Inter-Professional Education for Multi-Disciplinary Team

Contributed by Theresa E. Towle, DNP, FNP-BC, CNRN
Rush University Section of Movement Disorders
Rush University College of Nursing

January 2013

We are all aware that patients with movement disorders require a multi-disciplinary approach to care. In addition, the study and care of patients with movement disorders has evolved as one of the most rapidly expanding fields in neuroscience. Parkinson’s disease, already the second most prevalent neurodegenerative disorder, is expected to double in incidence by the year 2030 as our population ages (DeLau & Breteler, 2006; Nutt & Wooten, 2005).

Given the diverse physical, emotional and social ramifications of these syndromes, a multi-disciplinary approach with specialized knowledge of related neuropathophysiology is needed for the appropriate care and treatment of movement disorder patients (Guttman & Furukawa, 2003). Currently, specialty education and certification in treatment of movement disorders is available for neurologists; however, outside Europe, no advanced education and/or certification tracks are available for nurses, rehabilitation specialists, physical therapists or other members of the interdisciplinary team. This lack of advanced training for health professionals is a major barrier to providing the requisite multi-disciplinary care that addresses the complex needs of this population.

Although not widely documented in the movement disorder literature, the advantages of multi-disciplinary team (MDT) treatment and inter-professional collaboration are well documented for other specialties. Scascighini, Toma, Dober-Spielmann & Sprott (2008) conclude MDT’s should be established internationally to guarantee good outcomes in the treatment of chronic pain. Similarly, Jensen, Zeeberg, Dehlendorff & Olesen (2010) recognize the need for MDT efforts in tertiary headache centers. Again, within the pain management framework, MDTs are found to be cost-effective through rapid return to work for lumbar back pain suffers, thus, leading to societal savings and productivity gains (Skouen, Grasdal, Haldorsen, & Ursen, 2002). Within the neurology realm, MDT has proved beneficial in improving physical health and depression in patients with Alzheimer’s disease (Teri, et al, 2003).

As a precursor to MDT intervention, inter-professional learning had been established by the World Health Organization in 1978 as an initiative to assure common knowledge, skills, and collaborative attitudes were developed for the common purpose of delivering safe and effective treatment across the healthcare continuum (Oandasan & Reeves, 2005). Jansen (2008) supports the development of collaborative professional skills for patients with complex health and social needs in this age of accountability for health care costs, access and quality. In addition, Berwick (2003) reports on the prolonged amount of time that is needed for evidence-based care to reach the bedside for common use. Given the length of time needed for evidence-base care to become common practice and the need for inter-professional collaboration to develop for the continuity of care, interprofessional learning and subsequent team development is necessary for efficient delivery of knowledge.

In its landmark report, "Crossing the Quality Chasm: a New Health System for the 21st Century," the Institute of Medicine (IOM) describes a major challenge for health care is the continual advancement of team effectiveness (IOM, 2001). This report, which served as a foundation for a U.S. committee on health professions’ education, notes that while team practice in healthcare is common, training of health professionals is typically isolated by discipline (IOM, 2001; IOM, 2003). Thus, the dissemination of knowledge is fragmented by bias of a specific discipline rather than a holistic understanding of a health process.

In supporting the need for interprofessional education, the American Council for Graduate Medical Education (ACGME) identifies the ability to work in interprofessional teams for the enhancement of patient safety and improvement of the quality of patient care as a core competency for medical residents (ACGME, 2007). As such, the need for inter-professional learning has been recognized and adopted by the Movement Disorder Society (MDS) through the expansion of Health Professional (non-physician) presence and involvement within MDS. This inter-professional growth and development secures MDS’ role as the premier international professional society committed to advancing research and education in the movement disorders field (MDS, 2011).

About Dr. Theresa Towle

Theresa TowleDr. Theresa Towle is a nurse practitioner with the Rush University Section of Movement Disorders. She earned her Doctorate of Nursing Practice from Rush University through the study of interprofessional education and multi-disciplinary team development.

Dr. Towle is a faculty member of Rush College of Nursing and currently serves as the outreach director for the MDS Health Professional (non-physician) SIG.

 


References

American Council for Graduate Medical Education (ACGME) (2007). Common Program Requirements: General Competencies Approved by the ACGME Board, February 13, 2007. Retrieved July 9, 2011 from
www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf

Berwick, D.M. (2003). Disseminating innovations in health care. JAMA, 289, 1969-1975, DOI: 10.1001/jama.289.15.1969.
De Lau, L.M.L. & Breteler (2006). Epidemiology of Parkinson’s disease. Lancet Neurology, 5, 525-535. DOI: 10.1016/S1474-4422(06)70471-9

Guttman, M. Kish, S.J. & Furukawa, Y. (2003). Current concepts in the diagnosis and management of Parkinson’s disease. Canadian Medical Association Journal, 168, 293-301. Retrieved May 7, 2011 from
www.ncbi.nlm.nih.gov/pmc/articles/PMC140472/?tool=pubmed

Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press

Institute of Medicine (2003). Health Professions Education: A Bridge to Quality. Greiner, A.C. & Knebel, E. (Eds.). Washington, DC: National Academy Press

Jansen, L. (2008). Collaborative and interdisciplinary health care teams: Ready or not? Journal of Professional Nursing, 24, 218-227, DOI: 10.1016/j.profnurs.2007.06.013

Jensen, R., Zeeberg, P., Dehlendorff, C., & Olesen, J. (2010). Predictors of outcome of the treatment programme in a multidisciplinary headache centre. Cephalalgia, 30, 1214-1224, DOI: 10.1177/0333102410361403

The Movement Disorder Society (MDS) (2011). The Movement Disorder Society website. Retrieved 5/4/11 from www.movementdisorders.org

Nutt, J.G. & Wooten, G.F. (2005). Diagnosis and management of Parkinson’s disease. New England Journal of Medicine, 353, 1021-1027. Retrieved October 12, 2010 from www.nejm.org/doi/full/10.1056/NEJMcp043908

Oandasan, I., & Reeves, S. (2005) Key elements for interprofessional education. Part 1: The learner, the educator and the learning context. Journal of Interprofessional Care, S 1, 21-38. DOI: 10.1080/135618205000083550

Scascighini, L., Toma, V., Dober-Spielmann, S., & Sprott, H. (2008). Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatology, 47, 670-678, doi: 10.1093/rheumatology/ken021

Skouen, J.S., Grasdal, A.L., Haldorsen, E.M., & Ursin, H. (2002). Relative cost-effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave. Spine, 27, 901-910. Retrieved May 7, 2011 from
http://journals.lww.com/spinejournal/Abstract/2002/05010/Relative_Cost_Effectiveness_of_Extensive_and_Light.2.aspx

Teri, L., Gibbons, L.E., McCurry, S.M., Logsdon, R.G., Buchner, D.M., Barlow, W.E. Kukull, W.A., LaCroix, A.Z., McCormick, W., & Larson, E.B. (2003). Exercise plus behavioral management in patients with Alzheimer disease. JAMA, 290, 2015-2022, Retrieved May 4, 2011 from jama.ama-assn.org

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