Reflections From the Intersection of Health Professions Education and Clinical Practice: The State of the Science of Interprofessional Education and Collaborative Practice

Lutfiyya, M. Nawal; Brandt, Barbara F.; Cerra, Frank B.

doi:10.1097/acm.0000000000001139

Cited by 59 publications

(18 citation statements)

References 32 publications

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“…Interprofessional education (IPE), defined as students from different health professions ‘learning with, from and about each other’ ( 16 ), is considered the basis of interprofessional practice and team-based care, a paradigm shift from the traditional hierarchical health care delivery model intended to improve the efficiency and quality of care ( 17 – 20 ). A recent position paper ( 21 ) on the intersection of IPE and collaborative practice stressed that IPE and team-based care are interconnected and that there is a need to apply educational best practices to patient care.…”

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confidence: 99%

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

Lie

Forest

Walsh

et al. 2016

Medical Education Online

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BackgroundThe student-run clinic (SRC) has the potential to address interprofessional learning among health professions students.PurposeTo derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients.MethodsThe authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning.ResultsThirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process.DiscussionInterprofessional SRC participation promotes learning ‘with, from, and about’ each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.

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confidence: 99%

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

Lie

Forest

Walsh

et al. 2016

Medical Education Online

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“…Both surveys as well as research on interprofessional practice generally find that AHCs will need to become more inclusive of schools of nursing and other professional organizational partners and become more fully versed in evidence-based treatments if they are to effectively meet the needs of patients and adequately prepare the next generation of students. 7 …”

Section: Discussionmentioning

confidence: 99%

Nursing schools and academic health centers: toward improved alignment and a synergistic partnership

Emami

Jaffe

Minton-Foltz

et al. 2017

JMDH

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This paper presents the findings from a national survey which the University of Washington conducted among leaders of 32 US academic nursing institutions that are part of academic health centers (AHCs) and complements these findings with results from a separate report by the American Association of Colleges of Nursing. While expressing overall satisfaction with their AHC relationships, these leaders find that nursing is often given greater parity in matters of education and research than in mission setting, financial, and governance matters. AHCs are being asked to meet new health care challenges in new ways, starting with the education of health care professionals. AHCs need to be restructured to give nursing full parity if the nation’s and world’s needs for preventive and clinical care are to be best met.

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“… 28 , 32 – 34 For instance, a 2013 Cochrane systematic review 35 covering 30 years of IPE research concluded that “it is not possible to draw generalizable inferences about the key elements of IPE and its effectiveness” on professional practice and health care outcomes. Similarly, a 2016 critical review 33 confirmed that the impact of IPE on health care was still awaiting scientific support. Moreover, a 2013 WHO report 23 found “no practice-level impact” on patient care and consequently recommended implementing IPE “only in the context of rigorous research.” This recommendation reversed the WHO’s earlier position on IPE.…”

Section: How and Why The Third Wave Of Ipe Is Falling Short Of Meetinmentioning

confidence: 99%

“…In their recent Academic Medicine article, Lutfiyya and colleagues 33 quoted John Gilbert’s response to the vexing question of whether IPE makes a difference to health care: “interprofessional education is a great truth awaiting scientific confirmation.” We take a different stance, suggesting that this “great truth” rests on too many shaky assumptions and flawed premises to justify continued practice and inquiry. Third wave advocates have made a compelling case for why we should focus on patient care and transform individuals to improve health care, yet we believe that continuing to look under the same proverbial lamppost (i.e., IPE) will not help us find the lost key to useful and effective education for collaboration.…”

Section: Wave 4: Addressing Workplace Systems and Structuresmentioning

confidence: 99%

Beyond the Lamppost: A Proposal for a Fourth Wave of Education for Collaboration

2018

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Interprofessional education (IPE) is an increasingly popular educational model that aims to educate health care students to be better collaborators by enabling them to learn with, from, and about each other. IPE’s rising popularity is evident in the increase in scholarship on this topic over the last few decades. In this Perspective, the authors briefly describe three historical “waves” of IPE: managing the health workforce through shared curriculum, maximizing population health through health workforce planning, and fixing individuals to fix health care. Using insights from the social sciences and past practice, they then discuss six reasons why the current third wave of IPE is likely to fall short of meeting its goals, including that (1) IPE is logistically complex and costly, (2) IPE is developmentally inappropriate, (3) the link between IPE and key outcomes is still missing, (4) IPE insufficiently engages with theory, (5) IPE rarely addresses power and conflict, and (6) health care is an inertial system that IPE is unlikely to change. The authors conclude by sharing their vision for a fourth wave of education for collaboration, addressing workplace systems and structures, which would combine undergraduate, uniprofessional education for collaboration with practice-based interventions.

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Reflections From the Intersection of Health Professions Education and Clinical Practice: The State of the Science of Interprofessional Education and Collaborative Practice

Cited by 59 publications

References 32 publications

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

Nursing schools and academic health centers: toward improved alignment and a synergistic partnership

Beyond the Lamppost: A Proposal for a Fourth Wave of Education for Collaboration

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