STUDENT CLOSE-UP

MU Is Tops in Medical
Teamwork Training

By Kim Figg

At Arizona General Hospital, a woman with a mental illness is misdiagnosed and given the wrong treatment. She leaves and returns seven weeks later, psychotic and intoxicated.

Could the series of medical errors in this fictional case have been avoided?

According to a team of former University of Missouri-Columbia students, the answer is an unequivocal “yes.” The students, who all graduated earlier this year, combined their experiences and education to create a winning presentation at the Clarion Interprofessional Team Case Competition sponsored by the University of Minnesota in April. MU’s Rusty McCulloh, a medical student, Brian Stout, a health management student, Kevin Norris, a physical therapy student, and Ashley Mahon, a nursing student, walked away with top honors.

This was the first year the competition took on national status, with seven teams from across the United States competing. Each team was given the same patient case, instructed to create a presentation analyzing the case and asked to give quality improvement recommendations using a multidisciplinary approach.

Concerns regarding the quality of care and patient safety were raised in a 1999 Institute of Medicine report. According to the report, as many as 98,000 Americans die each year due to medical errors. With a lack of communication being cited as one possible cause, there is a renewed interest in interprofessional education in health care curricula nationwide.

The Clarion teams identified systems and processes that needed to be improved, changed or eliminated, rather than looking to place blame on individuals. The teams then presented their findings to a panel of judges, who evaluated each presentation in the context of real-world standards of practice.

MU’s team was familiar with the problem-based learning approach of the competition. In fact, the University has been a pioneer in teaching health care through problem-based learning, which uses patient cases, small groups of students and independent study guided by faculty mentors.

“Problem-based learning was the core of this presentation — and each team member has had experience with that,” McCulloh said. “This is a growing and evolving part of the curriculum in medical school, and I know I will be able to take something from this for my career track.”

“I could take the case, look at the important parts of it and break it down,” Norris said. “Then I could take that portion of the case, do some research and report back to the group. Because I was familiar with that approach, I was able to bring that to the team.”

The team members’ various skills and experiences allowed them to create their well-oiled machine, and they recognized how the competition could be applied to their future careers.

“We worked hard to integrate different perspectives in our presentation because no one profession — whether it be clinical or administrative — has the total experience or perspective on the actual patient care delivery. It’s a combination of all those different perceptions,” Stout said.

Clarion judge Dr. Sheila Ryan, director of international nursing education at the University of Nebraska Medical Center in Omaha, said MU’s group represented a thorough interdisciplinary team.

“MU’s framing of the problem and approach was, in my mind, the best of all,” she said. “The presentation was well-organized and very professionally developed. The students were equally passionate about their presentation and study analysis.”

MU’s students received the case at the end of February and spent six weeks developing their presentation. After many hours of research, such as becoming acquainted with root cause analysis instruments and reading related articles, textbooks and Institute of Medicine reports, the team was ready to present.

“Each of us had knowledge in different aspects of the health care field, and we all had previous degrees, plus life experience — all of these helped,” Mahon said. “In the nursing school they stress teamwork, so I felt I could relate to everyone.”

While faculty members were available to support and advise the students from all four fields, the students were in charge of their analysis and presentation. Stout referred to the opportunity as a student-based, organic experience with faculty members taking a hands-off approach.

MU advisers included Dr. Charles Brooks, professor of internal medicine; Kathryn Nelson, coordinator of clinical outcomes; Dr. Kristofer Hagglund, associate dean for health policy and student affairs in the School of Health Professions; and Dr. Kathryn Burks, assistant professor of nursing. She accompanied the students to Minneapolis.

“There will be many opportunities for these students to work with people from different health care perspectives in their careers,” Burks said. “The students were poised and shared their recommendations in an outstanding presentation. I was proud of the way they represented our University in this competition.”

Brooks said the key to advising these students was to offer direction, but then step back and allow them to do the work.

“In the medical school, I believe the problem based learning curriculum is a major factor that helps develop these skills,” he said. “The faculty that work with these students on a daily basis are aware of their capabilities and probably not surprised at this accomplishment. We should all be very impressed and proud of the effort and achievement of this group of individuals.”

The team received a $5,000 scholarship award and will be formally recognized at the Institute for Healthcare Improvement’s national forum on quality improvement in Orlando, Fla.

“For these students to perform at that level is impressive,” said Dr. Gordon Brown, chair of the Department of Health Management and Informatics. “This represents an early indication of what MU has invested in for several years — and on several fronts — regarding quality improvement.”

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Last Update: March 12, 2007