Medicine and pharmacy take collaboration online

Steven Walker and Nikki Cresswell

Steven Walker and Nikki Cresswell.

22 November 2021

In late October, 640 students from two different faculties took part in a ground-breaking new Interprofessional Education (IPE) activity. The activity was designed to build the collaborative decision making skills of medical and pharmacy students, and increase their familiarity with the electronic medical records (EMR) now used in most clinical settings.

Taking place on Friday 22 October, the IPE activity tied together elements of the Digital Health and Collaborative Care curriculum across the different health faculties. While similar activities have been run at Monash since 2018, this was the first to take place entirely online using EHR Go, an online simulation platform.

In the days leading up to the IPE event, students worked in interprofessional groups to manage an emergency department scenario involving an acute care admission. The medical students had a simulated experience of seeing a patient as a junior doctor, making a clinical assessment and management plan, and then creating an admission note in the patient’s EMR. Pharmacy students then analysed the admission notes, interviewed a virtual patient, and advised appropriate next steps with medication.

On the day of the IPE event, groups then met ‘face to face’ over Zoom to discuss the details in the patient’s electronic health record and collaborate on what decisions to make about the patient’s medication management.

Improving collaborative decision making

Steven Walker, Lead Practitioner-Educator in the Faculty of Pharmacy and Pharmaceutical Sciences, was part of the team who designed and delivered the activity, working with his colleague Nikki Cresswell, and Associate Professor Claire Harrison and Fiona Kent from the Faculty of Medicine, Nursing and Health Sciences.

The focus for the inter-faculty team was on helping students learn collaborative decision making. “The different professions no longer see each other in the hallways, in practice,” says Walker. “Now people interact over digital records. If they can teach each other to use digital records responsibly, and collaborate better online and face-to-face, it will improve the care they deliver as clinical professionals.”

The IPE activity builds on work by Dr Erica Tong and Professor Michael Dooley at Alfred Health, who pioneered the partnered pharmacist medication charting (PPMC) model now funded and used in multiple hospitals. PPMC has led to a significant reduction in misprescription and helped set a new standard of care across Victoria.

The IPE activity for students helps plant the seeds of this new approach early in their careers, empowering them to continue the behaviour and see the value in pharmacists and doctors talking and supporting each other’s care strategies.

Building dialogue between faculties

For students participating in the inter-faculty IPE, positive dialogue was part of the experience from the start and they appreciated the opportunity to connect across professions.

They found the EHR Go platform to be a great learning tool. They gave anonymous feedback following the activity, with one pharmacy student saying that “getting the medical students to complete an admission note first and then the pharmacists completing a medical reconciliation works well.”

The medicine students involved appreciated the dialogue and collaboration too, with one saying it was “good to discuss with the pharmacy students in real time and get their thoughts on the admission notes/medication rationales.”

Students saw the ongoing value in IPE activities like this. “Keep hosting sessions like these to help build interprofessional relationships,” one pharmacy student said in their feedback, “as this allows us to see a medical professional's point of view and how they differ from ours.”

For staff, there was the added bonus of inter-faculty collaboration, with facilitators from both faculties helping deliver on the logistically complex activity.

Responding to the post-activity survey, one of the medical facilitators said “I felt the session was well worth the effort and that the technical preparation and execution were excellent.”

The importance of this form of learning for the students’ professional development was underlined by one of the pharmacy facilitators in their survey response.

"I am lucky enough to have practiced at Alfred Health, a health care service which encourages collaborative care through the PPMC model,” said the respondent. “It was amazing to see the collaborative communication skills that I witness improve patients' outcomes on a daily basis be utilised by early career medical and pharmacy students in the IPE workshop.”

It again showed that Monash is taking a forward-looking approach that will serve the students well in their professional lives. “To have an awareness of the strengths each profession can bring to patient care and the confidence to use communication skills in active collaboration will be a huge advantage in their careers."