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Four UMD Medical School students.

These students from the University of Minnesota, Duluth, and the College of St. Scholastica are learning together to better care for patients. (From left, Mike Gerber, Angela Reese, Marie Roberts, and April Cook.)

Care conference

Students in medicine, pharmacy, and nursing learn together how to develop a care plan

By Brenda Hudson

From eNews, February 24, 2005

Medical student Mike Gerber takes a deep breath and opens the door. Waiting inside is his patient who was recently diagnosed with Alzheimer's. Gerber sits down next to him and begins explaining the medical aspects of the disease. "It's degenerative. Parts of your brain will begin to die away, losing the ability to store memory," Gerber says. "We can give you medication to slow its progression, but we don't have a cure."

The patient looks down. "What's the point if I'm not going to remember anything, if I'm going to die anyway?" he asks.

Afterwards, Gerber admits he was caught off guard. "I was ready to talk about his physical health, not his mental health. I wasn't sure what to say."

"It's a typical reaction for a second-year medical student," says Jeff Adams, curriculum director for the Medical School's Duluth campus. "They don't always know how to deal with the psychological aspects of a patient's medical condition. Sometimes they don't even catch the ways in which a patient may be at risk, outside of the main medical concern."

The Interprofessional Project uses standardized patients--people trained to exhibit symptoms--to help students become more comfortable taking histories before donning white coats and facing their real patients. It also introduces them to an interdisciplinary approach to patient care. Medical and pharmacy students on the Duluth campus, along with nursing students from the College of St. Scholastica, work together to form a comprehensive care plan for their assigned "patient."

"Working alone, we would never have come up with such a broad plan," says Angela Reese. "Working together actually made it easier."

"This is often the first opportunity they have at collaborating across disciplines," says Sarah Westberg, a pharmacy professor at Duluth. "Because as physicians, nurses, and pharmacists, they will all work together in a clinical setting, we think it's important that our students be exposed to this approach early in their careers."

Kathleen Thiede, professor of nursing at the College of St. Scholastica in Duluth, agrees. "We want them to understand and acknowledge the strengths that each discipline brings to the situation," she says, "while also appreciating their complementary and overlapping roles. And working together on a patient's care plan gives them this experience firsthand."

Meanwhile, as Gerber continues to discuss treatment options with his patient, Marie Roberts and April Cook, fourth-year nursing students, and Angela Reese, second-year pharmacy student, watch from behind a one-way mirror. "It's the equivalent of a verbal consult between the professions, or reading a previous note," explains Westberg, the idea being that team members build on previously gained patient knowledge, instead of using a "repeat line of questioning."

When Gerber's time is up, he is paged out of the room. Reese is next.

After each student has a turn, the group gathers to discuss and draft a care plan. For this patient, the plan included educating him about the disease and medication, offering advice on available support and counseling services, and proposing options of home health aid and nursing homes.

"We each took the areas we were most familiar with, gathered the information, and then put it all together in a comprehensive care plan for the patient," says Reese. "Working alone, we would never have come up with such a broad plan," she adds. "Working together actually made it easier."

Cook agrees. "I think we offer better care for patients if there's a good dialogue between all the professionals working together."

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