Sawatdee Ka: Hello from Thailand!

Written By: Erin VanMeter, PharmD, BCACP, Assistant Professor of Pharmacy Practice and Science

The University of Maryland School of Pharmacy has been an active member of the U.S.-Thai Pharmacy Education Consortium since 1993. The mission of the consortium is to foster collaborations between schools of pharmacy in Thailand and around the world in an effort to enhance academic, research, and clinical programs.

Through the relationships established by this consortium, I learned about an innovative program in which interprofessional education (IPE) is taken beyond the classroom and out into real life practice. Chanuttha Ploylearmsang, PhD, dean of pharmacy at Mahasarakham University (MSU) in Thailand, successfully implemented an IPE course in which students from six different disciplines (medicine, pharmacy, architecture, nursing, informatics, and veterinary sciences) participate in an interprofessional home-care visit. The IPE course was established in 2016, and within two years, a total of 324 students had participated in the course and were able to provide direct, multifaceted care to 50 patients in their homes.

We know that increasing access to health care is not the only barrier to improving health outcomes. Improving health and empowering patients to take an active role in their health care are unique challenges that often fall outside the walls of health care facilities. Explorations in providing high-quality patient care in an environment that is more familiar and comfortable to patients are already underway. However, there are a limited number of interprofessional teams in the United States that provide patient care within patients’ homes. The collaborative, in-home “patient care rounds” concept being practiced by faculty and students at MSU is not only an advanced concept for current IPE practices, but also a novel concept from a patient care perspective. And, after hearing about this program, I knew that I had to see it in action.

An International Learning Experience

From June 7-22, four students from the Schools of Pharmacy, Nursing, Medicine, and Social Work and I traveled to Thailand to visit MSU, and learn more about its innovative approach to IPE. MSU’s official course title for this program is IPE for Humanized Patient Home Care. Students from the schools of medicine, pharmacy, architecture, nursing, informatics, and veterinary sciences are required to take the course during their second and third year of study.

The course contains a mixture of learning experiences from traditional didactic learning to simulated and real patient care experiences. My students and I participated in an abbreviated version of the course with 12 MSU students from the various disciplines. The course was completed over four days, and mirrored the learning and activities in which students participated during the semester.

Our first day was focused on team building activities and strengthening foundational knowledge regarding home visits. During the second day, we met with faculty from each discipline to learn more about their role on the team. In the afternoon, we completed an activity with the school of architecture that taught us about universal design for the elderly population, which aims to make homes accessible for people both young and old, as well as the healthy and infirm. This modern concept for design allows populations to age safely in their homes, and includes changes such as modifying how doors are opened. For example, the way a door typically opens can make it challenging for people in wheelchairs to operate, or for care providers to quickly assist an elderly person who may have fallen in front of the door. If the door opens via a sliding mechanism, it provides more room and quicker access.

On the third day, we visited the Burapa Primary Care Unit and Community Drug Store that partners with MSU for this course. Patients who are selected to participate in IPE for Humanized Patient Home Care must also be patients at the Burapa Primary Care Unit. This targeted selection process ensures that patients receive the proper care following the home visit. That afternoon, we participated in learning activities that taught us how to engage patients and their families. We learned how to use the “INHOMESSS” mnemonic to assess patients, which was developed by the American Academy of Family Physicians to help family physicians remember the items to be assessed during the home visit: immobility, nutrition, housing, other people, medications, examinations, safety, spiritual health, and services by home health agencies.

On the fourth day, the students completed two home visits under the supervision of faculty members from the schools of medicine, pharmacy, and nursing. The afternoon was spent on the development of a personalized care plan for the patients. For example, one patient had suffered a stroke, and as a result, she had an unsteady gait and limited muscle strength, and found it extremely difficult to walk to the restroom. Students from the school of architecture devised a plan to add hand rails into the home to assist the patient.

One aspect that really stood out about the experience was how the course is designed to build a team first and then deliver patient care, which is the reverse of most practices in the United States. The level of professionalism and team work I observed among the students was inspiring; it was clear that this course integrates interprofessionalism into student’s foundational knowledge.

A Student’s Perspective

I want to leave you with the reflections of one student who participated in this trip with me: Betlihem Semma, one of our fourth-year student pharmacists.

“From this experience with the home visit program at MSU, I have learned key elements of interprofessional education and collaborative practice. I had the opportunity to interact with other health professionals and students who value interprofessional education. Having various professions (e.g., informatics, architecture, and veterinary services) involved in the home visit enabled the group to learn more about the patients, as well as from and with each other, leading to an effective collaboration that aided in improving health outcomes, such as the patient’s quality of life, prevention of complications, and maintenance of community/public health.”

“Because the IPE home visit program at MSU has been integrated into all disciplines, I was able to gain a holistic view on health, which will help me provide enhanced health care in my career. Improving my own knowledge and skills as a pharmacy student is also fundamental to my future endeavors. I will continue to incorporate MSU’s pharmacy faculty philosophy into my own practice: ‘Be knowledgeable about medicines and able to lead people to promote their healthy lifestyles.’”

Take the Next Step and Get Involved

This experience was made possible through an interprofessional global grant awarded by the Center for Global Education Initiatives (CGEI) at the University of Maryland, Baltimore (UMB). The UMB team that participated in this experience consisted of students from the schools of medicine, nursing, social work, and pharmacy. The CGEI helps students find, plan, and finance global learning opportunities to enrich their professional education. To learn more about the various opportunities, visit CGEI’s website . The Center for Interprofessional Education is another excellent way to get involved in IPE at UMB. I would encourage students and faculty alike to engage in IPE.

Sawatdee Ka: Hello from Thailand!

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