Creating Bridges of Interprofessional Education: Opportunities for Collaborating Across Multiple Disciplines and Campuses

Introduction and Purpose: The purpose of this special interest report is to discuss strategies used by to integrate simulation activities across multiple campuses and programs to foster inter- and intra-professional education. Inter-professional (IP) simulations were done between multiple campuses of a large scale, multi-state, health science university. These simulations utilized Doctor of Occupational Therapy (OTD), Doctor of Physical Therapy (DPT), and Master of Science Speech/Language Pathology (MS-SLP) students and faculty. IP simulations involved DPT students and faculty from the health sciences university in one state and physical therapist assistant (PTA) students and faculty from a different university in that same state. Summary of Use and Results: When IP learning opportunities are designed into health science curricula, it can enhance knowledge, skills, and attitudes to prepare future clinicians to work as part of a collaborative practice-ready workforce. Students participating in IP activities identified themselves having more competence and sense of salience with IP interactions. Valuable student learning occurs when students are armed with attitudes and knowledge of IP collaboration. Moving forward from these experiences, students can progress in IP activities that further translate into enhanced competencies and develop IP technical skills. Importance to Members: Integrating inter- and intra- professional education in clinical and academic settings has the potential to improve behaviors amongst team players promoting improved patient safety and patient outcomes. However, there continues to be a need for research demonstrating the efficacy of IPE and its impact on student and clinician learning and the effects on patient outcomes. IPE Simulation Opportunity 1: IP Collaboration of OT and PT Students: Within the first two weeks of beginning our OT and PT program, students are introduced to an interdisciplinary simulation experience to anchor emerging skills to basic concepts of patient care. The experience is simple and intimate, but organically creates open discussion much deeper than a lab activity involving students partnering with other students to practice learned therapeutic interventions and procedures. The experience is set up with a simulated patient prompted to ask the students questions such as “What is the difference between OT and PT?” Student observers watch as their fellow classmates in the simulation hot seat have to problem solve within a natural hospital environment. The experience brings to light the social components involved in the usually rehearsed informed consent, environmental barriers such as bed rails and tray tables, interprofessional communication with the other discipline with a patient present, and interpretation of vital assessments in patient friendly language. The class debriefs after the simulation to observations, perspectives, and insights. This initial simulation provides an initial experience bridging academia to real-world clinical practice. IPE Simulation Opportunity 2: Intgraprofessional Collaboration of PT and PTA Students Three short simulations were conducted with a group of DPT students and a group of PTA students. The first simulation was of PTA and DPT students reviewing a medical record together and planning for a treatment session on a complex neuro case with a recent history of seizures, traumatic brain injury (TBI), and craniotomy. They had a simulated Clinical Instructor (CI) to guide them. The second simulation involved mobilizing this patient in an EVA walker with multiple lines and tubes with the patient’s mother present with CI guidance as needed. The third simulation involved responding to the patient having a seizure with the mother present and then a debriefing with their CI on the session using the Clinical Performance Indicators (CPI) to guide the discussion. IPE Simulation Opportunity 3: Interprofessional Collaboration of OT, PT, and SLP During SLP program development, IPEC core competencies were mapped to the clinical curriculum and activities developed for OT, PT, and SLP students’ IPE experiences. The activities designed by an IPE faculty team included simulation case scenarios experienced by students each trimester. The case scenarios vary in complexity across IPEC competencies and sub-competencies. For each case scenario simulation, an SLP, PT, and OT student volunteer to act out the improvised scenario, with one or two other students acting as patients, caregivers, or other team members. The rest of the participants observe the scenario and upon completion, all students (actors and observers) participate in a debriefing, which includes reactions, observations, reflections, and discussion. The debrief sessions are structured using the General Interprofessional Debriefing Questions Facilitator Guide to ensure IPEC core competencies were addressed in the simulation. Student feedback is positive with general requests to offer additional experiences. Conclusions: It is important for future research to explore the validity, reliability, and efficacy of IP learning activities to develop best-practices in IPE. This will help clinicians and educators in customizing their needs to meet patient outcomes, accreditation standards, programmatic goals, and institutional goals in their respective programs and settings

