Core Concepts of Interprofessional Education and Practice

Emergence

Quality and safety

Chronic care

Rising costs

Patient-centeredness

Media coverage

Interprofessional education

Definitions

IPE

“occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (Barr et al 2005)

Definitions

MPE

“Occasions when members of two or more professions learn alongside one another: in other words, parallel rather than interactive learning” (Barr et al 2005)

Disciplines and professions

Disciplines – psychology, anthropology, economics, geography, political science,.

Professions – medicine, nursing, social work

IPE aims

• improving interprofessional communication • enhancing teamwork knowledge/skills• resolving interprofessional rivalry • improving quality (relationships, patient care)

IPE principles

• collaborative

• egalitarian

• group-directed

• experiential

• reflective

Types of IPE

Formal learning

Serendipitous learning (e.g. informal interactions between learners)

IPE foci

1. preparing individuals for collaboration

2. cultivating collaboration in groups or

teams

3. improving services & quality of care

Interactive learning methods

• exchange (seminars)

• problem-focused (problem solving)

• practice learning (student placements)

• simulation (role play)

• e-learning (internet interaction)

IPE outcomes

level 1 – reactions

level 2a – attitudes/perceptions

level 2b – knowledge/skills

level 3 – individual behaviour

level 4a – organisational behaviour

level 4b – patient/client benefit

Kirkpatrick 1967 (modified by Barr et al 2000, 2005)

environment

• group balance (professional mix)

• group size / stability

• reflection -learners & facilitators

-reflecting ‘in action’ and ‘upon action’

• creation of conductive environment-equal status of learners

-cooperative/supportive atmosphere

• awareness: heterogeneity of learners-profession, power, status, prestige

Interprofessional practice

Key factors

Individual willingness

Equitability (shared planning/decision-making)

Organisational/managerial support

Open systems of communication

Regular interaction/negotiation

Education/training

Underpinning issues

Joint activity

Working together on an agreed task

Equality, co-operation

Synchronous/asynchronous

Collaborating with an ‘enemy’

Networking

Coordination

Collaboration

Teamwork

Forms of interprofessional practice

Reeves et al., 2010

Notion of ‘exchange’

IP collaboration is not an altruistic act

Requires 'pay-off' for individuals/parties

Need to make exchange explicit

(Hudson 1987)

Risk

Unpredictable activity

Uncertain outcomes (possible failure)

Possibility of ‘cultural suicide’

(Brookfield 1993)

Competing interests…

“When individuals and groups come

together, even if they are form the same

organisation, and particularly if they are

from different organisations, there is

representation of different and often

competing interests [which] can generate

tensions and conflicts”

(Beattie et al 1996)

Professionalization

Creation of professional boundaries

Hierarchical division of labor

Imbalances of power/status

Time-space issues

Stairs separating teams can reduce interactions by 30% (Handy 1999)

Heavy profession-specific workloads can limit time for meetings

Emergence of ‘knotworking’ (Engeström et al. 1999)

Common problems

-Insufficient time for interaction/negotiation

-Lack of teambuilding activities

-Confused team roles (generic working)

-Vertical management

-Others..???