Monday, June 11, 2012

Third Base: Why do I care so much about Interprofessional Education (IPE)?

Blog Prepared by Dr. Bette Ann Harris

This is the third in a series of submissions this year concerning the Institute opportunity for a "triple play."   Earlier this semester, blogs have been presented about active learning  and inclusive excellence.  The final home run in this series comes from Dr. Bette Ann Harris.  Bette Ann (BA) has the distinctive historical role of being the Institute's very first graduate!   She is now completing 35 years of affiliation with the IHP.   Her history here includes leadership roles  in Physical Therapy, as a Dean, and most recently Associate Provost.   A common theme through her leadership experience has been that of Interprofessional Education.  As the interim Director of CIPSI she has been able to fulfill this long-time passion in interdisciplinary education.   BA will retire from her post in the Provost office in two weeks.    It is wonderful that she has chosen to share with us her rationale for her passion in interprofessional education.  Thanks BA for thirty five great years!
Since the Institute’s inception, interdisciplinary education has been a core value.

Why? We all knew empirically that collaboration and team work worked...many of us who were part of the early days at the Institute had experienced first hand how working together as a team not only improved patient outcomes but created a strong sense of community that together we can make a difference….fast forward to today…it’s still a work in progress but we are gaining on it!

The concept of Interprofessional Education (IPE) has been around for a long time and if you take the time to go back through the literature, you will find a call for educating health professionals together as early as the 1960s citing many common core competencies that apply to all health professionals from beginning skills such as communication, patient safety, culturally competent care to the more complex activities such as leadership, research and clinical decision analysis. Where IPE seems to break down, is how best to teach these skills. (OK, this is blog so I am not going to go into all of the details, but if you are interested in increasing your understanding of the pros and cons of IPE, please refer to the list of references at the end of this article)

In recent years, there has been much more buy-in as to the need for IPE, including incentives for working as a team. For example, many funding agencies, including the National Institutes of Health (NIH) now require that many grant proposals have an interprofessional team of collaborators as well as third party payers of health care. Also, students are demanding more interprofessional opportunities, as they rally together over common health care problems such as health disparities and social justice. In November 2010, there was a wonderful conference at Harvard Medical School that coincided with the seminal Lancet Report: Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World. Educational leaders from all over the world passionately cited their own experiences with IPE – from collaborations in the field to core curriculums. During one of the questions and answers sessions, a very articulate HMS medical student embraced the need for more interprofessional educational experiences. Like others, he went into health care because he wanted to improve the health and quality of life and make a difference. However, he felt that in an effort to socialize him to his profession, “the passion was beaten out of him” and he should be a physician first, then a humanitarian. From the applause in the room, it was clear that others felt the same way…we need to all focus on the outcome, and recognize each of us from the various professions, do bring a unique set of skills and expertise to the table, but the common goal is the same…to improve the health and well being of those we serve. Much of what we do does cross professional boundaries and if you examine the accreditation standards from the respective disciplines, many of the standards are exactly the same especially around ethics, research, professional behaviors, quality patient care, safety, evidenced based practice, etc, etc. The challenge in education is how to create a curriculum that creates a balance of interprofessional experiences (with core coursework, clinical experiences, activities) with professional specific content so we can graduate students prepared to meet the challenges of health care in the 21st century. No one said it was easy and the Institute is not alone in trying to figure out how to do this effectively and efficiently.

The Institute strives to become a leader in interprofessional education and as a commitment to this vision, the Center for Interprofessional Education and Innovation (CIPSI) was created on January 11, 2011. CIPSI is now the home for several academic programs open to all health professionals including: Health Professions Education, interprofessional content courses (known as HP), the newly established PhD in Health and Rehabilitation Sciences and the Prerequisites for the Health professions courses for those students interested in entering the health professions. CIPSI is also a place where faculty come together to discuss interprofessional curricula opportunities, launch new interprofessional activities, brainstorm innovative ideas and the center serves as a two-way bridge between our schools to move interprofessional opportunities forward. CIPSI is not the only place where interprofessional education takes place and there are exciting new opportunities for students such as the Dedicated Educational Unit (DEU) which was initiated by the School of Nursing and the School of Health and Rehabilitation Sciences. CIPSI, like the rest of the Institute, wants to be known as innovative, creative and to quote Clayton Christensen, disruptive!
As I end my tenure as Associate Provost for Academic Affairs on June 20 and head towards retirement on January 1, 2013, I find myself reflecting on how much the Institute has accomplished over the first 35 years. I am proud to be part of the journey and plan to spend more time working in collaboration with other health professionals (and other disciplines) both on my clinical research and in developing rehabilitation training programs in underserved communities.

Like the Institute, interprofessional collaboration is a core value of mine.


References

Health Professions Education: A Bridge to Quality Ann C. Greiner, Elisa Knebel, Editors, Committee on the Health Professions Summit. ISBN: 0-309-51678-1, 192 pages, 8 1/2 x 11, (2003) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/10681.html


Core Competencies for Interprofessional Collaborative Practice, Sponsored by the Interprofessional Education Collaborative. Pre-publication recommendations to support activities for the Team Based Competencies Conference, February 16-17, 2011, Washington, DCIPE. PDF is located here: https://www.aamc.org/download/186750/data/core_competencies.pdf

Frenk J, Chen L, Z, et.al: Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. www.thelancet.com Published online November 29, 2010 DOI:10.1016/S0140-6736(10)61854-5. PDF is located here: http://www.mededconference.ca/documents/CommissionReport_000.pdf

Harris, BA: The 2006 Pauline A. Cerasoli Lecture – Interdisciplinary education: what, why and when. Journal of Physical Therapy Education, Vol 20, no. 2, fall 2006, 3-8. PDF is located here: http://cedric.mghihp.edu/v3/dlefile/getfile?id=8538203610282835


What is interprofessionalism? http://highereducationresources.atspace.com/interprofessional.htm