Designing Medical Education Spaces for Interprofessional Learning

Facility design for teaching health sciences is evolving to accommodate and encourage an interprofessional approach to training.

• By Brenda Smith, Heidi Costello
• 06/08/18

The shift towards a team-based, interprofessional approach to healthcare delivery and education has left some medicine and health sciences teaching facilities behind the pedagogical times. Many campuses still teach the next generation of medical professionals—across a range of health sciences disciplines—in buildings separated by functional silos. Fortunately, several medical education building initiatives are setting the example for how to craft physical spaces to support this new, highly collaborative way of learning and working.

A confluence of circumstances has fostered the trend to team-based, interprofessional learning and the spaces that facilitate such learning. First, the medical profession’s mounting talent shortage requires today’s health professionals to have a broader understanding of other disciplines; to have the social and emotional intelligence to communicate across a range of other professionals; and to deliver patient care as part of a team. Next, a new generation of workers are now entering medical education programs and health professions. Their secondary education experience was active, immersive, and collaborative—and they expect similar applied learning and social engagement in higher education and work. Last, accreditation standards in all health science programs require students to have some level of learning with other health science programs to foster team-based delivery of care, collaboration, and problem solving.

To keep pace, medical and health science campus buildings that once were single-purpose facilities are now expected to support diverse functions and objectives that strain their functional capacities. Forward-thinking universities are creating multifunction facilities that combine and integrate traditionally siloed disciplines. The University of North Dakota (UND) School of Medicine and Health Sciences’ (SMHS) new facility in Grand Forks, ND, serves as a good example of how facility supports function.

Enriching Collaboration

The strategic plan for University of North Dakota School of Medicine and Health Sciences is replete with objectives related to student experiences enriched by team-based collaboration, interprofessional interaction, real-world simulations, and patient-centered learning. One objective of the building, for instance, is to “Encourage Gathering: UND SMHS will create a community for health professions education and research that is interprofessional/interdisciplinary and collaborative.” Another is to “Facilitate collaboration: UND SMHS will increase the potential for successful outcomes in health research through collaborative models. Reorganize the research enterprise away from traditional departmental lines into integrated subject-oriented collaborative research groups. Reorganize the basic science graduate student program into a multi-disciplinary program.”

University of North Dakota has offered interprofessional education since 2006 and the school has an Office of Interprofessional Education. New students are exposed to interprofessional learning concepts through UND’s Interprofessional Health Care Course and Interprofessional Student Community-based Learning Experience. Still, one big challenge in implementing interprofessional education was the fact that the eight SMHS programs were located in six different buildings dispersed throughout the campus.

In May 2013, the North Dakota Legislature approved funding for a new $123.76 million, 325,000-square-foot, four-story UND School of Medicine and Health Sciences building. This provided UND SMHS’ leadership the chance to ensure that its interprofessional learning commitment would be reflected, facilitated, and enlivened by the new space.

In planning the new facility for interprofessional interaction, the design team* was challenged to create a standalone building to house—all under one roof—UND’s School of Medicine and health science programs, including: The School of Medicine, Basic Sciences, Medical Lab Sciences, Physician Assistant Studies, Public Health, Physical Therapy, Occupational Therapy, and Sports Medicine. To accomplish this goal, the design team crafted the building to facilitate student and faculty interaction and sharing of technologically advanced learning spaces, simulation resources, and meeting rooms.

• Interprofessional interaction: To dissolve program silos and foster interaction, UND assigned eight learning communities, each with an even mix of students from across professional disciplines. Each group is co-located in one of eight dedicated community spaces for learning and socializing, each of which includes a kitchen, study space, lockers, and small group meeting rooms.  
• Collaborative collisions: The four-story facility is arranged around a main corridor that makes it easy for students to cross paths with others from their cohort community and to congregate and converse. This “main street” corridor is flanked by state-of-the-art classrooms, flexible learning environments, simulation labs, meeting and study spaces, and combined departmental office suites. 
• Shared spaces: Classroom spaces are shared across disciplines and accommodate high- and low-tech as well as large and small group learning scenarios. Interprofessional research spaces are designed as shared open lab spaces with shared equipment corridors. 
• State-of-the-art simulation: The building’s interactive simulation facilities include high-fidelity manikins and computer technology to simulate real-life patients and room for facilitated debriefing on both teamwork and individual performance assessment with video observation. 
• Faculty teaming: Faculty, staff, and administrative spaces consist of smaller private offices and shared space for faculty teaming—meeting/conference rooms and small privacy rooms to meet with students. Faculty office suites are intentionally distributed adjacent to student/learning spaces to encourage informal interaction with students.

Overcoming Challenges

As with any new construction project, there were hurdles along the path to completion. The main challenges to a successful new building for interprofessional learning, though, were related to culture, not construction.

UND SMHS experienced a tremendous shift from silos and legacy space assignments to an open, collaborative, and shared-resource culture that fully supports team-based, interprofessional learning and prepares the next generation of health professionals to deliver superb coordinated care and positive outcomes. Some of the essential interventions to smooth the transition included:

• Incorporating a deliberate transition management plan.
• Creating a “blue ribbon” committee to work through leadership and organizational changes.
• Development of space use guidelines for students in public/common spaces. 
• Hiring an associate dean for Teaching & Learning, versed in progressive pedagogy methods and technology.

To ensure the success of team-based, interprofessional learning curriculum, medical education programs like UND SMHS must marshal all possible resources to support this approach. That includes matching the program’s physical facilities to the pedagogy. Constructing a well-designed building for this purpose means, at the same time, enacting a change management plan that eases the effort.

* JLG Architects, lead architect; Perkins+Will, design architect; Steinberg Architects, medical education designer