What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

Medical education online

PubMedID: 27499364

Lie DA, Forest CP, Walsh A, Banzali Y, Lohenry K. What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care. Med Educ Online. 2016;2131900.
BACKGROUND
The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students.

PURPOSE
To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients.

METHODS
The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning.

RESULTS
Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process.

DISCUSSION
Interprofessional SRC participation promotes learning 'with, from, and about' each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.