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    Adam Fleischer, DPM reviewing best practices for obtaining an Ankle Brachial Index measurement at Bernard-Mevs Hospital, Haiti.

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    Foot prosthetics for amputees in Haiti after lower extremity amputation secondary to chronic wounds.

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    Kaplan-Meier plot demonstrating that the probability of patients with diabetic foot ulcers remaining unhealed through the first 90 days of treatment was significantly lessened after the telehealth program was implemented. Cohort 1 represents wound healing probability of individuals prior to implementation of the telehealth program. Cohort 2 represents wound healing probability of individuals after implementation of the telehealth program. (log-rank statistic of group 1 compared with group 2, 5.10; P=.024).

Interprofessionalism

A Cornerstone of Innovation and Medical Education at Scholl College of Podiatric Medicine

Robert Joseph DPM, PhD1, Richmond Robinson DPM1, Adam Fleischer DPM, MPH1, Leland Jaffe DPM1, Alison Joseph DPM1, Isabel Baker RN, WCC, OMS1, Jacqueline Truong DPM, MPH2, Aksone Nouvong DPM2, Nancy L. Parsley DPM, MHPE3, and John H. Becker PhD4
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  • 1 Department of Medicine and Radiology, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL.
  • | 2 Department of Podiatric Medicine, Surgery, & Biomechanics, Western University College of Podiatric Medicine, Pomona, CA.
  • | 3 Dean, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL.
  • | 4 Department of Basic Biomedical Sciences, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL.

In 1912, the Illinois College of Chiropody and Orthopedics was founded, and is today known as the Dr. William M. Scholl College of Podiatric Medicine. It has been an integral part of Rosalind Franklin University of Medicine and Science in North Chicago, Illinois since 2001. Through the ensuing decades, Scholl College alumni have been instrumental in moving the profession forward.

In 1912, the Illinois College of Chiropody and Orthopedics was founded, and is today known as the Dr. William M. Scholl College of Podiatric Medicine. It has been an integral part of Rosalind Franklin University of Medicine and Science in North Chicago, Illinois since 2001. Through the ensuing decades, Scholl College alumni have been instrumental in moving the profession forward.

A university-wide theme at Rosalind Franklin University of Medicine and Science (RFUMS) is interprofessionalism, and Scholl College has enthusiastically embraced that concept. The University's DeWitt C. Baldwin Institute for Interprofessional Education at RFU supports interprofessional education, research, simulation, and clinical experiences while contributing to ongoing conversations focused on patient-centered care and safety. In 2013, RFUMS students initiated a free clinic (Interprofessional Community Clinic) at which patients are seen by interprofessional teams of student volunteers, supervised by licensed faculty.

Another quality of the university and Scholl College is an emphatic belief in the importance of biomedical research and innovation. The University is now developing an innovation and research park that is expected to integrate academic innovation with the life science industry in the region. Scholl College's Center for Lower Extremity Ambulatory Research (CLEAR) performs biomechanical, biomedical, translational and clinical trials research. Student research is an important component of CLEAR, with a NIH-funded training grant that supports student research in summers. Many of the research projects are interprofessional and include participation by students and/or faculty from other colleges. Scholl College also confers the DPM-PhD degree; three highly select students have earned this prestigious dual degree in the past 5 years and two are in the PhD phase of their studies.

Medical education and faculty development are two of the last frontiers of podiatric medical education in which interprofessionalism plays a critical role in shaping and developing. Physician training follows clear stages of education, from medical student to resident physician to practitioner. Methods of education differ at each stage despite medicine being a continuum of lifelong learning. The early stages of training are classically classroom-based experiences, and later training is primarily patient care that is supplemented with continuing medical education (CME) conferences, grand rounds, and symposia. Because the forums of learning are so different between a practitioner and a student, they rarely occur in tandem. In academia, this commonly results in a clear distinction between “faculty development” and medical student education. At Scholl College, interprofessionalism and collaboration are keys to integrating all stages of medical education.

Today's medical student is vastly different than previous generations of students. The learning style of today's student is heavily influenced by technology and a precocious demand for learning in the “context of patient care.” In many circumstances, the insightful lessons from the clinical contexts of clinicians collaborating, delivering care, or engaging in meaningful interprofessional discourse are difficult to emulate in a large classroom. These lessons classically take place in hospital wards, clinics, and operating rooms, with a handful of students at a time, rather than in a crowded classroom of 100 students. For today's student, early integration of clinical contexts is essential to making the cognitive connection between the basic sciences and their application to patient care. Early exposure to clinical contexts is also essential to the medical school curriculum to remain relevant and compatible with the learning styles, strengths, and aptitudes of today's student. Bringing the lessons of small group interactions to large audiences has always been a challenge in medical training.

Advances in telecommunication have created widespread opportunity in education in the form of distance and e-learning programs. In health care, this has also created platforms of telemedicine and clinical conferencing that enable patient care and consultations to take place in remote regions of the globe with otherwise sparse access to medical experts. Scholl College has intersected telemedicine and distance learning to expose large numbers of medical students to the lessons of patient care, quality initiatives, and cultural competence before students enter the hospital wards and clinics. We believe that this creates a more agile, adept, and well-prepared student to begin patient care. Scholl College has taken strategic actions to develop these opportunities with domestic and global partners.

