Common Ground: Thoughts on IPE
As far back as 1988, The World Health Organization (WHO) began the call for interprofessional education as a means to manage the worldwide shortage of healthcare providers. A study group was convened to provide guidance on how interprofessional education (IPE) could be implemented to build a more flexible health care workforce to meet health needs while maximizing resources.¹ In 2010, the WHO study group published their findings.2 The study reported on effective factors that contribute to successful collaborative teams that can be adapted to local health care systems.
The call for interprofessional education continues today as part of the Affordable Care Act initiated by the Obama Administration. The Coordinating Center for Interprofessional Education and Collaborative Practice (CC-IPECP) is the agency responsible for providing leadership, expertise, and support as health professions create IPECP programs.3 Many institutions throughout the United States and across the world have heeded the call and have implemented IPE in their curricula.
Proponents of IPECP hail it as a means to provide successful health care that is integrated, efficient, and cost effective. However, not everyone is in agreement. In particular, many faculty members believe implementing IPE would involve too much time and work. Poirier and Wilhem also noted that professional egos among faculty members may be an additional blocking factor.4 This attitude was also expressed by Curran, Sharpe, & Forristall and may stem from a lack of knowledge about other health care providers.5 Collaborative efforts among health care professions would also require much strategic planning and coordinating of schedules and curricula.
Another problem may arise from an incorrect interpretation of what IPE actually is. The Center for the Advancement of Interprofessional Education (CAIPE) originally defined IPE as occurring when students from 2 or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes. In addition, CAIPE describes interprofessional collaborative practice as the process whereby multiple health workers from different professional backgrounds work together with patients, families, and communities to deliver the highest quality of care.6 This is different from a health care professional speaking to students in a different heath care profession about their role. IPE and collaborative education requires interaction between the different professions to achieve understanding and learning.
With all of the interest in interprofessional education today, perhaps it may be wise to focus on the common ground that exists between professions rather than focusing on the differences. This may provide an effective means to build, or-re-build, communication channels. It is easy to look back and see how specialization, the development of technology, and the advances in each area of health care have separated the professions. Perhaps focusing on the common goal of providing good health care should be the common ground.
A review of the standards in different health care professions will reveal the common ground shared among them. In 2007, the Liasion Committee on Medical Education (LCME) specified in The Standards for Accreditation of Medical Education Programs that “there must be specific instruction in communication skills as they relate to physician responsibilities, including communication with patients, families, colleagues, and other health professionals. A medical school must teach medical ethics and human values, and require its students to exhibit scrupulous ethical principles in caring for patients, and in relating to patients' families and to others involved in patient care.”7 The Commission on Collegiate Nursing Education states that “interprofessional education enables the baccalaureate graduate to enter the workplace with baseline competencies and confidence for interactions and communication skills that will improve practice, thus yielding better patient outcomes. …interprofessional education optimizes opportunities for the development of respect and trust for other members of the health care team.”8
Furthermore, the Commission on Dental Accreditation acknowledges “the dental school must show evidence of interaction with other components of the higher education, health care education, and/or health care delivery systems. The goals of these programs should include preparation of the graduate to function effectively and efficiently in multiple health care environments within interprofessional health care teams… including consultation and referral.”9 The Accreditation Council for Pharmacy Education (ACPE) notes “the college or school's values should include a stated commitment to a culture that, in general, respects and promotes development of interprofessional learning and collaborative practice.”10
Representatives from the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, Association of Schools of Public Health, American Association of Colleges of Pharmacy, American Dental Education Association, and the Association of American Medical Colleges joined together and created the Interprofessional Education Collaborative. In 2011, they released Core Competencies for Interprofessional Collaborative Practice which identified four competency domains. These include: values/ ethics for interprofessional practice, roles/ responsibilities for collaborative practice, interprofessional communication, and interprofessional teamwork and team based care.11
These values were utilized in the development of IPE programs at three different academic health centers. Aston, Rheault, Arenson, Tappert, Stoecker, Orzoff, Galitski, and Mackintosh described the developmental process and content of IPE programs at Western University of Health Sciences (Western U) in California, Thomas Jefferson University (TJU) in Pennsylvania, and Rosalind Franklin University of Medicine and Science (RFUMS) in Chicago. Despite the lack of established competencies or accrediting bodies, the universities incorporated the core competencies noted above as the basis of the development of their IPE programs. Each program differed in its curriculum content and manner of delivery. For example, Western University created a dedicated IPE day that was agreed upon by all participating professions. TJU adopted a strategic plan that led to the creation of a space specifically dedicated to IPE that encompassed a state of the art skills and simulation center. The president of RFUMS appointed a task force of approximately twenty individuals, representative of the participating schools, to achieve the integration of IPE as part of the university’s strategic plan. Each university developed a multi-phased approach to achieve their desired outcomes. It is imperative to note that each university had support from their respective administrators, thereby allowing for the collaborative efforts of many individuals.12 Furthermore, Solomon and Geddes described the introduction of a Health Professional Ethics e-learning module that utilized asynchronous on-line learning to overcome scheduling barriers.13
Each division of health care has a code of ethics that is based upon putting the needs of patients first and foremost. Superior care is delivered in various manners according to each profession, but the common ground among all health care professions is to provide the best health care possible to all, regardless of social status, religious preferences, or ethnicity. The four domains for interprofessional practice outlined by the Interprofessional Education Collaborative reflect the code of ethics of each health care profession. This creates a common ground from which to build upon when designing IPE programs. By encouraging the participation of all members of the health care team to participate by adding their unique services to patient care, greater understanding and respect would lead to better health care outcomes.
