Practical Strategies for Successful Interprofessional Education
You would expect any team caring for the health of you or your loved ones to be trained together, effective in communication and teamwork. You should expect for each professional to understand the roles of others on the team and share a mutual respect for patients and colleagues. You might expect this training to occur before graduation, prior to licensure, and before stepping into a high-stakes health care environment. If you share any of these expectations, you will be surprised to learn that most health professionals practicing today were not trained in this way. The adoption of interprofessional education (IPE) and collaborative practice (IPCP) is way overdue.
Why IPE? Why Now?
It has long been recognized that training health professionals in “silos” is misaligned to the practice of modern health care. Professional silos refer to the relationships among professionals based on “power, competition, and hierarchies, resulting in inadequate preparation for teamwork” (Margalit et al., 2009, p. 166). The call for change by breaking professional silos began during the early 1960s and continues today (McCreary, 1964).
The first Institute of Medicine (IOM) report speaking to this concern was published in 1972, titled Educating for the Health Team. Despite these and other calls for change, educational accreditation standards were slow to respond and we continued to train our health professionals in silos without shared identities, goals, or understanding of teamwork and roles. For many, the first-time collaboration with another profession occurred on the job, in a live practice setting.
The need for training of the team is no less important today. Today’s health care professionals must be prepared to work together in an increasingly diverse, fast-paced, and complicated environment. Health care workers are expected to communicate effectively, understand the roles and responsibilities of all team members, respond ethically, and understand teamwork to provide optimum care to patients and family members. The anticipated impact of IPCP on patient care includes improved safety, decreased mortality, and optimal health outcomes. Nearly two-thirds of serious medical errors come from failure in team collaboration, primarily linked to communication as a root cause (The Joint Commission, 2005). According to multiple national and international agencies, IPE and IPCP are the keys to improving health care in the 21st Century (Frenk et al., 2010; HPAC, 2019; HRSA, 2014, 2019; IOM, 2003, 2013, 2015; IPEC, 2011, 2016; Pew Commission, 1998; WHO, 2010).
A significant step in implementing IPCP is the integration of IPE in the training programs for health-related disciplines. IPE occurs when two or more disciplines come together and learn about, from, and with each other (WHO, 2010). Yet, students and faculty in health care–discipline academic training programs remain isolated from one another. Academic departments and programs persistently exist in silos. IPE faculty should work on developing dual professional identities (as a member of an interprofessional team as well as their own profession) in their students; yet, the focus is still mainly on uniprofessional education and identity (HPAC, 2019; Khalili et al., 2013).
In response to these national and international policies, there is a movement to implement IPE into university-based programs and professional development training. Further, the accreditation landscape supporting IPE is robust and rapidly evolving. Most health professional education accreditors and academic associations expect schools and colleges to develop interprofessional curriculum and assess learning of interprofessional communication, ethical practice, roles, and teamwork to ensure collaborative, practice-ready graduates (HPAC, 2019; IPEC, 2011, 2016).
National and international leaders and stakeholders in health care education and practice have largely advanced IPE and IPCP top-down, through changes to accreditation, research funding and best-practice guidance. There remains, however, disagreement on how to implement IPE and IPCP to accomplish this desired change. In many ways, health professions and educators are still learning how to implement robust training and assessment that leads to improved collaborative practice, which in turn creates positive results for patients and health systems.
This critical change starts with creating a big idea for IPE that everyone can get behind, when integrated into their mission, vision, values, and strategic plans. Equally important, it also starts with each of us telling our own stories—how IPE and IPCP unlocked a student, changed the outcome for a patient, opened up new areas of scholarship and resources, deepened the trust in our colleagues, and changed the culture at our institutions. Each of these stories we tell at our home institutions requires an understanding of our shared history, culture, organizational structure, communities, environments, resources, and leadership styles.
An IPE Toolkit to Help
The IPE Toolkit offers practical strategies for successful interprofessional education, to help with program design, implementation, and assessment. This book aims to meet the reader where they are, stimulate innovation in practice, and quickly help launch or advance IPE and practice. Throughout the text are abstracts, tables, checklists, figures, and appendices to accelerate the reader’s understanding and highlight essential IPE concepts and practices. This book also offers a systematic approach to IPE through backward design and alignment to IPEC competencies (IPEC, 2011, 2016) and the Triple Aim of Health (Berwick et al, 2008).
