New study demonstrates impact of interprofessional collaboration on health sciences education and practice

When five USC health sciences schools were brought together under one umbrella, part of the university’s Transforming Health Sciences moonshot, a principal goal was to create a new, integrated and interprofessional approach to the education and practice of health care. 

For more than a decade, the Interprofessional Education and Collaboration for Geriatrics (IECG) has harnessed the collaborative power between the health sciences schools at USC to transform the way that services are delivered to the older adult population, setting a new standard for the future of health sciences education and practice in the process. IECG is a community-based geriatric interprofessional education program that trains up to 150 USC students per year across seven health professions to provide collaborative, coordinated, team-based and patient-centered care specifically tailored to the needs of older adults. 

The latest study from IECG, published in the Journal of Interprofessional Care, brings together professors from all five health USC health sciences schools: USC Suzanne Dworak-Peck School of Social Work, USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Keck School of Medicine of USC, USC Leonard Davis School of Gerontology, and two divisions under the administration of the Herman Ostrow School of Dentistry of USC — the USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy and USC Division of Biokinesiology and Physical Therapy.

The study followed health professionals across seven disciplines, one to three years post-graduation, to determine the impact of IECG on their practice. It is the first such analysis to look at the long-term impact of interprofessional education on practice outcomes. Findings indicate that IECG students take the interprofessional skills into their practices, with many also using these skills beyond their chosen discipline resulting in a more holistic approach to treatment for their patients and clients. The study specifically found that 81 percent of the IECG graduates currently worked on interprofessional teams, 80 percent reported that the IECG experience significantly impacted their practice, and all confirmed they regularly use the validated assessment tools taught in the IECG program. 

“We've really seen over the last decade that this program consistently improves health profession graduate students’ interprofessional knowledge and attitudes and also helps them prepare them for collaborative practice,” said Dawn Joosten-Hagye, first author on the study and professor of social work at USC Suzanne Dworak-Peck. “This is one of the first studies to actually look at how students sustain their interprofessional education training.”

IECG was formed fourteen years ago when Jo Marie Reilly, MD, professor of clinical family medicine at the Keck School of Medicine, went to the deans for each of the major health sciences schools at USC to propose an innovative, interprofessional and collaborative approach to training the next generation of health science practitioners. The deans agreed and IECG was born. The collaborative has included students from dentistry, medicine, occupational therapy, pharmacy, physical therapy, gerontology, psychology and social work. The latest study demonstrates that this interprofessional collaboration positively impacts the education of health sciences students, and its impact extends beyond school into real-world practice.

“We found that the IECG program really afforded students a richer set of skills that they could use to more holistically care for patients,” said Reilly, co-author on the study. “This study has felt really rewarding because one of my dreams when birthing this collaborative 14 years ago was to see that happen.” 

Complex health care is a team sport

Reilly intentionally launched this interprofessional educational initiative with a focus on the complex health care needs of older adults. She found that most students had little familiarity with this rapidly growing patient population and that a collaborative, interprofessional approach offered a very effective, sustainable training model.

The IECG program accepts between 100 to 150 students in each year’s cohort, with as many as 32 students from each health sciences discipline. Over a six-month period, the students participate in 24 hours of didactic seminars consisting of interprofessional education team building, knowledge around working with older adults, and skillsets that are specific to each discipline. Students are then paired with an older adult who they call each week for a minimum of one hour, and complete three in-home visits with an interdisciplinary team that includes one faculty leader. 

“You could line up ten 80-year-olds and they are all going to have completely different needs,“ said Tatyana Gurvich, second author on the study and associate professor of clinical pharmacy at USC Mann. “An older adult is very complex medically, psychosocially, physically and occupationally. A single person can’t take care of all those needs. It’s a team sport.”

One of the values of the IECG program is that students learn essential cross-disciplinary skills and assessments they can provide to patients in their own clinical practices. They also learn about other health sciences-based disciplines they may work with throughout their careers. This is particularly important for professions that are traditionally practiced in isolation from other health care disciplines, such as physical therapy or occupational therapy. This training gives students the confidence to accurately assess their patients’ additional health care needs. Knowing when to consult with colleagues from multiple disciplines can be critical to early intervention in patient care, such as mental health issues or pharmacological side effects or reactions. 

“From a population health perspective, as our population continues to live longer, providers increasingly will be working with older adults, and this work needs to be interprofessional to be effective,” said Ashley Halle, study co-author and associate professor of clinical occupational therapy at USC Chan. 

A distinctive aspect of the IECG program is its focus on the whole patient, including their physical and social environment. Social determinants of health have been found to be responsible for up to 80% of health outcomes and are a growing primary focus of health care practice. This statistic illustrates the importance of fully understanding the complete picture of a patient’s life when assessing and treating their health conditions, and the importance of interprofessional training and practice. However, the majority of health care services are currently delivered in clinical or hospital settings where providers do not always have direct access to information about a patient’s social factors and daily living conditions. For this reason, there is a specific emphasis on home visitation in the IECG program. This provides an opportunity for students to see how clinical recommendations actually play out within the patient’s daily life, environment and circumstances.

“We wanted to expose students to older adults in the community where they live,” said Freddi Segal-Gidan, study co-author and associate professor of clinical neurology at the Keck School and gerontology at USC Leonard Davis. “Too much of geriatric training across disciplines is in hospitals, emergency rooms or nursing homes and that's not where people spend their time. You have to understand where the person is living, what their support system is and what their neighborhood is like, to see them within the context of where they live their lives.”

Adaptable model represents the future of health care

The study’s authors believe their results demonstrate that an interprofessional education model is highly effective and could be readily adapted to multiple populations with complex health care needs. Training USC health sciences students to bring the strength of interprofessional collaboration into their future practices better prepares them for the evolving health care landscape, helping them to more efficiently treat their patients. 

“It is critical to the development of the future of health care providers that they have these skills,” said Cheryl Resnik, study co-author and professor emerita of clinical physical therapy at USC Division of Biokinesiology and Physical Therapy. “We would love to see our model expanded. This program is scalable to other diagnoses, to other ages, to other groups and leads to better patient outcomes.”

Among the populations that Resnik and her IECG colleagues believe could benefit from collaborative interprofessional health care teams are people living with disabilities, transplant recipients, cancer patients, people managing diabetes and children.

“As the world changes, medical practice changes in ways that are unpredictable,” said Segal-Gidan. “Providing people, in their training, the skills that they can use as things change is really essential. These principles are becoming even more core to ensuring practitioners don’t get left behind.”