Interprofessional Education Faculty Feature: Amber Fitzsimmons
From clinician to automotive marketing to professor, the broad experience of Amber Fitzsimmons, PT, MS, DPTSc, demonstrates the diversity that interprofessional education (IPE) at UC San Francisco aims to exemplify.
An assistant professor with joint appointments in the School of Medicine’s Department of Anatomy and the Department of Physical Therapy (PT) and Rehabilitation Science, Dr. Fitzsimmons serves as the PT lead in the IPE program at UCSF. The UCSF Program for IPE (PIPE) was created to enable students from different fields to interact and learn in a way that prepares them for the seamless teamwork of interprofessional collaborative practice that successful modern patient care delivery requires.
“The goal is to learn about and from each other and not just to work side by side,” Fitzsimmons said. “IPE started in a classroom setting, but at UCSF we are trying to move it outside the classroom and into a collaborative practice known as interprofessional collaboration (IPC).”
After receiving her Masters in Physical Therapy in 1996 from Pacific University in Oregon, Fitzsimmons moved to the Bend area. While there, she practiced as a clinician in inpatient and acute rehabilitation settings. After nearly a decade, she took a new opportunity in automotive marketing as an independent consultant for companies, such as Toyota in their mobility program.
“I used my PT experience to educate Toyota on functional challenges that those with disabilities might face,” Fitzsimmons said. “I also educated consumers about various adaptive equipment that could be added to Toyota vehicles to allow for automotive independence for patients, families, and caregivers,” Fitzsimmons said.
She worked with adaptive mobility equipment for scooters and wheelchairs, such as: assistive driving technology, ramps, and carriers. She also helped navigate the access to equipment. After four years, Fitzsimmons left her work with Toyota and came to UCSF to get her Doctorate of Science in Physical Therapy (DPTSc) degree in 2013.
“I wanted to combine my clinical experience and business development/mobility advocacy experience, so that I could teach physical therapy at a university level, and at the time UCSF was one of a few programs in the United States that offered the degree I was looking for,” Fitzsimmons said.
Fitzsimmons said her past two careers’ versatility make her a natural fit for interprofessional collaboration, specifically her experience in the acute rehabilitation setting.
“In that setting you have various professions located in one building, so acute rehab is notorious for interprofessional team based care,” Fitzsimmons said. “You have PTs, occupational therapists, speech-language pathologists, physiatrists, case workers, social workers, and neuro-psychologists all in one location.”
Her IPE experience in the clinical setting benefits her now as she interacts with UCSF colleagues.
At UCSF, the IPE program has an Executive Committee that governs and oversees the three IPE Working Groups, ensuring they adhere to the UCSF mission and vision.
The three UCSF IPE committees are the Curriculum Development Working Group (CDWG), the IPE Assessment Committee, and the Faculty Development and Scholarship Working Group. CDWG has seventeen members from all schools and discovers IPE curriculum delivery opportunities. The Assessment Committee has five members and assembles the IPE framework and ensures that outcome goals are met. The third committee, Faculty Development and Scholarship, has two members: JoAnne Saxe, RN, FAAN, Community Health Systems, who is part of the Academy of Medical Educators (AME) and Research and Development Medical Education and assists with IPE faculty development; and Shelley Adler, PhD, Family & Community Medicine, who develops scholarship plans for research and ideas.
Fitzsimmons said that when she came to UCSF, IPE was in its early stages at the University, but the history of IPE began long ago.
“In reality if you look at the history of IPE, there are reported teams of professionals working together in mission hospitals, particularly in India prior to 1900,” Fitzsimmons said. “Fast forward to World War II and two WHO [World Health Organization] reports in the ‘80s, IPC was seeing some success both here and in the U.K.”
However, Fitzsimmons said while IPE or IPC have both been taking place for decades, it didn’t transition to the forefront at UCSF until recently with the national mandate of the Affordable Care Act and the emphasis of the Triple Aim, which was created by the Institute for Healthcare Improvement.
Interprofessional Education at UCSF
The idea of IPE is that it will be a foundational support of the Triple Aim: improving the quality of care, decreasing cost of care, and promoting value or improving population health in the health care system.
“IPE is the means by which the triple aim is achieved,” Fitzsimmons said.
Fitzsimmons said at UCSF, IPE teaches students and faculty preceptors about the roles and responsibilities, values and ethics, communication, and teamwork competencies needed to optimize team-based care for patients.
“IPE is ultimately about the patient and improving patient care and experience,” Fitzsimmons said.
