Developing Clinical Simulations for Teaching and Evaluating Teamwork and Communication Skills in Medical and Nurse Practitioner Students

This presentation will describe the development of an interprofessional education (IPE) clinical simulation experience designed for teaching and evaluating teamwork and communication skills. This experience uses the University of Toronto’s Centre of IPE’s Curriculum concepts of Exposure and Immersion as its framework and builds on existing IPE resources from the University of Washington and the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program. The program focuses on medical and nurse practitioner (NP) students learning with and about each other while they complete an assessment and health teaching for a patient with severe mental illness and medical co-morbidities in an outpatient setting. Each team consists of one medical and one NP student who will complete two online sessions, two standardized patient experiences, and two debriefing sessions using the same team members over a 2 to 3 week period. The online sessions is synchronized allowing a forum for the team members for discussing their pre-conceptions about each other’s roles and for planning the health education tailored for the patient. Changes in teamwork and communication skills are to be measured behaviorally using The Performance Assessment for Communication and Teamwork instrument. Lessons learned from its development will be presented. This IPE experience can provide awareness of each other’s unique contributions to providing care for complex patients. This experience will be pilot tested for feasibility in November 2014. If successful, it will be practice sessions before expanding the IPE to clinical practice placements with student teams conducting health teaching for patients with severe mental illness over time. Learning Objectives: 1. Describe the use of conceptual frameworks in developing interprofessional education programs. 2. Identify challenges and successful strategies in incorporating existing interprofessional education resources into local initiatives

Depression after Delivery: Risk Factors, Diagnostic and Therapeutic Considerations

Postpartum mood disorders can negatively affect women, their offspring, and their families when left untreated. The identification and treatment of postpartum depression remains problematic since health care providers may often not differentiate postpartum blues from depression onset. Recent studies found potentially new risk factors, etiologies, and treatments; thus, possibly improving the untreated postpartum depression rates. This integrated review examined several postpartum psychiatric disorders, postpartum blues, generalized anxiety, obsessive compulsive disorder, post-traumatic stress disorder, and postpartum psychosis for current findings on prevalence, etiologies, risk factors, and postpartum depression treatments

Changes in Allergy Symptoms and Depression Scores Are Positively Correlated In Patients With Recurrent Mood Disorders Exposed to Seasonal Peaks in Aeroallergens

Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers) or “traits” (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state-level rather than only trait-level relationship, and thus lends optimism to future causality-testing interventional studies, which might then lead to novel preventative environmental interventions in mood disorders