School draws on diversity of disciplines
Written by Phillip Fiorini
As a researcher, Pi Ju “Marian” Liu has seen countless cases of abuse, neglect and exploitation of the elderly by not just strangers but trusted family members. Unfortunately, any assistance and emotional support from social workers for these victims is often met with resistance — out of embarrassment or concern about losing their decision-making rights. But when a professional nurse is added to the equation, the victims are more receptive to the help that can be provided by social services and community organizations.
“The nurse plays a critical role in that environment,” says Liu, a developmental psychologist who joined the Purdue School of Nursing faculty this fall. “The nurses and the social workers partner to develop strategies about how to communicate with their clients. Alongside the social worker, they work together to make the elderly person feel comfortable in explaining what happened and willing to receive the necessary assistance, be it medical or social.
“When you partner a social worker with a nurse in these situations, you get an entirely different story.”
Liu says her research to address the growing issue of elder abuse points to the very nature of how several perspectives can come together to solve a complex problem. The thriving interdisciplinary and interprofessional culture of Purdue Nursing was a key factor in her decision to join the faculty.
The Purdue School of Nursing has embraced interprofessional education, or IPE, to both better prepare its students and push the boundaries of its research to improve patient care. The school recruits top faculty, such as Liu, from professions that complement and enhance its existing academic teaching and research strengths in nursing. Purdue Nursing faculty includes a sociologist and an engineer as well as psychologists, statisticians and public policymakers.
“The diverse professional backgrounds of our faculty enrich our programs and infuse interprofessional educational and collaborative experiences within our nursing faculty,” says Pamela Karagory, interim head of the School of Nursing.
“Interprofessional education is especially valuable for nursing students, because it exposes them to opportunities for viewing health care environments as complex systems that must be considered as they work to deliver quality care and ensure patient safety,” Karagory says. “Students are exposed to concerns in health care settings that expand beyond the traditional nurse’s scope of practice and expertise, and they work with those in other disciplines to navigate and resolve these challenges. These experiences prepare nurses to lead diverse health care teams and the complex system in which they work.”
Many of these professors who have joined Purdue nursing faculty the past few years also have deep connections with industry, government agencies or organizations that enhance their interprofessional expertise. The result: An immersive, realistic learning experience that requires students to practice gathering evidence, applying concepts learned, and advocating from their unique professional perspective as part of an interprofessional team, says sociologist Greg Arling, the Katherine Birck Chair in the School of Nursing.
Building bridges from Purdue’s strengths
As part of an initiative to infuse systems and quality improvement approaches in its undergraduate program, Purdue Nursing added industrial engineering professor Sara McComb to its faculty in 2011.
“We have embedded systems thinking and quality improvement throughout all the curricula within Nursing. At the undergrad level, they call it scaffolded learning,” McComb says. “This is where we increase what we require of them and what we’re teaching them, progressively increasing the depth and the breadth as they move through the four-year program.”
The bridge generated between Engineering and Nursing through McComb’s appointment has led to many interprofessional learning experiences, including the launch of an Institute for Healthcare Improvement (IHI) Open School student chapter at Purdue that is co-led by the schools of Nursing and Industrial Engineering.
“Our long-term goal is that every college at Purdue will have representation in the IHI Open School,” McComb says.
Purdue Nursing’s curriculum provides students with hands-on opportunities to address challenges in the dynamic environment of today’s health care system. Purdue Nursing graduates are prepared to recognize and collaborate with interprofessional practice partners to successfully improve health care delivery, McComb says.
Purdue nursing senior Claire Hornsby, IHI Open School Purdue chapter president in 2017-18, worked on a project where she joined a team of physicians, nurses and public health experts to plan a campaign for combating substance-use disorders in the communities of the more than 900 chapters of the institute worldwide.
“By combining the power of very different perspectives and ways of thinking, we have accomplished many quality improvement and social justice projects. I am very grateful for the opportunities I have had to work with so many people in and outside of the profession of nursing,” says Hornsby, of New Palestine, Indiana, who plans to be a pediatric nurse when she graduates. “I would not approach my work in health care the same way if I did not have these interprofessional learning experiences. I feel that I am equipped to bring a unique skill set to the workforce.”
Through her leadership position, Hornsby also coached other chapters across the world to bring interprofessionalism and quality improvement education to their campuses and health care institutions.
Differing perspectives = Equipped leaders
Arling, who joined the Purdue Nursing faculty four years ago, teaches graduate courses on quantitative research methods and health care innovation, and his research is focused on health care quality assessment, evaluation, and policy analysis. In his work, mostly with elderly patients in long-term care settings, Arling has helped develop comprehensive measures of care quality; has assessed the accuracy and effectiveness of these measures; and has applied them to quality improvement, public reporting, and pay-for-performance.
“If you look at the faculty of Purdue Nursing and you see the degrees, particularly among the tenured-track faculty, we have people who have clinical degrees who also have degrees in other disciplines,” Arling says. “Intellectually, it’s both challenging and exciting to cut across disciplines and learn from different people.”
Liu, who came to Purdue from the University of California, San Francisco (UCSF), has focused her research on elder justice, covering topics on elder abuse/neglect and Medicare/MediCal health care policy. She has studied risk and protective factors of potential elder financial exploitation victims, while working with researchers from UCSF and the University of California, Berkeley, to evaluate California’s Coordinated Care Initiative for seniors and people with disabilities.
Liu serves as co-chair of the National Adult Protective Services Association’s Research Committee and is on the board and executive committee of the National Committee for Prevention of Elder Abuse.
“I would definitely advocate for interprofessional education, preparing our future nurses to learn more about what other people are doing, how to collaborate with them and how to converse with them. In the process, I see my role as helping the next generation of nurses to find their passion,” Liu says. “In today’s world, it would be very hard not to work with those from other professions and backgrounds, and it is immensely beneficial to collaborate with them.”
‘You did that as an undergraduate?’
At the end of the day, the interprofessional approach to learning — for undergraduate and graduate students alike — is working, says McComb. The proof is the strong job placement rates for undergraduate and graduate students completing their Purdue Nursing program.
“What we’ve heard back anecdotally from the students is that when they go out to interview for a job and they say, ‘Can I tell you what I did in my senior leadership class?’ They pull out their summary document, and the response they get is, ‘You did that as an undergraduate?’ And they’re getting the jobs,” McComb says.
