Team Players
New institute will develop and oversee education across the Medical Center
Extensive changes in health care and rapidly developing technology require new and creative approaches to teaching and training. To accomplish this, the University of Rochester Medical Center has created the Institute for Innovative Education (IIE) to identify common educational priorities across the institution and develop a strategic plan for URMC's educational missions.
The IIE board of directors will serve as a kind of "think tank," identifying educational needs across the medical center and leading initiatives to address those needs most effectively. The board's first task is the development of the medical center's educational strategic plan.
The IIE board of directors consists of key leaders from the Medical Center. The board includes: Mark B. Taubman, M.D., dean of the School of Medicine and Dentistry; Kathy Rideout, Ed.D., P.N.P.-B.C, F.N.A.P., dean of the School of Nursing; David R. Lambert, M.D., the School of Medicine's senior associate dean for medical student education; Diane Hartman, M.D. School of Medicine's senior associate dean for graduate medical education; Edith M. Lord, Ph.D., senior associate dean for graduate education; Janine R. Shapiro, M.D., the School of Medicine's associate dean for faculty development; Cyril Meyerowitz, D.D.S., M.S., the director of the Eastman Institute for Oral Health; Kathy Parrinello, R.N., Ph.D., chief operating office of Strong Memorial Hospital; Pat Witzel, R.N., M.S., M.B.A., the chief nursing office of Strong Memorial Hospital; Bill Passalacqua, M.B.A., the School of Medicine's senior director of finance; and Sarah E. Peyre, Ph.D., the director of the Center for Experiential Learning; and Pamela Herendeen, D.N.P., R.N., P.N.P, B.C., School of Nursing's associate dean for education and student affairs.
Four members of the board—Taubman, Rideout, Lambert and Peyre—discussed the institute for Rochester Medicine.
What is the Institute for Innovative Education?
Taubman The pace of change in information, technology, and the way we have to deliver health care is extremely rapid. We want to intelligently disseminate information and educate our entire workforce on changes that will result in the best possible care for patients. It no longer makes sense for our medical school to be educating independently from our nursing school, our residents and fellows, or our hospital staff and docs. It won't work. There is teaching and training we have to do across the entire system, and the Institute for Innovative Education will enable us to do that.
Peyre The IIE is a mechanism for us to come together as a larger health care professional community to learn and train together around educational issues that we all face. The IIE board of directors will identify educational training needs for URMC as a whole and develop interprofessional and technology-driven educational initiatives that strengthen and complement our existing educational programs.
What programs should the Institute address?
Taubman Take new technology as an example. The handheld portable ultrasound looks like a PDA and gives far more information than you can get with a stethoscope. You can see a baby in utero, a stone, or a heart beating, and you can transmit what you see wirelessly. Let's say we adopt a portable ultrasound. You can't just teach 100 medical students how to use it. You have to teach residents, fellows, nurses, attendings and other physicians. We will need an educational body that can develop a mechanism to educate 20,000 people across our system.
Rideout When health care providers from different disciplines—nurses, physicians, social workers, nutritionists, pharmacists and others—work well together as a team it has been shown to decrease the length of stay for patients and increase the quality and safety of their care. The very best path to having teams of providers work well together is to have them educated together.
Taubman We need to cut costs. We need to create a model that will be efficient and high quality, and that will require teams. Everybody is now struggling with how best to educate people to prepare them be part of teams. Our educational system has been built in silos where doctors learn to be doctors, nurses learn to be nurses. There might be some places where they interact, but if you are going to create a hospital where people's skills are not duplicative and are being used efficiently, you have to train people how to work effectively in teams.
Lambert Additional programs I would like to see include public health and health care economics. This would increase understanding of the evolving medical landscape and how it influences what we as physicians and nurses do on a daily basis. We have to look at how we can impact individuals and populations in a high-yield, cost effective manner. When we fully understand the costs of interventions and the medications we prescribe, we have a better appreciation for the costs that disease and illness bring to patients, families, and society. This would help us all to do better at prevention.
Rideout My goal is that the institute supports the School of Nursing's focus on three key critical educational areas which are health care economics, patient- and family-centered care, and quality and safety.
Will simulation be a major part of the Institute's work?
Taubman Simulation will be a major area for the institute. Every health care provider needs some simulation for training. Medical students increasingly are being taught with simulators. Certainly as the number of hours they can spend in the hospital decreases and the number of hours patients spend in the hospital decreases, it become more important that we provide other ways for them to be exposed to a diversity of patients and cases. Simulation is being used to train residents, fellows, and doctors how to do procedures, work in teams, and deal with crises. From an economic and efficiency point of view, having every individual group in the medical center come up with a simulation plan doesn't make a lot of sense. We want to make sure that we are not wasting money or duplicating services.
Will the Institute oversee all areas of education across the Medical Center?
Peyre No. The institute will identify educational needs that all of our areas might share in common and then develop curricula that are complementary to the education and training programs already in place.
Lambert The institute will set priority areas for education across the medical center and facilitate their delivery. Each different area or school will determine its own curriculum with some reflection on URMC priorities.
Taubman We're not interested in micromanaging our schools.
How will the Institute foster innovation?
Lambert The institute will foster innovation not only through the education programs that are created but also in the assessment and evaluation tools that are developed. The goal is to return to fundamentally important concepts, demonstrate how they are applicable to a changing health care environment, and assure they are not just achieved but that they excel.
Peyre The institute will foster innovation through the interprofessional makeup of the board and the integrated approach to addressing educational issues. We are able to create and implement educational programming, overcoming traditional barriers that exist at other academic medical centers.
Taubman We want to establish an office of innovation. The person who heads that office would have a seat on the Institute's executive committee. We will look in all directions for innovation. We will bring in people from outside who are doing innovative things, particularly in technology. We want to encourage and incentivize people at every level to come to us with ideas.
Rideout The synergy and shared sense of mission and purpose that exists across the medical center—between the School of Medicine and Dentistry, the School of Nursing, and Strong Memorial Hospital—gives us an opportunity to be at the forefront in creating effective and sustainable interprofessional education initiatives. URMC is one of only a handful of medical centers across the country to enjoy this level of collaboration. In addition to the strong partnerships we share, we have the infrastructure and technological resources in place for us to be the gold standard for interprofessional education. I know we can become a model for how the next era of health care providers can and should be educated.