- World Health Organization. Learning together to work together for health Report of a WHO study group on multiprofessional education for health personnel: The team approach. Technical Report Series. http://apps.who.int/iris/bitstream/10665/37411/1/WHO_TRS769.pdf?ua=1. Published 1988. Accessed March 17, 2015.
- World Health Organization. Framework for action on interprofessional education and collaborative practice; http://www.who.int/hrh/resources/framework_action/en/. Published 2010. Accessed March 17, 2015.
- Affordable Care Act: Coordinating Center for Interprofessional Education and Collaborative Practice. http://www.topgovernmentgrants.com/cfda.php?CFDANumber=93.622. Accessed March 17, 2015.
- Poirier TI, PharmD, Wilhelm M. Interprofessional education: Fad or imperative. American Journal of Pharmaceutical Education 2013; 77 (4) Article 68. Accessed March 17, 2015.
- Curran VR, Sharpe D, & Forristal J. Attitudes of health sciences faculty members towards interprofessional teamwork and education. Medical Education 2007; 41 892-896. doi: 10.1111/j.1365-2923.2007.02823.x. Accessed March 16, 2015.
- Centre for the advancement of Interprofessional education. Defining IPE. CAIPE. http://caipe.org.uk/resources/defining-ipe/. Accessed March 16, 2017.
- Liaison Committee on Medical Education Standards for Accreditation of Medical Education Programs Leading to the M.D. Degree: Functions and Structure of a Medical School; 2007. http://www.lcme.org/functions2007jun.pdf. Accessed April 2, 2015.
- The Essentials of Baccalaureate Education for Professional Nursing Practice, 2008. http://www.aacn.nche.edu/education-resources/BaccEssentials08.pdf. Accessed April 12, 2015.
- Commission on Dental Accreditation, Accreditation Standards for Advanced Education Programs in General Dentistry; 2007. www.ada.org/prof/ed/accred/standards/aegd.pdf. Accessed April 12, 2015.
- The Accreditation Council for Pharmacy Education (2007). https://www.acpe-accredit.org/pdf/CPE_Standards_Final.pdf. Accessed April 2, 2015.
- Interprofessional Education Collaborative (2011). Core Competencies for Interprofessional Collaborative Practice. Retrieved from: http://www.aacn.nche.edu/education-resources/ipecreport.pdf
- Aston SJ, Rheault W, Arenson C, Tappert SK, Stoecker J, Orzoff J, Galitski H, & Mackintosh S. Interprofessional education: a review and analysis of programs from three academic health centers. Academic Medicine 2012; 87 949-955. doi: 10.1097/ACM.0b013e3182583374. Accessed April 1, 2015.
- Solomon P, & Geddes EL. An interprofessional e-learning module on health care ethics. Journal of Interprofessional Care 2010; 24(3) 311-314. doi: 10. 3109/13561820902886303. Accessed May 6, 2015.
Ryan S, Bolden A. Common Ground: Thoughts on IPE. The Internet Journal of Allied Health Sciences and Practice. 2015 Oct 09;13(4), Article 6.