Interdisciplinary teams are becoming increasingly crucial to improving patient care as the profession of medicine evolves. The relatively stable relationships and hierarchies of the past are more likely to evolve to meet the needs of patient care, especially in acute care environments.¹ Several studies have shown that interdisciplinary training of medical students and allied-health students improves communication and collaboration. These improvements in teamwork have been shown to impact patient care in meaningful ways.²  Teamwork can be hindered by stereotypes of the health professions. Stereotypes of the health professions have been reported to be present in students at the beginning and the end of their training.³ Many of these stereotypes are developed due to ignorance of the role and responsibilities of the profession. “Working together as an effective team requires mutual respect and a knowledge of the skills and abilities of each team member.”³

To address these stereotypes and improve patient care, institutions accrediting medical schools have instituted guidelines for the incorporation of interdisciplinary education into the medical school curriculum. The Liaison Committee on Medical Education’s standard for accreditation includes the following:

ED-19-A. The core curriculum of a medical education program must prepare medical students to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients. These curricular experiences include practitioners and/or students from other health professions. ⁴

 This emphasis is echoed in the Association of  American Medical Colleges’ Guidelines for Medical Schools

An understanding of, and respect for, the roles of other health care professionals,and of the need to collaborate with others in caring for individual patients and in promoting the health of defined populations⁵

The Accreditation Council for Graduate Medical Education, which oversees U.S. residency training also recognizes the importance of collaboration and interdisciplinary professionalism.

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.⁶

Students participating in interprofessional education have been found to rate other health care professionals more positively after their experience than they did prior to the experience.³ What is not clear, is the best way to educate students about health care teams, team-based models of care and the day-to-day activities of their future colleagues.

We propose the integration of a coordinated, one-week, multidisciplinary experience with practicing non-physician professionals in the clinic and hospital settings into the medical school curriculum. The following discusses the development of a interdisciplinary education program based on current perceptions and issues relevant to interdisciplinary training and patient care, and potential barriers to implementation. We used this information, as well as the competencies set forth for medical education by the Liaison Committee on  Medical Education (LCME), the AAMC, the Accreditation Council for Graduate Education, and Mayo Medical School to define the program and its participants’ objectives, and a method by which to evaluate participant performance and the program.

Design

Mayo Medical School integrates interdisciplinary training in its curriculum in several areas. Mayo Graduate School’s Physical Therapy program overlaps its anatomy course with the first-year medical students’ gross anatomy block. Collaboration and peer-teaching between the different programs’ students is incorporated into the curriculum. Second-year medical students and pharmacy students staff the free community medical clinic. This team-based approach with fellow learners in varying areas of study, enables students to work together in a collaborative educational and professional environment.

Building upon this institutional embrace of teamwork, a one-week curriculum was developed within the existing Mayo Medical School “Selectives” program. The MMS selectives program enables first and second-year medical students to select/develop 1-2 week experiences in nearly any area or aspect of medicine. A proposal for the selective is submitted to the medical school’s Selectives Director with a summary of the planned activities, as well as a set of personal learning objectives, and envisaged outcomes. The authors organized a one-week selective in which students shadow non-physician staff members of the hospital health care team. This selective consists of 6 half-day slots of shadowing in fields such as nursing, pharmacy, physical therapy, occupational therapy, social work, respiratory therapy, and administration with several additional slots open for the student to customize the areas of practice and experience desired. Upon completion of the selective, a debriefing session is performed with their physician preceptor, and a reflective essay is written regarding the experience using the following prompts:

• What preconceptions of non-physician patient care professions did you have prior to your selective?
• What did you enjoy?
• Did your perspective change?
• What did you find exciting or frustrating?
• What was your interaction with your preceptor(s) like?
• What is the role of the physician?

Evaluation of each participating student is performed by the staff member being shadowed according to criteria given to them and the student prior to the experience. These evaluations are reviewed by the selective preceptor (a physician) and a passing or failing grade given for the Selective, with feedback included for the student’s review. The student is given the opportunity to participate in a pre- and post-selective survey on their experiences and perceptions.

We surveyed a variety of key players including medical students, nurses, nurse practitioners/physician assistants, physical therapists/occupational therapists, and other allied health professionals regarding their perceptions of integrating interdisciplinary education into the medical school curriculum and changing professional roles in health care. A one-week curriculum was developed based on these responses.

Table 1.    Responses to Survey Questions