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Interprofessional Education – Reflecting Upon the Past, Scanning the Future
During my nearly 20 year involvement in the field, I have witnessed an impressive expansion in the use of interprofessional education (IPE) across the globe. From countries geographically spread as far apart as Japan, Sweden, Australia, the U.K. and Canada, I have seen a range of impressive IPE activities during this time period (e.g. online learning, teamwork simulation, IPE competencies). For colleagues based in the U.S., it has also been encouraging to be experiencing a renaissance of interest in IPE with the leadership of the Macy Foundation, the growth of funding, recent IPE workshops at the Institute of Medicine and a newly forming National Center. While we have made some extremely valuable progress in the field, I believe there are still a number of areas which we need to address in the coming years.
First, there continues to be an ongoing fuzziness linked to the use of terminology. While there is, more or less, agreement with the use of IPE, there is far more limited stability with the use of IPE-related terms such ‘interprofessional collaboration’ and ‘interdisciplinary teamwork’ (in essence the outcomes of IPE). This imprecise use of language actually generates a whole range of differing assumptions and beliefs, which in turn impacts on the next area we need to address.
Second, we need to generate good quality evaluative evidence, from our IPE activities to help us determinate their impact. Without a clear and consistent conceptualization of these outcomes, our evidence base will remain limited and fragmented. Our evidence base is also restricted by a historical trend to undertake IPE evaluation work in isolation from one another, as we continue to engage in single-site studies. As result, there is a propensity to duplicate the work our colleagues are doing.
Third, there continues to be a limited use of theory to help us illuminate and understand underlying issues (e.g. the impact of hidden curriculum on IPE) which are not immediately visible in the educational landscape. As a result, we continue to have only a partial comprehension of the complexity of the social and educational world we are attempting to positively affect through the use of IPE.
Fourth, there is a tendency to focus our IPE curricular developments on classroom activities rather than expand our IPE offerings within the clinical workplace. There are, of course, a number of very good reasons for this focus. The primary reason being classroom-based IPE is far less logistically and financially challenging than expanding IPE in clinical areas. As someone now charged with this task of advancing IPE at my university, it is an issue I know well.
So where should we aim to go in the next few years? To begin resolving the limitations outlined above, I believe there are four routes we should consider as an IPE community:
- • Conceptually, we need to work on a common language and set of shared concepts and terms to ensure we are talking about the same thing, rather than contributing to ongoing confusions.
- • Empirically, we should look for opportunities to develop multi-sited IPE studies where we can collate evidence to generate better inferences. This in turn will help identify the rigorous IPE models which are scalable.
- • Theoretically, we ought to begin identifying and drawing upon the theoretical work which is beginning to amass – see: http://informahealthcare.com/toc/jic/27/1. This will help produce more insightful understandings of the complexities we are dealing with in the IPE field.
- • Educationally, we need to strengthen our links between universities (where we create the IPE) and the practice settings (where care is provided).
In attempting to move forward here, I believe there is one central factor to address—we need to do a better job collaborating ourselves. There is, however, a tension which impedes this: we all need to compete for limited IPE resources, so working together can be problematic. But let’s not forget developing IPE is not a ‘zero sum game’ with winners and losers. A more coordinated approach between all members of the IPE community will help us build and share knowledge in a synergistic manner, rather than the more piecemeal and insular way we have been doing.
Scott Reeves, PhD
Center for Innovation in Interprofessional Education
University of California, San Francisco