No place like home redesign: home-based clinical care as an interprofessional training model for medical and pharmacy students

ABSTRACT

Proper program assessment is necessary to ensure the delivered curriculum aligns with the intended curriculum. No Place Like Home (NPLH) is an interprofessional experience in which a healthcare team provides clinical services to patients in a home environment. Following review of program evaluation data, we determined the original design of NPLH was not meeting the intended objectives, and NPLH was redesigned in January 2018. Changes include lengthening the experience, decreasing the team size, improving assessment tools and additional training for the preceptors. The revised curriculum includes a care team with a preceptor, a medical, and a pharmacy student who visit four to six patients on an assigned day. From May 1, 2018 to April 30, 2019, there were 320 students who participated in NPLH. The preceptor assessments of students across the five objectives had mean scores of 3.4–3.7 on a 4 point scale indicating that on average preceptors placed students between Demonstrates Competence and Demonstrates Excellence for all objectives. When students were asked to compare their ability to collaborate interprofessionally after NPLH to the time before, 79% stated Somewhat Better Now or Much Better Now. It is not sufficient to create interprofessional learning activities and assume learning objectives are being met. Ongoing performance assessment and curricular evaluation are essential to ensure such goals are achieved. When intended objectives are not being met, it is possible to make deliberate and purposeful changes to redirect interprofessional learning experiences while maintaining the integrity, novelty and uniqueness of the experience.

KEYWORDS:

• Medicine
• pharmacy
• students
• home visits

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Catherine L. Hatfield

Catherine L. Hatfield, Pharm.D. is the Director of Interprofessional Education, the Director of Introductory Pharmacy Practice Experiences, and a Clinical Associate Professor in the Department of Pharmacy Practice and Translational Research at the University of Houston College of Pharmacy. She started the interprofessional education program at the College over a decade ago and has implemented several interprofessional education programs with multiple institutional partners.

Anita Bagri Major

Anita Bagri Major, M.D., is an Assistant Professor in the Department of Internal Medicine, Division of Geriatrics and Palliative Care at Baylor College of Medicine.  She specializes in geriatrics and house call medicine. For the past decade, she has utilized the patient's home as the setting for interprofessional educational activities.

Joel Purkiss

Joel Purkiss, Ph.D., serves as Assistant Dean of Evaluation, Assessment, and Education Research, and Assistant Professor of Medicine, at Baylor College of Medicine.  His administrative work focuses on medical education program evaluation and improvement, and student performance assessment processes and systems.  His education research has focused on evaluation of curriculum innovations, mistreatment and the learning environment, interprofessional education, and prediction of performance assessment outcomes.

Frene’ LaCour-Chestnut

Frene’ LaCour-Chestnut, M.D., is an Associate Professor in the Department of Clinical Sciences at the University of Houston College of Medicine.  At the time this research was conducted she was the Associate Program Director for the Medicine-Pediatrics Residency Program, the Associate Clerkship Director for the Internal Medicine Core Clerkship and an Assistant Professor at Baylor College of Medicine. Her passion and interests include primary care of urban and underserved communities as well as education across the continuum of undergraduate and graduate medical education.

Anne C. Gill

Anne C. Gill, DrPH, MS, RN is the Assistant Dean of Interprofessional Education and a Professor in the Department of Pediatrics and the Center for Medical Ethics and Health Policy at Baylor College of Medicine. She is a co-creator of the No Place Like Home activity and serves on the American Association of Medical Colleges Advancing Holist Review Committee.