Jennifer A Kaplan1, Zabecca Brinson2, Rebecca Hofer2, Patricia O'Sullivan3, Anna Chang4, Helen Horvath5, George J Chang6, Emily Finlayson7. 1. Department of Surgery, University of California, San Francisco, San Francisco, California. Electronic address: Jenny.Kaplan@ucsf.edu. 2. Department of Surgery, University of California, San Francisco, San Francisco, California. 3. Department of Surgery, University of California, San Francisco, San Francisco, California; Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California; Department of Medicine, University of California, San Francisco, San Francisco, California. 4. Department of Medicine, University of California, San Francisco, San Francisco, California; Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California. 5. Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California. 6. Department of Surgical Oncology, U.T.M.D Anderson Cancer Center, Houston, Texas. 7. Department of Surgery, University of California, San Francisco, San Francisco, California; Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California.
Abstract
BACKGROUND: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches. MATERIALS AND METHODS: Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist. A curriculum for health coaching by early learners was developed, implemented, and evaluated in this clinic. Students attended the clinic visit with their patient, reviewed the interdisciplinary care plan, and called patients twice weekly preoperatively and weekly in the first month after discharge. Students logged all calls, completed patient satisfaction surveys 1 wk before surgery and participated in feedback sessions with team members and medical school faculty. Call success rate was calculated, and team communications were recorded and analyzed. RESULTS: Median call success rate was 69.2% and was lowest among medical students (P = 0.004). Students and research assistants contacted or facilitated patient contact with their medical team 84 times. Overall, patients were extremely satisfied with the health coach experience, felt better prepared for surgery, and would recommend the program to others. CONCLUSIONS: Early medical and nurse practitioner students can serve the important function of health coaches for frail patients preparing for surgery. Motivated students benefited from a unique longitudinal experience and gained skills in communication and care coordination. Not all students demonstrated capacity to engage in health coaching this early in their education.
BACKGROUND: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches. MATERIALS AND METHODS: Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist. A curriculum for health coaching by early learners was developed, implemented, and evaluated in this clinic. Students attended the clinic visit with their patient, reviewed the interdisciplinary care plan, and called patients twice weekly preoperatively and weekly in the first month after discharge. Students logged all calls, completed patient satisfaction surveys 1 wk before surgery and participated in feedback sessions with team members and medical school faculty. Call success rate was calculated, and team communications were recorded and analyzed. RESULTS: Median call success rate was 69.2% and was lowest among medical students (P = 0.004). Students and research assistants contacted or facilitated patient contact with their medical team 84 times. Overall, patients were extremely satisfied with the health coach experience, felt better prepared for surgery, and would recommend the program to others. CONCLUSIONS: Early medical and nurse practitioner students can serve the important function of health coaches for frail patients preparing for surgery. Motivated students benefited from a unique longitudinal experience and gained skills in communication and care coordination. Not all students demonstrated capacity to engage in health coaching this early in their education.
Authors: Jed D Gonzalo; Paul Haidet; Klara K Papp; Daniel R Wolpaw; Eileen Moser; Robin D Wittenstein; Terry Wolpaw Journal: Acad Med Date: 2017-01 Impact factor: 6.893
Authors: Anna Kata; Rebecca Sudore; Emily Finlayson; Jeanette M Broering; Sarah Ngo; Victoria L Tang Journal: J Am Geriatr Soc Date: 2018-10-05 Impact factor: 5.562