Creating a Charrette Process to Ignite the Conversation on Equity and Inclusion

The gaps in graduation and retention rates between ethnic and gender groups continue to be a foremost area of focus at Borough of Manhattan Community College (BMCC), The City University of New York (CUNY). Equity and inclusion is also a critical concern as it relates to faculty and staff. At BMCC, a college-wide initiative, Designing for Success, is seeking to improve declining retention and graduation rates. At its core is the question, “Have we designed our operations to produce these results?” The answer is, “Yes”. BMCC’s Designing for Success strategic planning process seeks to re-design administrative processes and teaching in an effort to eradicate these gaps through efforts which include a community-wide discussion and action planning on equity and inclusion inspired by the charrette process. The charrette creates small groups that meet on more than one occasion to identify critical barriers to addressing equity and inclusion and develops action plans for addressing these barriers from stakeholders at all levels of an organization. This paper proposes that public scholarship is at the core of the charrette process, that it is uniquely appropriate for the higher education environment and moves the community from a “discussion” of the barriers to fully engaging the entire college community in meaningful action-oriented strategic planning

Systematic review and individual patient data meta-analysis of sex differences in depression and prognosis in persons with myocardial infarction: a MINDMAPS study

Objective - Using combined individual patient data (IPD) from prospective studies, we explored sex differences in depression and prognosis post-myocardial infarction (MI), and determined whether disease indices could account for found differences. Methods - Meta-analysis of IPD from 10,175 MI patients who completed diagnostic interviews or depression questionnaires from 16 prospective studies of MI patients, identified by systematic review for the MINDMAPS study. Multilevel logistic and Cox regression models were used to determine sex differences in prevalence of depression and sex-specific effects of depression on subsequent cardiovascular morbidity and all-cause mortality. Results - Combined interview and questionnaire data from observational studies showed that 36% (635/1760) of women and 29% (1575/5526) of men reported elevated levels of depression (age-adjusted OR=0.68, 95% CI 0.60 to 0.77, p (sex*depression interaction p Conclusions - The prevalence of depression post-MI was higher in women than men, but the association between depression and cardiac prognosis was worse for men. LVEF was associated with depression in men only, and accounted for the increased risk of all-cause mortality in depressed men versus women, suggesting that depression in men post-MI may in part reflect cardiovascular disease severity

Attributes of legitimate venture failure impressions

The current research investigates the effectiveness of impression management strategies available to entrepreneurs to foster social legitimacy with stakeholders following venture failure. We use a conjoint experiment to examine how different attributions of causes of failure influence the general public's legitimacy judgments. The most effective strategy proves to be the entrepreneurs distancing themselves from the failure, in that they attribute the failure to external factors that are not under the entrepreneurs' volitional control, and brought about by circumstances that are unlikely to reoccur. Our analysis also considers how the audience members' dispositional agreeableness and general self-efficacy influence judgment formation

The Novel Tubulin-Targeting Agent Pyrrolo-1,5-Benzoxazepine-15 Induces Apoptosis in Poor Prognostic Subgroups of Chronic Lymphocytic Leukemia

Pyrrolo-1,5-benzoxazepine-15 (PBOX-15) is a novel microtubule depolymerization agent that induces cell cycle arrest and subsequent apoptosis in a number of cancer cell lines. Chronic lymphocytic leukemia (CLL) is characterized by clonal expansion of predominately nonproliferating mature B cells. Here, we present data suggesting PBOX-15 is a potential therapeutic agent for CLL. We show activity of PBOX-15 in samples taken from a cohort of CLL patients (n = 55) representing both high-risk and low-risk disease. PBOX-15 exhibited cytotoxicity in CLL cells (n = 19) in a dose-dependent manner, with mean IC50 of 0.55 mu mol/L. PBOX-15 significantly induced apoptosis in CLL cells (n = 46) including cells with poor prognostic markers: unmutated IgV(II) genes, CD38 and zeta-associated protein 70 (ZAP-70) expression, and fludarabine-resistant cells with chromosomal deletions in 17p. In addition, PBOX-15 was more potent than fludarabine in inducing apoptosis in fludarabine-sensitive cells. Pharmacologic inhibition and small interfering RNA knockdown of caspase-8 significantly inhibited PBOX-15-induced apoptosis. Pharmacologic inhibition of c-jun NH2-terminal kinase inhibited PBOX-15-induced apoptosis in mutated IgV(II) and ZAP-70(-) CLL cells but not in unmutated IgV(II) and ZAP-70(+) cells. PBOX-15 exhibited selective cytotoxicity in CLL cells compared with normal hematopoietic cells. Our data suggest that PBOX-15 represents a novel class of agents that are toxic toward both high-risk and low-risk CLL cells. The need for novel treatments is acute in CLL, especially for the subgroup of patients with poor clinical outcome and drug-resistant disease. This study identifies a novel agent with significant clinical potential. [Cancer Res 2009;69(21):8366-75