20. July 2021

Practicing and acting together IPSTA: Interprofessional learning in the day-to-day life of a pediatric cardiac unit, complete with direct feedback

Interprofessional learning in the day-to-day life of a pediatric cardiac unit, complete with direct feedback

On the “Kinder IPSTA Bonn” interprofessional training ward at University Hospital Bonn’s Center of Pediatric Medicine, student physicians and trainee healthcare specialists and pediatric nurses are responsible for looking after up to four children with heart conditions. They are being given intensive support from experienced doctors and nurses who are supervising their learning. Constant communication and cooperation in interprofessional teams of two is increasing each member’s understanding of their teammate’s profession. An article from forsch 2021/01.      

With patient safety a top priority at the pediatric cardiac unit, participants on the IPSTA scheme get a whole introductory day on the subject, including simulation training and managing emergencies.
With patient safety a top priority at the pediatric cardiac unit, participants on the IPSTA scheme get a whole introductory day on the subject, including simulation training and managing emergencies. - Here, the IPSTA team are practicing resuscitation. © Johann Saba
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Venusberg Campus, 6:15 am: It will soon be time for Isabelle Claus and Melina Schütz to start their early shift on Ward I on the fourth floor of the Parent-Child Center (ELKI). The 26-year-old medical student and the 20-year-old trainee healthcare specialist and pediatric nurse are jointly responsible for looking after two young pediatric cardiology patients, both girls. One of them is eight-month-old Lina, who laughs joyfully as the pair approach her cot early in the morning. “Lina’s always happy when the girls pop their heads round the door,” says her mother. She appreciates the more one-to-one care her daughter gets: “Thanks to IPSTA, there’s more personal contact and we feel very well looked after.”

Establishing medical histories, making diagnoses, planning therapy and delivering treatment: everything that is normally the job of experienced teams of physicians and nurses every day on the ward has now been in the safe hands of Claus and Schütz for the past two weeks. This has been made possible as part of the new IPSTA interprofessional training ward at University Hospital Bonn, the only one of its kind in Germany to be affiliated to a pediatric cardiac unit.

Seeing how things are done in other professions
The innovative approach, based on a Swedish model, was launched over two years ago with funding from the Robert Bosch Stiftung. Having proven a great success, it is now firmly established at ELKI and is in its third year. Throughout the year, two pairs –each made up of one medical student and one trainee pediatric nurse– spend three to four weeks taking responsibility for looking after up to four children with heart conditions on the early and late shifts, apart from weekends and public holidays. They are aided by experienced physicians and nurses, who supervise their learning.

“Interprofessional working has not yet become a standard component of university or vocational education across Germany,” says Rebecca Maria Knecht, who coordinates and leads on the concept behind the IPSTA project at the Dean’s Office in the Faculty of Medicine at the University of Bonn. “By contrast, the IPSTA project allows advanced students to learn together under real-life conditions. In terms of content, we focus on self-management, responsibility and interprofessional cooperation.”

Watching out for each other and appreciating your partner’s work

Claus is on her practical year, i.e. the final year of her degree, and will face the third state examination in November. As she can readily see herself working with children further down the line, the 26-year-old picked pediatrics as one of her electives. “IPSTA is a privileged environment in which to learn,” says the medical student. “We’re very well supported and get fast, personalized feedback through very short channels.” Schütz has also nearly finished. The 20-year-old is in the third year of her training to become a healthcare specialist and pediatric nurse. Together, the pair familiarize themselves with the workflows in the pediatric cardiac unit, talk everything through and make decisions. “We see up close what the other person’s doing and get an idea of what you do in a different profession. This means we find compromises and reach better agreements,” Schütz says, emphasizing one of the advantages of interprofessional training that also significantly benefits patient safety.

Being there for children with heart conditions and their families to rely on

The hands of the clock tick slowly toward 9:15 am: visiting time. Lina had been admitted to ELKI six days ago as an emergency patient, suffering heart failure, failure to thrive, feeding problems and sweating. Since then, the two pairs of current IPSTA students have been keeping a very close eye on the little girl, who was born with a heart defect. Lina was originally not supposed to have surgery until the summer, but it is being brought forward and is in two days’ time. Until then, the little patient needs to be made strong enough for her operation with the support of her physicians and nurses. “In IPSTA, we work very independently and make decisions – in tandem,” Claus says. “And this also benefits the families. They can always talk to the four of us and our supervisors. This arrangement just isn’t possible with standard shift patterns.” She now has the opportunity, together with her colleague, to be with her patients right through to when they are discharged. “Lina’s condition has improved since she was admitted. We can see that because we’re looking after her so intensively,” says Schütz, putting it in a nutshell.

“Lina is our ray of sunshine!”

11:50 am: the early shift is nearly over. In the IPSTA room at the pediatric cardiac unit, Claus and Schütz summarize the findings on their two little patients and all the medical and nursing care provided during the morning. Handover to the IPSTA pair working the late shift takes place at 12:15 pm on the dot, with the students’ supervisors continuing to take a step back. About Lina, for instance, they can say that she is getting better by the day and that she is put on 1.4 ounces (40 grams) since yesterday. For her planned operation, which Lina’s mother remains a bit worried about, she still needs an ultrasound examination of her heart, among other things. Lina’s mother knows that her daughter is in good hands: “Both pairs of students are highly competent, dovetail perfectly with each other, are interested in pediatric cardiology and enjoy their work. I’m really impressed by them, but also by everyone else as well. The whole team is fantastic.”

At 2 pm, it’s the end of the early shift, and the soon-to-be physician and future pediatric nurse have gained new experience yet again. “You learn how to structure and organize yourself better,” says Claus, identifying an additional benefit of the IPSTA approach. Schütz adds: “The insight you get into the other profession also makes your work on the ward easier.” Prof. Dr. Johannes Breuer, Medical Director of the Department of Pediatric Cardiology, firmly believes that the modern training concept is making the nursing profession in particular more attractive: “It’s more than just checking things off a medical to-do list. It’s about team spirit.”

The IPSTA pair chatting
The IPSTA pair chatting - before simulation training on pediatric emergencies and resuscitation. © Johann Saba
“Kinder IPSTA Bonn” at the pediatric cardiac unit:
“Kinder IPSTA Bonn” at the pediatric cardiac unit: - medical student Isabelle Claus (left) and trainee nurse Melina Schütz (right) are learning together on an interprofessional scheme and working in tandem to care for two children with heart conditions on their own responsibility, receiving swift feedback. Photo: Johann Saba © Johann Saba
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