Interprofessional Care Teams Working Together In Underserved Health Clinics: Increasing the Cultural Competency of Nurse Practitioners and Other Healthcare Professionals

Background:  This project created an Interprofessional Collaborative Practice (IPCP) model at two community-based urban clinics, extending classroom IPE experiences.  IPE is a growing area of interest in the healthcare professions, focused on roles/responsibilities; values/ethics; communication, and teamwork (IPE Expert Panel Report, 2011).  The project provided innovative opportunities, placing health profession graduate students from a university’s Schools of Nursing, Dentistry, and Pharmacy to improve health outcomes in patient centered care by providing primary and preventative services to underserved populations. Both clinics are located in a health professional shortage area (http://hpsafind.hrsa.gov/HPSASearch.aspx) serving an urban population living at 50% at or below 200% of the federal poverty level; approximately 41% of patients are uninsured with 39% receiving Medicaid (Mid-America Regional Council, 2013).  One clinic serves high numbers of immigrant and refugee populations.

Methods: Students completed surveys pre/post semester-long clinical rotations. Surveys included the Cultural Competence Assessment (Schim et al., 2004), a 44-item scale that assesses students’ cultural competence attitudes and behaviors.

Results:  From pre- to post-rotation, students reported a significant increase in overall perceptions of competence in “working with people who are from cultures different than your own.” They also reported a significant increase in experiences with special populations. Finally, students reported a significant increase in the frequency with which they performed cultural competence behaviors.

Discussion: The project provided IPCP experiences for healthcare professions students to make more informed care decisions regarding vulnerable patient populations. Students reported an increase in cultural competency across several areas, including attitudes, experiences, and behaviors. The patient populations served, as well as increased interactions across professions (nursing, dentistry, and pharmacy) allowed students to have new perspectives regarding caring for vulnerable patient populations and has helped to prepare future leaders for the healthcare arena.

Summary Recommendations: For others who may be considering a similar approach, we would recommend creating community partnerships in advance, allowing for students to work with the same interprofessional team members throughout a semester-long rotation, and providing routine meetings for feedback and communication between the students, faculty, and clinical preceptors throughout the grant.