Implementing Interprofessional Education

Interprofessional education (IPE) describes the shared learning that occurs when students from two or more professions associated with health or social care, are engaged in learning with, from and about each other (Bridges et al. 2011).

Yet with such diverse training needs across a broad spectrum of healthcare professionals, implementing IPE can present a challenge that requires creative thinking as well as logistical flexibility.

So, how can facilitators bring diverse groups of practitioners and students together and successfully implement IPE at an organisational level?

Keys to Success

Bridges et al. (2011) suggest that the following resources are essential for the success of the interprofessional learning experience:

• Commitment from departments and colleges to set aside time for students to participate in joint learning activities;
• Curricular mapping between schools to facilitate activities;
• Adequate rooms and facilities able to accommodate large numbers of students and faculty staff;
• Creation of a space for a sense of community and shared purpose through ice-breaking activities and introductions; and
• Technology for web-based conferences to reach all participants, as well as a learning system to administer course content materials and grade students.

Learning Methods That Work Well with IPE

Depending on the topic and the learning needs of the group, a variety of educational methods can be used to deliver IPE.

Barr et al. (2018) suggest the following methods are particularly helpful and can be used in combination to enhance learning:

• Exchange-based learningg. debates and case studies;
• Action-based learning, e.g. problem-based learning, collaborative enquiry and continuous quality improvement (CQI);
• Observation-based learning, e.g. joint visits to a patient by students from different professions, or shadowing care given by another health professional;
• Simulation-based learning, e.g. role-play, games, skills labs, and experiential groups;
• Practice-based, e.g. co-location across professions for placements, out-posting to another profession and interprofessional training wards;
• E-learning, e.g. reusable learning objects relating to the above and blended learning, e.g. combining e-learning with face-to-face learning; and
• Received or didactic learning, e.g. lectures.

Challenges to Implementing Interprofessional Education

Most teaching programs included IPE in their curricula by placing groups of students from different professions together for lectures or including them on ward rounds.

More intentional and integrated IPE models include students from two or three disciplines addressing a clinical case presented as text, using a simulation lab, or using standardised patients, while some students observe others conducting their discipline-specific assessments.

However, as Wilkes and Kennedy (2017) point out, given that IPE is rarely more than an occasional addition within long established medical and nursing curricula, most of the current models of IPE not only lack a diversity of healthcare disciplines but also lack the time needed to explore and understand any cultural differences in the approach to care.

In other words, as Steketee (2014) notes, based on findings from previous studies, IPE tends to be marginalised in mainstream health curriculum.

Remote locations can also pose problems where a university may have programmes for just one or two professions and the time and cost to link up with students from others would be prohibitive (Barr 2018).

IPE can also take a number of forms:

• Sessions can be freestanding or woven into the fabric of two or more professional programs;
• Training sessions may last from just a few hours or be incorporated into an extensive training program lasting several years; and
• Training sessions can take place in the classroom, the workplace, at a distance, or in combination (Barr 2018).

Taken together, these variables can make implementing IPE a challenging task.

More Than Just Collaboration

A key underlying assumption of interprofessional education is that if allied health professionals are brought together they can learn both from and about each other, and in doing so dispel any negative stereotypes which might hamper their collaboration in practice (Carpenter and Dickinson 2016).

For many educators however, facilitating IPE can seem idealistic rather than realistic.

Combining professional groups can be particularly difficult for profession specific educational institutions, which need to enter into partnerships with each other, before IPE becomes possible.

Bridges (2011) states that it’s important to secure agreement and commitment from all of the departments or colleges involved, to ensure adequate training resources are available and to foster a sense of community.

Maximising Opportunities for Interprofessional Education

Incremental steps can nevertheless be taken to introduce interprofessional perspectives into teaching.

These may include:

• Inviting practitioners from different professions to explain about their roles and working relationships.
• Arranging observation visits and placements to experience other professions at work.
• Utilising the pool of interprofessional e-learning material.
• Choosing case studies that present other professions positively and purposefully.

