers

CAB VIII:

Nexus Summit 2022:

presentations

presentations

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The U-M team representing C-IPE at Nexus Summit 2022

Improved Patient Experience

Better Health Outcomes

Quadruple Aim

Improved Staff Experience

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Peerreviewed publications:

49

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Led member-wide leadership sessions on experiential IPE at American Interprofessional Health Collaborative (AIHC).

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Led seminar on “Leading Change in IPE” at National Academies of Practice (NAP).

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Presented poster on “Identifying Opportunities to Enhance Team-Based Care with Systems Data” at Institute for Healthcare Improvement (IHI).

Partner Highlight: Institute for Healthcare Policy and Innovation (IHPI) Lower Cost of Care

C-IPE is building a partnership with IHPI to develop a program that measures the impact of IPE and team-based care on the Quadruple Aims of Health, bringing together researchers, clinicians and educators on this mission.

BUILDING MOMENTUM Conference Highlights University of Michigan faculty, staff and students shared their presentations and research with national and international audiences.

Nexus Summit 2022 sample presentations: •

Student-led seminar series geared toward increasing interprofessional education.

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Interprofessional pharmacy experiences in dental clinics.

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Developing awareness of the social determinants of health by engaging early health professions students with real patients.

CAB VIII sample presentations: •

Data exploring relationships between workforce well-being, patient experience and teamwork.

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Advancing anti-racism through IPE practices.

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Innovations in IPE faculty recruitment, engagement and retention.

Peer-Reviewed Publications from U-M Faculty, Staff and Students The following is a sample of publications from the past year: •

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Hollenbeck J, Smith L, Muralidhar S. Exploring interprofessional roles and responsibilities of physical therapists and radiation therapists during the care of patients with breast cancer using IPE. Journal of Interprofessional Education & Practice. 2023 Sep 1;32:100640.

practice through the lens of acute care physical therapists: a case series. J Acute Care Phys Ther. 2023 Apr;14(2):93-103.

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Pandian V, Atkins JH, Freeman-Sanderson A, Prush N, Feller-Kopman DJ, McGrath BA, Brenner MJ. Improving airway management and tracheostomy • care through interprofessional collaboration: aligning timing, technique and teamwork. J Thorac Dis. 2023 May 30;15(5):2363-2370.

Yorke AM, Smith LM, Mostrom E. The impact of COVID-19 on interprofessional collaborative

Allen BB, Schiller JH, Roberts SJ, Allen SG, Morgan HK, Malone A. Collaboration in interprofessional teams: A needs assessment of factors that impact new resident physicians [published online ahead of print, 2022 Jul 26]. J Interprof Care. 2022;1-8.

Waldron-Perrine B, Mudar R, Mashima P, Seagly K, et al.

Interprofessional collaboration and communication to facilitate implementation of cognitive rehabilitation in persons with brain injury. J Interprof Care.

2022;36(4):529-537.

For a more thorough list of publications, please visit interprofessional.umich.edu.

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FIVE STRATEGIES FOR IMPROVING THE QUADRUPLE AIMS OF HEALTH

STRATEGY 4: EDUCATOR DEVELOPMENT GOAL:

WHY:

Implement a development and training program drawn from the identified needs for faculty and practitioner IPE educators in both teaching and assessment.

We must develop a community of collaborative practitioners, educators and scholars to prepare future healthcare providers to be team ready.

“I think emphasizing teambased care is important. In

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The education and assessment of team-based behaviors in students from multiple disciplines raises new challenges for educators.

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An educated and trained IPE community is required to sustain and expand IPE across the university.

the Quality Department, we want to model respect for

Partner Highlights: Office of Patient Experience (OPE)

interdisciplinary expertise.

I recognize that physicians do not carry expertise for all aspects of a patient’s care, and we care for patients in teams. One of the things we can do as leaders is help support the voices of those who are advocating for the patients or may have expertise for a patient. This could be a nurse, medical assistant,

C-IPE partners with OPE to support educator development, core curriculum and experiential innovation. Highlights this year include analyzing patient data to provide insight on enhancing team-based care and providing access to patient advisors to work with interprofessional teams of students participating in the LIFE course.

pharmacist or a family member.”

Wellness Office

~ Brook Watts, M.D., M.S., chief quality officer in Michigan Medicine’s Quality Department

C-IPE is partnering with the Wellness Office to analyze workforce data as it relates to teamwork, which will be used to implement team-based interventions.

Educator Development: By the Numbers

HPE Day registered attendees:

214

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HPE Day poster presentations:

49

HPE Day IP facilitation workshop:

13

BOOST! workshop:

24

The Marteney Group leadership training:

15

BUILDING MOMENTUM Health Professions Education (HPE) Day 2023 The 8th annual HPE Day brought faculty, staff and student attendees from all three U-M campuses together for a day that highlighted interprofessional education, collaborative care and the scholarship of learning and teaching. Notable presentations included opening remarks from U-M President Santa J. Ono, a moving student-led panel featuring participants from UM-Flint’s HEART program and lightning talks and poster displays. After the formal event, a small group participated in an IP facilitation workshop, adding a skill-building component to the day for the first time.

