Diving Deep to Swim Upstream: Integrating Social Determinants of Health into Virtual Interprofessional Education
The majority of health outcomes are due to factors such as housing, income, poverty, and racism, referred to as social determinants of health (SDOH). Virtual interprofessional education (V-IPE) student experiences are time-constrained, with most focusing on objective criteria and evidence-based practice (known as an “etic” approach), while not teaching an “emic,” patient-centered approach of understanding health issues from the patient’s perspective. Aims include: 1. Integrate SDOH into a V-IPE case to incorporate population health variables for a patient-centered, holistic experience. 2. Use problem-based learning for students to learn about, from and with each other.
Design or methodology
A V-IPE conference was developed by faculty from nursing, pharmacy, physician assistant, and social work programs from two universities with the goal of providing teams of five mid-level students a 90-minute experience. The patient case was a minor with a single parent deploying to the military (standardized actor). Social determinants of health factors were integrated into the case (e.g., stable caregiver and adverse childhood experiences) along with effective asthma management. Interprofessional teams were oriented, met in virtual breakout rooms, and then given time to read the case with profession-specific patient information. Interprofessional teams discussed and developed care plans in preparation for meetings with the standardized parent (SP). Two facilitators were assigned to each team to observe team interactions with minimal intervention. To conclude, the teams conducted a meeting with the SP and were debriefed at the end of the meeting by the actor.
Results (data, outcomes and evidence)
Standardized parents and planning committee members evaluated interprofessional teams using the TEAM modified McMaster-Ottawa Scale to allow evaluation comparisons. Students completed the UWE Interprofessional Questionnaire and demonstrated statistically significant findings for communication and teamwork and interprofessional learning, interaction, relationships scales between pre and post this V-IPE.
Conclusion
Integrating SDOH into a V-IPE provided students an opportunity to experience a holistic, patient-centered care approach. Given the impact on health outcomes, incorporating SDOH into cases with debriefs from trained standardized actors are critical to teach students about roles and responsibilities of professionals, practicing interprofessional communication skills, developing team work, and addressing ethics/values.
Reflections/lessons learned/implications
Students developed effective care plans with minimal facilitator interaction while SP meetings had mixed results. Lessons learned include providing students background case information prior to the event, increasing the role of facilitators during team meetings, and decreasing the number of facilitators during the student-led, problem-solving experience.
