1. Interprofessional Education for
OB GYN Residents and Nurse-Midwife Students
Improving
Maternity
Care:
Phillip Rauk, MD, MFM, FACOG, Melissa D. Avery, PhD, CNM, FACNM, FAAN, Ann Forster Page, DNP, CNM, FACNM, and Samantha Hoffman, MD, FACOG
Department of OB, GYN, & Women’s Health, Medical School; School of Nursing; University of Minnesota, Minneapolis, MN
Background
Interdisciplinary or interprofessional education has been called for since as far back as the 1970s when the Institute of Medicine identified educating health professions students together to improve quality care.
The American College of Nurse-Midwives (ACNM) and American College of Obstetricians and Gynecologists (ACOG) 1971 joint statement included high quality maternity care in teams by physicians, midwives, others.
In 2003 IOM further articulated all health professionals should be educated to deliver "patient-centered care as members of an interdisciplinary team".
Four national project demonstration sites:
University of Minnesota
University of California, San Francisco
Baystate Medical Center
Partnership site - Frontier midwifery distance program and ob-gyn residences at Drexel U and Reading Hospital/Tower Health
ACNM-ACOG Maternity Care Education
and Practice Redesign national project
Two Main Project Objectives
1.     Develop and implement IPE model curriculum for midwifery students and ob-gyn residents
2.     Examine barriers to  IPE curricula in maternity care training centers.
Modules identified for development consistent with IPEC competencies (Values/ethics; Roles/Responsibilities; IP communication; Teams/teamwork)
Guiding Principles for Team-Based
Care
Patient-centered Care
Role Clarification
“It was good to work with residents in this learning experience. It helps to make collaboration more natural.”
“I learned a lot more about CNM training/role...How to collaborate in front of a patient. It’s important to get perspectives from different team members.”
Inpatient:
Risk for shoulder dystocia
Collaborative Practice
History & Culture (of both professions)
Care transitions/Situational leadership
Difficult Conversations
UMN Learning Activities for Ob-gyn Residents and Nurse-Midwifery Students
*All learners attend full TeamSTEPPS program
These activities supported (in part) by the Josiah Macy Jr. Foundation
Learning Module Created: Midwife and Ob-gyn Role Clarity for Team-Based Practice
Implementation: Summer 2019 residents and midwifery students will begin to formally complete the modules as program requirement.
Labor and Birth Skills Lab:
Pre-brief, 4 station skills lab: 
AROM and placement of a fetal scalp lead
Labor support techniques
Manual removal of the placenta and bimanual compression
Cervical exam, station of vertex, place intrauterine pressure catheter
Debrief
Objective Structured Clinical Experience (OSCE)
Resident and midwife student enter patient room together, interact with trained standardized patients
Introduction of best practice IP skills and collaboration provided to learners
3 clinical scenarios
Used “Debriefing with Good Judgment” with all learners and project team
Highly satisfactory experience for learners
Faculty able to watch videos to improve for debriefing feedback
Outpatient: Breastfeeding, low milk supply
Side by side learning: on the labor unit: Midwifery student, Ob-gyn PGY2 and OB attending caring for patients together.
Inter-
action demo
Inpatient: Transfer from Birth Center, lack of progress
Sharing QI work:
Midwife students present their projects on MHealth labor unit to interprofessional morning rounds conference.
Evaluation will be ongoing assessment of satisfaction of IPE activities, and pre-post program assessment with two validated tools:
Interprofessionl Education Collaborative (IPEC) Self Assessment Tool: measures aspects of the IPEC competencies.
Interprofessional Collaborative Competencies Attainment Survey: asks learners to assess their level of self-reported IPE collaboration competencies in IPE program.
Ob-gyn and Midwifery Faculty staff stations
afp,ma, 4/20919