Health Mentors Program

The Thomas Jefferson University Health Mentors Program is required for all first and second year medical, physical therapy, occupational therapy, couples and family therapy, nursing, and pharmacy students. As part of this curriculum, interprofessional teams of five to six students meet with a health mentor to complete a series of four modules centered on team-based, person-centered care. The student team members and health mentor remain the same throughout this longitudinal two-year interprofessional education (IPE) curriculum. The health mentor is identified as a teacher as well as a team member; each mentor is a community-dwelling adult with one or more chronic conditions or impairments who is interested in sharing his/her personal narrative with a team of health professional students.

Overarching Program Goals:

1. Students will understand and value the roles and contributions of various members of the interprofessional healthcare team.
2. Students will understand the perspective of the patient and value patient-centered care.
3. Students will appreciate how a person’s health conditions and/or impairments interact with personal and environmental factors.

In year one of the Health Mentors Program, all students from the six professional programs participate in a half day orientation where they meet with their new team members, discuss group processes, set team ground rules, and participate in a problem-based learning exercise.   For module one, each of these student teams meets on campus with their mentor to obtain a comprehensive life and health history. For module two, each team interviews their mentor about his/her wellness practices (e.g. spiritual, occupational, emotional, physical, etc.). In year two, all student teams participate in a one hour orientation where they reconnect with their team members, practice and discuss home safety assessment, and take time to prepare for module three. For module three, student teams go into their health mentor’s home for the first time and perform a comprehensive home and medication safety assessment.  For module four, student teams interview their mentor about health behaviors, evaluating stage of change, readiness for change and confidence level.  They also assess strengths, weaknesses, opportunities and threats (SWOT analysis) for behavior change. The meetings with the mentors are scheduled on campus by staff in year one of the program. However, in year two, student teams work with their mentors and assume scheduling responsibilities for the final two modules. Concepts of teamwork and professionalism are interwoven throughout each component of the two-year curriculum. A multifaceted educational design was used in the development of each of the four new team-based modules. Each module concludes with a 50-minute faculty-facilitated interprofessional small group session (IPE session), where groups of four to five teams are brought together to share experiences from health mentor visits and present/discuss materials from their assignments. Module assignments evaluate achievement of module-specific objectives and program goals. Individual reflection papers assess what students’ value and personally learn from their participation. Mid-year self and peer-evaluations assist in measuring professionalism and year-end surveys (including the Team Performance Scale1 and course evaluations) are administered to assess student attitudes toward teamwork, collaborative care and understanding of discipline-specific roles as well as opportunities for ongoing continuous quality improvement.

 Special Implementation Guidelines and Reflective Critique:

Particular challenges with implementing a broad IPE curriculum like this program include programmatic and scheduling logistics, student perceptions and the health mentors themselves. During the quality improvement phase of this curriculum, it was critical that the program modules did not contribute to curriculum overload or repetitiveness in any particular program. Module content was designed to meet curricular objectives for all participating disciplines and was integrated into the existing discipline-specific courses.

Logistics of coordinating each discipline’s academic and examination schedules with scheduling dates for orientation, mentor visits, assignment due dates and interprofessional team debriefing sessions are an ongoing challenge. An interprofessional faculty steering committee now begins the scheduling process six to 12 months before the start of the academic year. In addition, the program has implemented a two-hour time block, during which time no classes are scheduled, for hosting health mentor visits and for interprofessional small group sessions.

A primary challenge for IPE curricular innovations is the lack of a common language across health professions’ regarding health and wellness. This challenge was addressed in 2010 by incorporating the International Classification of Functioning, Disability and Health framework (ICF) throughout the two-year program curriculum. Students now use the ICF framework to communicate more effectively as a team and to better understand the interaction of a patient with his/her health conditions, social roles, and environment.

Tips for Practical Implementation:

• Involve all disciplines and students in the planning phase. It is important to have everyone at the table in the beginning rather than bringing disciplines on at a later date.
• Have the modules replace existing curriculum in each discipline rather than adding to the curriculum. This will help to prevent curriculum overload and help with buy in for the program.
• Strategize about how to receive approval by the curriculum committees of each discipline. Have faculty members present the curriculum to discipline-specific curriculum committees who are knowledgeable about the modules and passionate about IPE.
• Involve administration in the discussion of how the program fits into faculty workload. Work with your institution and administration to gain buy in and support for faculty time and effort.
• Health mentor recruitment is an ongoing process. Each year a few health mentors must drop out of the program, usually due to illness. By recruiting mentors throughout the year, the program is able to maintain a waitlist who can fill in for student teams in such instances.
• Retention of good health mentors is key. Approximately 80 percent of our mentors return after completing their initial two years with a team, and many will take on more than one team each year. Saying thanks to our mentors is important; each year, student teams write a “thank you” note to their health mentors at the end of the program, and staff send “certificates of participation” to recognize their significant volunteer effort.
• Recruit health mentors with disabilities. Originally, the program only recruited mentors with chronic conditions. Mentors with disabilities have enriched our program and provided students with a unique perspective.
• Remind both students and mentors that the students are not yet licensed professionals and cannot provide treatment or interventions. In this program, health mentors are “teachers” and not patients/clients. Students are told not to provide interventions or treatments, and they are encouraged to refer health mentors back to his/her health care team if specific issues or questions arise. Students are also advised that they can contact the program coordinator and director of the program in an emergency or if they have a concern about a health mentor.
• Incorporating new technologies allows for greater flexibility in completion of team-based assignments. Given students’ busy schedules, new technologies that allow for asynchronous work such as Wikis and online discussion boards have eased the burden on students.
• Consider need and plan for faculty development activities around IPE competencies, teamwork and module-specific topics. In-person and online training sessions have met the program’s needs.