Our guest blogger is Jill Thistlethwaite, MBBS, MMEd, PhD, FRCGP, FRACGP, a Fulbright scholar, health professions education consultant and family medicine physician from Australia (but originally from the UK). She is spending four months at the National Center exploring evaluation and research methods for IPECP.

Hard to believe that I arrived in Minneapolis two months ago; the time has flown by. Some days are still warm, but the leaves have fallen to the ground after a few weeks of showing beautiful fall colours. No need for severe weather clothing yet, but I’m not sure how I will cope with sub-zero (centigrade) temperatures later in the year.

The staff at the National Center, and the Academic Health Center, have been so welcoming. No problems as yet with being understood at work, though a bartender couldn’t make out my request for a Blue Moon beer, though she ‘loved my accent.’ And I am now the proud owner of a U.S. social security number!

The buzz here around interprofessional education and collaborative practice (IPECP) is invigorating. There is definitely something in the Minnesota air to suggest that the Nexus will have a real impact on generating and analyzing data to answer big questions, such as whether IPECP has a positive impact on patient care.

So now I know that the Nexus is the meeting of practice and education. As we have recognized for many years in the UK and Australia, one cannot change without the other. But so often it is hard to influence both at the same time. The opportunity to spend four months here on the banks of the Mississippi, courtesy of the American-Australian Fulbright Commission, has demonstrated to me, once again, that reading about initiatives, and speaking and listening to people at conferences, just isn’t the same as immersion, participation and experience. From a research point of view, that is one good reason why observation on-site approaches are so important to complement interviews and quantitative methodologies.

The changes in the U.S. stemming from the Affordable Care Act are leading to discussion, implementation and evaluation of new models of health care delivery. The goals of these models, and the planned evaluation processes, focus on the Triple Aim:

• To improve patient experiences of care (in terms of quality and satisfaction);
• Enhance the health of the population; and
• Reduce costs. The country is well aware of its position on the league table of costs versus health outcomes. 

IPECP is seen as a potential means of meeting the Triple Aim, and not just in terms of enhancing patient safety. However, the big questions remain as to the effectiveness of IPECP, what particular elements are responsible and why and how it might be measured longitudinally.

As a team of us in Australia are finishing a government funded project on assessment of teamwork, with an emphasis on observation and feedback, I have spent some of the last few weeks continuing to look at the multitude of instruments, tools and surveys available globally for evaluation and assessment. The National Center website has a Resource Exchange that includes many of these measurement instruments available for use or comment. I have been working with Sean Lind, the web librarian, to identify other measures and to encourage people to visit the site and post feedback. 

Educators and clinicians continue to ask: “What measurement tool should I use for X, Y and Z?”  With upcoming enhancements to the Resource Exchange, hopefully they will find it easier to answer this question.

In closing here are some interesting things I’ve learned while in Minneapolis:

• Throwing clay pots on a wheel is fun even if I’m not very good at it
• Strange initiation rites go on at sorority houses (I am living between two)
• Bob Dylan lived in Dinkytown (where I am) as a young singer-songwriter
• Some health care professionals are involved in moving from an item-of-service payment model to models that reward quality and cutting costs (similar to a capitation type model)
• Cars don’t give way – they yield
• ‘Minne’ means water in the local Native American language
• The emblem of the university football team is a gopher
• Doctor Who is on BBC America a few hours after it is shown in the UK and before it airs in Australia
• In some areas patients can access their medical records and test results as soon as they are reported through a patient portal; the majority think this is a great idea
• Puccini wrote an opera set in the wild west

I’ve spent time traveling the past few weeks –  to Ohio, Washington D.C and Kansas – and I’ll share some thoughts from those trips in a later post.