Interprofessional Patient Pathways

This innovative course gives health profession students a first-hand experience of the challenges of teamwork in clinical care by bringing them together to collaboratively plan patient's care. The basis of this module is the filmed patient scenario about this very patient, called Mrs Eggli, that has been carefully compiled from the authentic experiences of a real patient.

This filmed representation not only serves as a didactic tool, but also runs like a thread through each session and promotes continuity in the teaching. By embedding theoretical knowledge in the tangible complexity of patient pathways this approach goes beyond traditional educational boundaries. It not only provides clinical insights, but also fosters deep empathy and a holistic understanding of the patient as an individual moving through the complexity of illness.

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When treating patients e.g. in hospitals, many different health professionals work together. However, it is still a fact that the different health professionals know little about each other’s work and competences. This can lead to overlaps, unnecessary delays and costs, because the competences of the other disciplines are not known. It has been studied that seamless care by different health professionals working closely together has been shown to increase patient safety and save costs. Yet many professionals often learn in silos.

Methods, tools or strategies used to encourage student engagement for learning success

The structure of this course is a strong engagement in promoting collaborative learning, a pedagogical cornerstone that should overcome the silos of the health professions. By bringing together students from different disciplines and health professions, including but not limited to pharmacy and nursing, the course aims to facilitate rich interprofessional exchange.

A further educational approach is the interprofessional and interdisciplinary discussion of patient situations – a joint exploration in which medical, pharmacy and nursing students come together to analyze and synthesize their unique perspectives on complex clinical scenarios. This exchange not only broadens the horizons of individuals, but also promotes a shared understanding of the multi-faceted nature of patient care.

Peer learning, another essential aspect, provides a platform for students to learn not only from faculty but also from each other. This mechanism of collaborative knowledge sharing allows students to draw on the collective expertise within their group and fosters a culture of mutual support and joint problem solving.

The course is further enhanced by interprofessional simulations, a hands-on experience that seamlessly blends theory with practice. Working with nursing students in a simulated patient ward round adds an additional quasi-realistic layer and requires students to manage the complexity of patient care within a team. This not only sharpens their clinical skills, but also fosters the ability to work synergistically in a collaborative healthcare environment. A written assignment entitled «Bring your own Patient» invites students to actively engage with the healthcare system in their immediate environment. This involves collecting, analyzing and reflecting on patient information from a patient in their immediate environment, and provides a link between classroom learning and the real healthcare environment. Through the learning experience into the patient’s pathways, students become not only passive recipients of information, but active participants in the process of understanding the complexities of patient care.

Innovative Elements of the Course

The module was planned and conducted by an interprofessional group, led by a nurse who holds a PhD in Health Profession Education and is unique among the medical faculties in Switzerland. It covers the competences described in the curriculum, and aims to widen participants’ perspectives through active learning and collaborative work. The course weaves together various elements that redefine traditional health education. One of its pioneering features lies in the deliberate effort to foster the exchange of knowledge between different disciplines in the health sector. In contrast to conventional, siloed learning, students are immersed in a collaborative milieu where they gather knowledge from, about and with others. This promotes a comprehensive understanding of the context of health care.

One innovation is the visit in the Cantonal Hospital of Uri to experience at first hand the importance of collaboration with other healthcare professions (physiotherapy, nutrition therapy occupational therapy) in a smaller hospital setting with direct ways and
communication.
Another innovation of the course is the inclusion of knowledge of complementary medicine – a dimension often peripheralized in traditional medical education. By integrating this aspect, the course recognizes the holistic nature of patient care and prepares students to appreciate and navigate the diverse landscape of health care modalities.
The introduction of the Swiss insurance system and the importance for patients on their pathway adds a pragmatic layer to the course. Understanding healthcare financing is crucial for future doctors, and this innovative inclusion gives students an understanding of the broader healthcare delivery system.
A further innovative element is the hands-on experience with actor-patients in a simulated interprofessional patient ward round, which allows all students to apply their theoretical knowledge in a quasi-realistic environment. Collaborating, with nursing students and exploring patients perspectives during the simulations, enhances reality and promotes teamwork and communication skills that are essential for effective healthcare delivery.
Peer feedback in essay writing introduces a collaborative assessment model. This departure from traditional teacher-centered assessment gives students the opportunity to learn not only from faculty but also from each other. This interactive assessment for learning instead assessment of learning feedback improves critical thinking and fosters a culture of continuous improvement among peers.
One of the teaching methods used in the patient safety lecture is virtual reality technology to create a virtual Room of Horror. Virtual reality (VR) technology is a powerful tool for immersive training, providing students with quasi-realistic and risk-free environments to improve their skills. It also provides students with immediate feedback on their performance.

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Effect of the innovative elements on student learning

«What makes a child (student) gifted and talented may not always be good grades in school, but a different way of looking at the world and learning.» —Chuck Grassley. In this module the students have the opportunity to learn and reflect upon the context of their future workplace and their roles in complex healthcare processes. They realize that interdisciplinary and interprofessional teamwork enhances patient safety and cut costs. An open attitude towards interprofessionality was found in the essays and in the conversations with the students. The increase in self-efficacy in relation to interprofessional communication was investigated (during the hospital ward-round-simulation with nursing students) with promising results. As we are teaching tomorrows generation, we assume, that they also learn from the role models they meet in clinical practice and become role models themselves in the near future. Students course evaluation shows us how we can improve continuously, and their involvement is an important part of the development of the course. However, the aim is not only to involve students in course development, but to include them as co-creators.

Ensuring continuous feedback on the student learning process

As feedback is important for learning, students receive feedback during several occasions. Students receive feedback from faculty but also from their mono- and interprofessional Peers. To promote assessment for learning instead of assessment of learning, the essays are sent to a randomly selected fellow student for peer review where a rubric was provided.

This helps students learn to evaluate the work of a peer; to practice writing meaningful feedback; and benchmark their own work. This peer review is deliberately not anonymized, to foster a respectful and considerate feedback culture. At the end of the module, students present their written essay in a plenary session, requiring them to condense and synthesis complex interrelationships in a limited time, as will be expected in clinical settings. Interested students have also the possibility to publish their written work in a medical education journal.

Course element recommendations for others

Bringing together students from different disciplines and fostering their awareness of the strength that comes from working efficiently and respectfully in teams can be transferred to many other topics and learning scenarios. Working in real life scenarios of the future profession creates a motivating learning environment that gives students the possibility to build bridges to future challenges and even build relationships and networks among their peers and future colleagues. However, interprofessional courses are rarely fully integrated into the curricula. Involving different educational institutions is a challenge. Many interprofessional events therefore become one-day events, as more ambitious planning seems too daunting. This course shows how the Bachelor of Medicine project team at ETH Zurich overcame these obstacles through enthusiasm, openness, and negotiation skills, establishing this novel program in the curriculum.

Project team

Dr. Claudia Schlegel

Lecturer at the Department of Health Sciences and Technology

Medizinausbildung ETH
Leopold-Ruzicka-Weg 4
8093 Zürich
Switzerland