The team-based work environment is beneficial Fitzsimmons said, because it alleviates one person from carrying the sole responsibility. Rather, colleagues are able to contribute to patient care in their area of expertise, collaboratively brainstorm, and problem solve with each other. Yet, providing care to patients and families is not without its own set of stressors for providers.
“Teams/Teamlets may be a method that prevents provider burnout and may promote health provider job satisfaction,” Fitzsimmons said. “This belief is reflected in a recent published paper by Dr. Thomas Bodenheimer.”
Bodenheimer, MD, MPH, is a UCSF primary care doctor whose paper suggests the current triple aim add one more component of improving job satisfaction of health care workers. Bodenheimer discusses how data has been collected to show that significant job dissatisfaction and burnout is occurring in the health care professions. By first ensuring job satisfaction, health care workers are then able to perform their duties more effectively.
“IPE is a huge driver for my job satisfaction,” Fitzsimmons said. “My scholarly work, my committee work, and my conference presentations allow me to interact with a diverse group of professionals who share the same goal. We intellectually stimulate one another in order to provide optimal educational and patient outcomes.”
One way that Fitzsimmons said she is most intellectually challenged is through her involvement with the Department of Anthropology, History, and Social Medicine (DAHSM). Housed in the School of Medicine, DAHSM trains and conducts research on social and historical health implications. While Fitzsimmons doesn’t hold an appointment in that department, she does interact with their faculty.
“Working with people from pharmacy, dentistry, medicine, nursing, as well as the experts in the Department of Anthropology, History, and Social Medicine constantly challenged me to think outside my own lens, and because of that no one day seems to be the same in my job, especially in IPE responsibilities,” Fitzsimmons said.
While Fitzsimmons’ role in IPE is rewarding, it requires time. Fitzsimmons involvement with IPE includes both national and international commitments.
National Level Involvement
At the national level, she is a member of IPE CDWG, is on a grant review committee, serves as a faculty lead for the Interprofessional Standardized Patient Experience Committee (ISPE), teaches faculty development courses, is a recipient of innovation grants, and attends conferences.
First, on CDWG, she represents the PT department for interprofessional curriculum at the University and attends monthly meetings. On ISPE, she helps design third-year stimulation patient cases for students in different schools and attends quarterly meetings.
Second, Fitzsimmons is the primary investigator on two innovation grants. The first was used during the 2014-2015 academic year for interprofessional quality improvement through a patient safety project that brought PT and Pharmacy students together. They worked on an aggregated database that assessed falls that took place in the UCSF medical center. The collaboration was created in order to predict future falls and teach students the importance of interprofessional teamwork.
The second grant is in progress and focuses on IPC team based care. As part of the Total Care Support Team within the Division of Population Health, Fitzsimmons and faculty colleagues Rosalind De Lisser, RN, MS, NP; Kara Birch, RN, DNP, NP; and Kirby Lee, PharmD, MAS, oversee a triad of Psychiatric Nurse Practitioners, Pharmacy, and PT learners in providing home-based care for adults with chronic complex conditions and co-morbid mental health challenges. This is a longitudinal ten-week elective for UCSF students interested in interprofessional team-based care in the clinical arena.
“The goal was to introduce learners to a vulnerable patient population, while also providing a longitudinal opportunity to learn with, from, and about one another in a supportive team-environment,” Fitzsimmons said.
Third, Fitzsimmons recently attended an American Physical Therapy Association (APTA) national conference where she presented a faculty development session on IPC in the clinical setting. Fitzsimmons also recently trained approximately 100 clinical instructors throughout Northern California about IPE and the ways to incorporate into the Physical Therapy clinical education.
Fourth, she was a founding board member of the National Interprofessional Education Consortium of the APTA and is now transitioning to the chair position of the nomination committee.
Lastly, she teaches a session with colleagues in the School of Medicine and the Office of Medical Education called “Capitalizing on Teachable Moments.” Participants in this course are required to complete an online module prior to the workshop. By the end of the course, participants should be able to implement and improve on IPE-based teaching skills. This session is one of ten workshops in the Teach for UCSF Certificate Program that allows UCSF faculty to receive a UCSF IPE teaching certificate. To obtain a certificate in the recommended two-four years timeframe, participants must attend two-three workshops per year.
International Level Involvement
Fitzsimmons’ involvement at the international level is through attendance at international IPE conferences. She attends Collaborating Across Borders between locations in Canada and the United States every two years. This conference began in 2007 and focuses on IPE and interprofessional practice. The conference hosts not just educators, but also clinicians, students, researchers, and policy creators. The next conference will take place in early October.
