Medical, nursing, pharmacy and law students from KU are working together at KUMC's family medicine clinic

November 17, 2011

By Donna Peck

Nursing student James Machauf and medical student Allison Edwards talk with a patient at the KUMC family medicine clinic.

Three students - one from the University of Kansas School of Medicine, one from the School of Nursing and one from the School of Pharmacy - huddle around a conference table in KU Medical Center's new family medicine clinic. The three students have just examined a patient with advanced diabetes who hasn't been feeling well, and they are reporting their observations to a group of faculty mentors from their three respective schools. After the students describe their examination of the patient, the faculty members pepper them with questions.

"How often is she testing her blood sugar?"

"When was her last colonoscopy?"

"How high is her blood pressure?"

The nursing student reports the patient's blood pressure was significantly higher than at her last examination. One of the professors asks the students whether they think the high blood pressure could be a medication or a stress issue. The pharmacy student mentions that the patient admitted she had stopped taking one of her medications because she can't afford the $150-a-month co-pay. The students and teachers then brainstorm solutions that could help the patient get the medication she needs to manage her diabetes.

Situations like this are playing out several times a week as part of KU Medical Center's new interprofessional student clinic. The clinic, which launched in August of this year, allows third-year medical students, senior nursing students, sixth-year pharmacy students and KU law students to work together as a team, with faculty supervision, to diagnose and recommend treatment to patients at the KU family medicine clinic.

Doctors, nurses, pharmacists and other professionals have traditionally worked in parallel universes when it comes to health care, but many academic health centers are beginning to explore how students and patients could benefit from a more cohesive approach.

"When many of us went to medical school, there wasn't anything mentioned about interprofessionalism other than the general notion that you're supposed to be nice to the people around you," says Heidi Chumley, MD, senior associate dean for medical education. "There wasn't much thought given to how all of us were to function as a team."

Chumley says School of Medicine leaders had been thinking about an interprofessional clinic for some time, and the idea finally came to fruition at the beginning of the 2011-12 academic year. Now students from medicine, nursing and pharmacy can opt to take a rotation in the clinic.  KU law students can also be brought in when there are legal issues surrounding a patient's medical care.

Courtney Tenbarge, RN, MNSc, a clinical instructor with the School of Nursing, says the goal of the clinic is to teach students to work in teams while they are still in school, in the hope that they will carry that over to their clinical practices. "We are training all these health care professionals on our campus, and it's critical that we give them the opportunity to collaborate while they're still students. The first time a doctor, nurse and pharmacist work together should not be after graduation."

Allison Edwards, a third-year medical student who is doing a rotation at the clinic, agrees. "We all need to be on the same page for the good of our patients. Being part of the clinic is really helping me understand the benefits of working together."

Edwards just spent the morning examining patients with James Machauf, a nursing student. Machauf says he signed up for the interprofessional clinic because there isn't much of an opportunity in nursing school to interact with medical and pharmacy students. "It's so exciting to be part of a health care team that consults one another about patients. I don't know if this is what it will be like in an actual clinical situation after we graduate, but I hope this will help all of us down the road."

The pharmacy students seem especially pleased to be part of the clinic. James Kleoppel, PharmD, is a clinical assistant professor at the KU School of Pharmacy and works as a faculty advisor at the clinic. Kleoppel says pharmacy students rarely have the chance to see patients in a clinical setting. "I think the clinic gives our pharmacy students some valuable insight into how and why physicians prescribe the medications they do," Kleoppel says.

Katie Blackbourn, a sixth-year pharmacy student, says she jumped at the opportunity to observe doctors, nurses and patients in a clinical situation. "It's a fact of life that most pharmacists only interact with patients across a counter when they are handing you a prescription. This has been such a great experience to actually see doctors and nurses at work and to talk with them about the best medicines to prescribe for a particular patient."

Perhaps one of the most interesting aspects of KU Medical Center's interprofessional clinic is the involvement of the KU law students. Eunice Lee-Ahn, a fellow with the KU Medical-Legal Partnership Clinic, says that because of malpractice issues, medical and legal professionals often have adversarial relationships. The clinic helps show future doctors and lawyers the benefits of working together. "There are times when a medical solution to a patient's problem is not enough," Lee says. "The clinic really gives the medical and nursing students the chance to see how lawyers can be of great assistance in making sure patients get the best care."

The law students can help patients resolve past-due medical bills, apply for disability and general financial assistance, deal with immigration issues, research safe housing and navigate divorce and custody disputes.

KU has been one of the country's pioneers when it comes to partnerships between medical and law students. Since 2008, the KU Medical-Legal Partnership Clinic has provided KU law students with the opportunity to assist clients referred to them through Southwest Boulevard Family Health Care in Kansas City, Kan. The health clinic serves some of the state's poorest residents and is staffed, in part, by medical students volunteering at the JayDoc Free Clinic.

Although the interprofessional clinic has only been operational for a few months, the faculty mentors and the students already consider it successful in giving students a broader understanding of what it means to be part of a health care team.

"We shouldn't assume that our students will automatically acquire professional communication and effective teamwork skills - we need to give them a place to develop those tools," Chumley says. "The clinic is such a great opportunity for all our students to learn to communicate and work together. And the ultimate beneficiary of this will be their patients."

Categories: School of Medicine, School of Nursing, General Information