For colleagues interested in jumping into IPE for the first time, the authors suggest you frame your understanding of IPE through history and shared outcomes (Chapter 2), and understanding IPE stakeholders and the need for a Dual Professional Identity (Chapters 4 & 5). Then, find a partner from another health professional program and begin experimenting in offering IPE activities using the toolkits (Chapter 10).
For colleagues who wish to add to an existing IPE curriculum, we encourage you to think deeply about creating change (Chapter 3) and reinforcing the IPE leadership team (Chapter 5). Begin gathering evidence of individual competency and collective achievements through the application of toolkits (Chapter 10). IPE events have a tendency of running their course and ending when the leadership team is storming or if there is not clear evidence of meaningful outcomes and student achievement.
For colleagues interested in globally rethinking their IPE to help achieve powerful results, a deliberative stepwise backward design process is offered (Chapter 6) with a framework for assessment beyond just the IPEC outcomes (Chapter 7).
It is our sincere hope that this book helps to further advance IPE and IPCP at each of your programs. We hope that all stakeholders will find the IPE Toolkit inspiring, enlightening, and useful. May this work serve to contribute to the transformation of health care education and practice, and collectively achieve the Triple Aim of Health.
Berwick, D., Nolan, T., & Whittington, J. (2008). The Triple Aim: Care, cost, and quality.
Health Affairs, 27(3), 759–769.
Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., Fineberg, H. et al. (2010).
Health professionals for a new century: Transforming education to strengthen health systems in an interdependent
world. The Lancet, 376 (9756), 1923–1958.
Health Professions Accreditors Collaborative [HPAC]. (2019). Guidance on developing quality
interprofessional education for the health professions. Chicago, IL: Health
Professions Accreditors Collaborative.
Health Resources and Services [HRSA]. (2014). Transforming interprofessional health
education and practice: Moving learners from the campus to the community to
improve population health.
Health Resources and Services [HRSA]. (2019). Preparing the current and future health care
workforce for interprofessional practice in sustainable, age-friendly health systems.
Institute of Medicine [IOM]. (1972). Educating for the health team. Washington, DC: National
Academy of Sciences. https://files.eric.ed.gov/fulltext/ED110819.pdf
Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington,
DC: The National Academies Press. https://doi.org/10.17226/10681.
Institute of Medicine. (2013). Interprofessional education for collaboration: Learning how to
improve health from interprofessional models across the continuum of education to practice: Workshop summary. Washington, DC: National Academies Press.
Institute of Medicine. (2015). Measuring the impact of interprofessional education on
collaborative practice and patient outcomes. Washington, DC, USA: The National
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for
interprofessional collaborative practice: Report of an expert panel. Washington, DC:
Interprofessional Education Collaborative. https://www.aacom.org/docs/default-source/insideome/ccrpt05-10-11.pdf?
Interprofessional Educational Collaborative. (2016). Core competencies for interprofessional
collaborative practice: 2016 Update. Washington, DC: Interprofessional Education Collaborative. https://aamcmeded.global.ssl.fastly.net/production/media/filer_public/70/9f/709fedd7-3c53- 492c-b9f0-b13715d11cb6/core_competencies_for_collaborative_practice.pdf
Khalili, H., Orchard, C., Laschinger, H. K. S., & Farah, R. (2013). An interprofessional
socialization framework for developing an interprofessional identity among health
professions students. Journal of Interprofessional Care, 27(6), 448–453.
Margalit, R., Thompson, S., Visovsky, C., Geske, J., Collier, D., Birk, T., & Paulman, P. (2009).
From professional silos to interprofessional education: campuswide focus on quality of
care. Quality Management in Healthcare, 18(3), 165–173.
McCreary, J. F. (1964). The education of physicians in Canada. Canadian Medical Association
Journal, 90, 1215–1221.
Pew Health Professions Commission (Pew), & O'Neil, E. H. (1998). Recreating health
professional practice for a new century: The fourth report of the Pew Health Professions Commission. Pew Health Professions Commission, Center for the Health Professions, University of California, San Francisco.
The Joint Commission. (2005). The Joint Commission’s sentinel event policy: Ten years of
improving the quality and safety of health care. Joint Commission Perspective, 25(1).
World Health Organization [WHO]. (2010). Framework for action on interprofessional education and collaborative practice.
Geneva, Switzerland: Author. http://www.who.int/hrh/nursing_midwifery/en/