Wednesday, June 24, 2015

Medicine and Nursing

IOM recently held a workshop on “Envisioning the Future of Health Professional Education,” which is part of the Global Forum on “Innovation in Health Professional Education,” which I co-chaired with Dr. Jordan Cohen up until recently.  I was filled with rejoice and some concern.  I rejoiced because the momentum started by the IOM “Future of Nursing” report and the Lancet Report on “Health professionals for a new century: transforming education to strengthen health systems in an interdependent world” continue to escalate.  There were tangible examples given by participants (representing global interdisciplinarity and interprofessionalism) of innovative ideas and dialogues about changing curricula to reflect community partnerships, interprofessionalism and flipped classrooms, among other changes.  One example is that presented by Dr. Francisco Campos (who is the former National Secretary of Labor and Education Management in Health of the Ministry of Health in Brazil) about the close linkages established between communities and schools of medicine and nursing which shaped curricula and graduates.  In Sao Paulo and other parts of Brazil, additional examples  involved the creation of joint curriculum and learning experiences for physicians and physician assistance, the inclusion of social determinants in health profession schools and joint programs to train faculty from medicine, nursing and dentistry to become leaders in interprofesional education.  These examples were from the University of New Mexico, the University of Iowa and East Carolina University.

That being said, my enthusiasm and excitement about the apparent “working together, learning together and learning from each other” crashed with another presentation.  This one was about developing a new model for medical education in which students learn to be navigators for patients.  In order to train medical students for this role, they are taught to listen to patients’ life stories, probe for lived illness experiences and explanatory models and reflect on and analyze these stories so they may create and implement plans for patients’ lives.  So here I ask my nursing colleagues, does this sound familiar?  How fantastic that a medical school developed this model for truly engaging students in the lives of their patients and the empowerment of their patients!  While this part of the innovation is to be lauded, where is the part about working with, and learning from the other distinguished schools within the same university?  Nursing curricula has included advocacy for patients, uncovering life experiences, reflecting on meaning and exploratory frames of reference of patients and students who are taught how to and when to ask and interpret findings.

Nursing faulty in many institutions reach to, learn from and work with colleagues in numerous disciplines including medicine.  Nursing students are expected to read and use knowledge from medical journals.  It is time to expect the same form medical faculty.  We should not have to create new untested models.  Instead we should build on, improve and enhance existing ones.

To my medical faculty colleagues,


If you want to teach about patient centered care, reflective clinical judgement, patient advocacy, social determinants of health, building effective patient relations, check nursing literature and reach out to your nursing colleagues.  They will be more than happy to partner and collaborate.  They have been waiting for this!