In Haiti, Scholl College faculty have collaborated with DePaul University, two US-based wound care centers, and a wound care center in Haiti to provide clinical consultation and quality of care initiatives relating to wound care in Haiti (Figs. 1-2). Monthly teleconferencing and consultation among US-based and Haitian physicians has provided faculty development opportunities for Haiti and the United States through quality of care initiatives co-developed with Haitian partners. This has resulted in significant improvements in the rate of diabetic wound healing at the Haitian center and has been educational for all of the participants, particularly students who have participated in teleconference sessions and on-site visits to the wound care center in Haiti. Students have benefited from early exposure to the clinical contexts of global health. The Kaplan-Meier plot in Figure 3 demonstrates that the probability of patients with diabetic foot ulcers remaining unhealed through the first 90 days of treatment was significantly lessened after the telehealth program was implemented (Cohort 2) compared with before (Cohort 1) (log-rank statistic, 5.10; P = .024)

Figure 1. . Adam Fleischer, DPM reviewing best practices for obtaining an Ankle Brachial Index measurement at Bernard-Mevs Hospital, Haiti.
Figure 1

Adam Fleischer, DPM reviewing best practices for obtaining an Ankle Brachial Index measurement at Bernard-Mevs Hospital, Haiti.

Citation: Journal of the American Podiatric Medical Association 108, 6; 10.7547/8750-7315-108.6.560

Figure 2. . Foot prosthetics for amputees in Haiti after lower extremity amputation secondary to chronic wounds.
Figure 2

Foot prosthetics for amputees in Haiti after lower extremity amputation secondary to chronic wounds.

Citation: Journal of the American Podiatric Medical Association 108, 6; 10.7547/8750-7315-108.6.560

Figure 3. . Kaplan-Meier plot demonstrating that the probability of patients with diabetic foot ulcers remaining unhealed through the first 90 days of treatment was significantly lessened after the telehealth program was implemented. Cohort 1 represents wound healing probability of individuals prior to implementation of the telehealth program. Cohort 2 represents wound healing probability of individuals after implementation of the telehealth program. (log-rank statistic of group 1 compared with group 2, 5.10; P=.024).
Figure 3

Kaplan-Meier plot demonstrating that the probability of patients with diabetic foot ulcers remaining unhealed through the first 90 days of treatment was significantly lessened after the telehealth program was implemented. Cohort 1 represents wound healing probability of individuals prior to implementation of the telehealth program. Cohort 2 represents wound healing probability of individuals after implementation of the telehealth program. (log-rank statistic of group 1 compared with group 2, 5.10; P=.024).

Citation: Journal of the American Podiatric Medical Association 108, 6; 10.7547/8750-7315-108.6.560

Technology-based collaborations have not been limited to global partnerships but also occur domestically on a bimonthly basis. Scholl College has partnered with Western University College of Podiatric Medicine to develop the Debates in Current Concepts series that uses evidence-based medicine to scrutinize current health-care concepts. The debates are between students from the two colleges and are moderated by faculty. The debates spawned from an established teleconference program that Western University developed in 2013 that provides CME to practicing podiatric physicians from across the country in a forum of collaboration, education, and consultation. Concepts such as gastrocnemius recession versus Achilles tendon lengthening and double versus single calcaneal osteotomy correction of the flatfoot have been reviewed and debated in a moderated forum. The teleconference series integrates faculty development at the colleges with student education and CME for the greater podiatric medical community. Faculty from Scholl College and Western University also participate in bimonthly lectures that follow a specific Accreditation Council for Graduate Medical Education theme. These lectures create a platform for both student education and professional networking. The intersection of academia, community practitioner, and student interaction in one forum provides a unique opportunity to expose students to the context of clinical collaboration and debate among academicians and community practitioners with students. On a scale from 1 to 10, where 10 is strongly agree and 1 is strongly disagree, a sample assessment of 20 student experiences showed a mean ± SD score of 8.15 ± 1.72 strongly agreeing that the debates were an effective means to discuss clinically relevant concepts and their application to patient care, and 8.2 ± 1.96 strongly agreeing that it was an effective means to observe practicing clinicians collaborate and discuss current concepts in care.

The rapid changes in health-care delivery today are equally matched by the changing needs and demands of today's medical student. Today's medical student's need for early application and integration of knowledge with clinical contexts and practice challenges the methods of traditional medical education models. Scholl College is meeting the challenges of medicine and medical education through collaboration and interprofessionalism.

Acknowledgment: Lawrence Harkless, DPM, Diane Tower, DPM, MPH, Patrick DeHeer, DPM, Judy Costner, John McDonald, MD, Faye Rose, DPM, Francius Adler, MD, Patrick DeHeer, DPM, Judy Coster, RN, and Olayele Adelakun, PhD for their instrumental support, participation, and leadership throughout various stages of collaboration. Drs. Harkless, Tower, McDonald, Rose, Adler, and Adelakun participate in and contributed to CME teleconferences with Western University. Dr. Tower also participates in and contributed to Global Wound Care Initiatives in Haiti. As a member of AACPM since its inception in 1967, Scholl College appreciates the work of the Association in student recruitment and application processing, in clerkship and residency applications and matching, for college faculty, administrations and clinical program directors, for liaisons with the professional societies, and for advocacy of podiatric medical education with other organizations.

Financial Disclosure: None reported.

Conflict of Interest: None reported.

Drs. R. Joseph, Robinson, Jaffe, A. Joseph, Truoung, and Nouvong also participate with and contribute to continuing medical education teleconferences with Western University.

Drs. R. Joseph, Robinson, Fleischer, and Baker also participate in and contribute to Global Wound Care Initiatives in Haiti.

Corresponding author: Robert Joseph, DPM, PhD, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064. (E-mail: Robert.joseph@rosalindfranklin.edu)