On the alternate years, she attends the All Together Better Health conference held in various U.S. states and other countries, where Fitzsimmons has had the opportunity to present in Virginia, Japan, and the upcoming conference in Canada.
In the future of IPE and IPC, Fitzsimmons would like to see more themes incorporated to educate students on pertinent issues at the start of their careers. This includes increasing the quality of patient improvement initiatives, health disparities, social determinacy of health, and diversity inclusion issues.
IPE proves to be important not just for students, but faculty as well, and the university provides avenues in which IPE faculty can receive support.
AME and Educator Portfolio
One way UCSF cultivates IPE faculty is through the Academy of Medical Educators (AME). AME was created in 1999 as a program that supports the educational mission at UCSF and rewards teaching excellence through small IPE grants.
Initially, only School of Medicine faculty were involved with AME, but now it welcomes all faculty. Fitzsimmons and Kimberly Topp, PhD, PT, are the only PT faculty who are in AME. Topp is a Professor and the Chair of the School of Medicine’s Department of Physical Therapy and Rehabilitation Science, the Vice Chair of the Academic Senate’s Committee on Educational Policy (CEP), and the Chair of the IPE Executive Committee, where she organizes IPE opportunities for students.
One of the things that AME has improved in the past few years is the Educator Profile, which allows faculty involved with curriculum or educational efforts to highlight it within their CV in a more substantive manner than standardized CVs. In 2013, the AME assembled an action group to improve the Educator Profile.
“I benefitted from using the Educator Portfolio as a means to document my primary creative endeavor of teaching, as opposed to research or clinical endeavors,” Fitzsimmons said. “I found it valuable to do an Educator Portfolio, because it now only highlights my teaching time and effort, it really allowed me to self-reflect on what I was doing and where I wanted to go in my career.”
The Educator Portfolio focuses on direct teaching and mentoring; curriculum development, instructional design, and technology; educational leadership; and includes a learner assessment. These sections have lengthy answers and data that include anything from roles the faculty has held to research methods.
“The amount of time put into the Educator Profile shows just how time intensive a career in education is,” Fitzsimmons said.
Upon completion, the profile is circulated to Departments, Schools, and the Academic Affairs Office for review during advancement and promotion actions.
“IPE is something I am passionate about, because my nature has always been to work in a very diverse setting, and the Educator Profile allows me to show a part of that diversity through teaching,” Fitzsimmons said.
Journey to UCSF
After working with people in various lines of work, including consulting with Toyota and through working in diverse clinical settings, Fitzsimmons completed her dissertation on IPE’s role in clinical practice. It was published in the Journal of Physical Therapy Education and recently highlighted at a national meeting she attended.
“I love my colleagues in PT, but what keeps me at UCSF is the ability to constantly collaborate with physicians, pharmacists, dentists, nurse practitioners, and colleagues from the DAHSM,” Fitzsimmons said.
Fitzsimmons also felt drawn to UCSF because of the University mission.
She describes the steps she has taken to UCSF as “circuitous,” and not the usual order. However, she encourages those pursuing a career similar to hers to explore opportunities that “knock on your door, even if they don’t necessarily make sense at the moment.”
“When I was a clinician and took the opportunity in automotive marketing it came full circle in helping with my communication skills and my ability to work with people outside of physical therapy,” Fitzsimmons said. “Sometimes we make career decisions only with our heads, but I think we have to also go with our hearts too, and follow our passions.”
When Fitzsimmons is not actively involved in academia, she enjoys outdoor activities, such as: backpacking, camping, and open water swimming with her dog throughout California, Oregon, and Washington. She once hiked from Mexico to Canada on the Pacific Crest Trail, which spans 2,650 miles, but her favorite places to hike are the Northern Cascades National Park and Goat Rocks Wilderness in Washington.
Created by UC Board of Regents Standing Order 105, the UC San Francisco (UCSF) Academic Senate is empowered to exercise direct control over such academic matters as admissions for degrees and curricula, which are of central importance to the University. The UCSF Division of Academic Senate provides an independent forum to discuss faculty-related campus wide academic concerns. In other areas, the Senate exercises an active advisory role. The Academic Senate works within the larger body of UCSF, a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Kathryn Sill is a Communications Specialist in the Academic Senate Office, San Francisco Division. She can be reached at firstname.lastname@example.org.