Giving a BOOST! to Team-Based Collaborative Care C-IPE partnered with facilitators from CACHE at the University of Toronto to participate in the virtual BOOST! workshop (Building Optimal Outcomes from Successful Teamwork). Those involved in educator development and experiential innovation participated in this workshop that focused on how to optimize teamwork in the clinical space. The team is now planning to repackage this information for broader implementation at Michigan Medicine.

Enhancing Team-Based Care with Systems Data C-IPE dedicated time and energy to exploring ways in which we could add value to the clinical enterprise. We partnered with Michigan Medicine’s Office of Patient Experience and the Wellness Office to understand what types of team-based interventions could have the greatest impact on both patient and healthcare professional experiences.

Leadership Team Coaching with The Marteney Group The C-IPE Leadership Team, made up of the co-chairs of all the committees and workgroups, participated in leadership development and professional coaching, facilitated by The Marteney Group.

Leadership team members will utilize the skills they’ve developed as leaders of each strategic workgroup.

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FIVE STRATEGIES FOR IMPROVING THE QUADRUPLE AIMS OF HEALTH

STRATEGY 5: SYSTEMS-BASED PROBLEM SOLVING GOAL:

WHY:

Establish a workgroup that will address the most pressing challenges to our Goal and Strategies.

Progress on strategic initiatives depends on addressing systemic, structural and organizational challenges to interdisciplinary teaching and learning. Maturation of the Center requires us to directly address our organizational challenges as initiatives continue and grow.

Partner highlights: Information and Technology Services (ITS) C-IPE collaborated with ITS to leverage Canvas in tracking student competency attainment in IPE offerings.

School of Dentistry The School of Dentistry led the infrastructure development for the IPE data visualization system, leveraging enterprise data systems like Canvas and student records and connecting them to the IPE database.

Big Ten IPE Academic Alliance The Big Ten IPE Academic Alliance aims to facilitate sustainable interprofessional practice and education through

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multi-institutional collaboration, innovation, scholarship and resourcesharing that leads to improved education, better care, added value and healthier communities. C-IPE is collaborating with the alliance to expand the IPE data visualization infrastructure and system across institutions, supporting them in their IPE strategic efforts but also creating opportunities for cross-institutional research.

Center for Academic Innovation (CAI) C-IPE is partnering with CAI to develop a student-facing version of the IPE data visualization system, which will allow students to track their IPE competency development throughout their programs.

BUILDING MOMENTUM Competency-Based Tracking for Interprofessional Education Leveraging Institutional Data After working with ITS to bring IPE data together from across the institution, the focus is now on creating a model that can be piloted for feedback among stakeholders. The team has focused on showcasing IPE efforts and experiences for educators and students across all collaborating units by 1) making them visible and 2) through deliberate tracking. The first step has been making the teaching efforts of faculty visible through the DataViz platform.

“It is a big step forward in being able to track IPE competencies that students achieve through diverse learning experiences from our different health science schools.” ~ Gundy Sweet, Pharm.D., assistant dean for curriculum and assessment in the College of Pharmacy and the team lead for the IPE data visualization project

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CONNECT WITH US Do you have an interest in learning more about interprofessional education?

We invite you to connect with us on social media, join our mailing list or reach out for more opportunities. Learn more by visiting our website.

Michigan Center for Interprofessional Education 5100 THSL, 1135 Catherine Street • Ann Arbor, MI 48109 IPEcenter@umich.edu interprofessional.umich.edu @umichHealthIPE facebook.com/IPEcenterUM The Michigan Center for Interprofessional Education is supported by the Provost and the Health Sciences Council of Deans.

Executive Officers of Michigan Medicine Marschall S. Runge, M.D., Ph.D., Executive Vice President for Medical Affairs and Dean, Medical School, CEO, Michigan Medicine (chair); Steven L. Kunkel, Ph.D., Executive Vice Dean for Research, Chief Scientific Officer, Michigan Medicine, and Professor, Departments of Molecular and Integrative Physiology and Internal Medicine; David C. Miller, M.D., MPH, Executive Vice Dean for Clinical Affairs and President, U-M Health System (ex officio); Debra F. Weinstein, M.D., Executive Vice Dean for Academic Affairs and Interim Chief Academic Officer, Michigan Medicine Regents of the University of Michigan Jordan B. Acker, Michael J. Behm, Mark J. Bernstein,​Paul W. Brown, Sarah Hubbard, Denise Ilitch, Ron Weiser, Katherine E. White, Santa J. Ono, ex officio. © 2023 Regents of the University of Michigan Nondiscrimination Policy Statement The University of Michigan, as an equal opportunity/affirmative action employer, complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University of Michigan is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight, or veteran status in employment, educational programs and activities, and admissions. Inquiries or complaints may be addressed to the Senior Director for Institutional Equity, and Title IX/Section 504/ADA Coordinator, Office for Institutional Equity, 2072 Administrative Services Building, Ann Arbor, Michigan 48109-1432, 734-763-0235, TTY 734-647-1388, institutional. equity@umich.edu. For other University of Michigan information call 734-764-1817

Cover photo: University of Michigan-Flint faculty and students work with patients as part of the HEART (Health Equity. Action. Research. Teaching.) free rehabilitation clinic.

(Photo Credit: Michigan Photography/Eric Bronson)