What's Working

'REACH'-ing for Change
Health Students Learn the Value of Teams

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  What's Working - Fall 2011 - 'REACH'-ing for Change

Julia Fairbank
Health sciences student
University of Colorado Denver

By Sandy Graham
Photography by Dan Sidor

As the five-member Mount Everest expedition labored up the world's highest peak, leader Julia Fairbank and her team of fellow health sciences students grappled with life-and-death issues – albeit on computers.

Was everyone well enough to climb that day? Would the group's limited medical supplies last? Ultimately, the team never reached the virtual summit – but they all survived the simulation, which was nearly as harrowing as the real thing, says Fairbank, who is training to be a physician assistant. The computerized exercise was part of a groundbreaking program that helps University of Colorado Denver health sciences students learn collaboration and teamwork.

"It was a really neat activity. I've been in that very position," says Fairbank, a former outdoor educator and ski patroller who skied on Denali in Alaska. "The simulation emphasized teamwork and all the different components that go into problem-solving, especially when you're working with a number of people."

As primary care becomes more of a team effort that integrates physical, mental and dental care, health professionals in all those areas need to sharpen their collaborative skills, according to Mark Earnest, MD, PhD, associate professor of General Medicine at the University of Colorado's Anschutz Medical Campus in Aurora and director of Realizing Educational Advancement for Collaborative Health, or REACH, the university's interprofessional education initiative.

"We've made a big commitment to REACH," Earnest says. Traditionally, students in health professions learned clinical skills – the nitty-gritty of diagnosing and treating people – but had little training in collaborating with other professionals or working in a team setting.

CU's programs in medicine, nursing, pharmacy, public health, physical therapy and dentistry along with the program training physician assistants created REACH to fill this gap. Nearly every entering health professions student on the Anschutz Medical Campus must participate.

The program has three core elements: First, there's a mentor program in which small groups of students from different health professional training programs are assigned to community volunteers who have chronic medical or mental health issues. Second, the Clinical Transformations Program uses role-playing and computer simulations for risk-free, collaborative learning. Third, students rotate through clinical settings that give them practical experiences in different models of interprofessional collaborative practice.

"With REACH, we'll see the professional schools in each discipline be held accountable for producing graduates who have the competencies to function in team-based, collaborative care settings," Earnest says.

Alicia Oberle, a fourth-year medical student who plans to be an emergency-room physician, was part of a different REACH simulation with three other students from nursing, pharmacy and public health. A high-tech mannequin portrayed a 20-year-old HIV-positive woman in probable shock, and an actor played the woman's frantic father. The students successfully treated the mannequin, but afterward, the "father" confided he had felt shut out of the team's communications at times.

"For me, I gained some medical knowledge, but the real emphasis was on the communications piece," Oberle says. "It was a learning experience."

Fairbank, the second-year physician assistant student, has been inspired by her REACH mentor, a Denver-area woman in her 50s who has high blood pressure, high cholesterol and diabetes, and is a breast cancer survivor. Fairbank's five-member REACH group, consisting of Fairbank, two pharmacy students, a dental student and a medical student, spent hours getting to know their mentor and learning about her health care experiences.

"She really respects both her physicians: her primary care doctor and her oncologist. They're open, honest and incorporate humor into her care. This is the kind of relationship I want to have with my patients," Fairbank says.

Earnest believes that REACH is a trendsetter.

"We think this is here to stay," he says. "We're on the leading edge of interprofessional education, and I think we'll be in a position here in Colorado to innovate and let others learn from our experience."