(Barr 2018)

Even when IPE isn’t possible on a full-time basis, short term interventions can also be valuable and effective.

Darlow et al. (2015) give the example that a short term eleven-hour IPE programme resulted in improved attitudes towards interprofessional teams and interprofessional learning. This suggests that even a brief intervention of a few hours can have positive effects and contribute to improved interprofessional practice.

Summary

Interprofessional collaboration is expected of healthcare providers to effect positive patient care experiences, reduce healthcare costs, and improve population health.

However, to date, the key challenges of implementing interprofessional education seem to be at an organisational level.  In practice, this implies a greater need for collaboration and creative use of teaching facilities.

Alongside this Walkenhorst et al. (2015) suggests that there are also still deficits in the attitudes and cultures of both under- and postgraduate health professionals, which must be worked on before IPE can realise its true value.

As Gilbert (2010) remarks, once students understand how to work inter-professionally, they are ready to enter the workplace as members of a collaborative practice team.

The benefits are clear. Not only do interprofessional teams innately understand how to share case management and optimise the skills of their members, but they are also able to provide better health services to patients and the community as a whole.

Key to this is moving from a position of fragmented care to unified strength, and when that happens everyone benefits.

References

• Barr, H. (2018) Interprofessional education, Available at: http://www.nvmo.nl/resources/js/tinymce/plugins/imagemanager/files/20120926_HFDS24boekXX-2002_Barr-H_Interprofessional_Education.pdf#page=29(Accessed: 23rd September 2018).
• Bridges, D.R., Davidson, Soule Odegard, P. et al. (2011) 'Interprofessional collaboration: three best practice models of interprofessional education', Medical Education Online , 16( 1), pp. [Online]. Available at: https://www.tandfonline.com/doi/full/10.3402/meo.v16i0.6035(Accessed: 23rd September 2018).
• Darlow, B., Coleman, K., McKinlay, E. et al. (2015) 'The positive impact of interprofessional education: a controlled trial to evaluate a programme for health professional students', BMC Medical Education, 15(1), pp. [Online]. Available at: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-015-0385-3#Sec1(Accessed: 23rd September 2018).
• Carpenter, J. and Dickinson, C. (2016) 'Understanding interprofessional education as an intergroup encounter: The use of contact theory in programme planning', Journal of Interprofessional Care , 30(1), pp. [Online]. Available at: https://www.tandfonline.com/doi/abs/10.3109/13561820.2015.1070134(Accessed: 23rd September 2018).
• Gilbert, G.H.V., Yan, J. and Hoffman, S.J. (2010) 'A WHO Report: Framework for Action on Interprofessional Education and Collaborative Practice', Journal of Allied Health, 39(No 3 Pt 2 (Special Report)), pp. [Online]. Available at: http://scholar.harvard.edu/files/hoffman/files/18_-_jah_-_overview_of_who_framework_for_action_on_ipe_and_cp_2010_gilbert-yan-hoffman.pdf(Accessed: 23rd September 2018).
• C., Forman, D., Dunston, R. (2014) 'Interprofessional health education in Australia: Three research projects informing curriculum renewal and development', Applied Nursing Research, 27(2), pp. 115 - 120 [Online]. Available at: https://www.sciencedirect.com/science/article/pii/S0897189714000433(Accessed: 23rd September 2018).
• Walkenhorst, U., Mahler, C., Aistleithner, R., er al. (2015) 'Position statement GMA Comittee – “Interprofessional Education for the Health Care Professions”', GMS Zeitschrift Für Medizinische Ausbildung, , 32(2), pp. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446653/(Accessed: 23rd September 2018).
• Wilkes, M, and Kennedy, R. (2017) 'Interprofessional Health Sciences Education: It’s Time to Overcome Barriers and Excuses', Journal of General Internal Medicine, 32(8), pp. 858–859 [Online]. Available at: https://link.springer.com/article/10.1007/s11606-017-4069-z(Accessed: 23rd September 2018).