“What is IPE, and why do you think it is important?” This is what my husband, a vascular surgeon, asked me (an educator and researcher of team-based care) when I told him I was writing a piece for this blog.
I knew he didn’t want a detailed history of IPE, or a description of the competency domains of IPE (now required for accreditation of medical, nursing, pharmacy and other health profession schools, etc.), or an explanation of the conceptual framework guiding IPE across the learning continuum (foundational learning to continue professional development).
Instead, I suggested he think of IPE as a means to improve collaboration among healthcare providers in the different practice environments he was familiar with—clinics, operating rooms, inpatient floors, and the vascular laboratory. It is a way to know who is on his team, what expertise they contribute, and how they can learn from each other to provide safer, higher-quality care for patients with vascular disease.
“We know from the literature that communication breakdowns within and across teams contribute to medical error and harm. Health professionals are trained in silos and expected to know about other professions when they start practicing. They are not trained to practice in teams, nor do they know enough about what each profession knows or what they can contribute to the medical and social care of the patient/population. This lack of knowledge about each other and the lack of mutual respect for professions outside of their own leads to team communication failures and the lack of collaboration. The most recent literature has demonstrated that improved communication and collaboration of interprofessional teams leads to better delivery and access to care.”
Below is a historical timeline of IPE in the United States over the last decade that has moved the concept and rationale of IPE to the forefront. Although many of the activities described below are United States centric, many countries (United Kingdom, Canada, and Australia) have been active in leading IPE efforts internationally.
2009 – Six national associations of schools of health professions formed a collaborative (Interprofessional Education Collaborative – IPEC) to promote and support interprofessional learning. The collaborative represented nursing, medicine, dentistry, osteopathic medicine, pharmacy and public health. You can read about the history of IPEC here.
2010 – The World Health Organization defined IPE and developed a framework for action on IPE and collaborative practice “when students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes.”
2010 – Lancet Commission Report: Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World (Frenk et al., 2010). The Lancet Commission report suggested a redesign of professional health education for the 21st century to facilitate “mutual learning and joint solutions offered by global interdependence” (page 5). Several instructional reforms were articulated and one focused on IPE, “promote interprofessional and transprofessional education that breaks down professional silos while enhancing collaborative and non-hierarchical relationships in effective teams” (page 6). This report was the basis for an Institute of Medicine (IOM) Forum that was established in 2012 and highlighted the need for IPE and collaborative practice as a workforce issue.
2011 – The “Core Competencies for Interprofessional Collaborative Practice” were published and broadly disseminated. Originally, IPEC proposed 4 competency domains for IPE: teams and teamwork, interprofessional communication, roles and responsibilities, and values and ethics. These four domains would be updated in 2016 to one overarching competency domain – interprofessional collaboration.
2012 – The Global Forum on Innovation in Health Professional Education was established by the National Academies of Sciences, Engineering, and Medicine (previously called the IOM) for the purpose of bringing together stakeholders from multiple nations and professions to network, discuss, and illuminate issues within health professional education. IPE was the topic for multiple forum meetings including the first workshop – IPE for Collaboration: Learning How to Improve Health from Interprofessional Models across the Continuum of Education to Practice.
2012 – The National Center for Interprofessional Practice and Education (NCIPE) was founded through a unique public-private partnership to provide leadership, resources, and evidence for IPE needed to guide the United States on the use of IPE and collaborative practice as a way to address the Triple Aim (enhancing patient care experience, improving population health, and reducing overall cost of care).
2016 – The IPEC Board updated the original four IPE competencies from 2011 (teams and teamwork, interprofessional communication, roles and responsibilities, and values and ethics) and organized within a single domain of “interprofessional collaboration.” In addition, the competencies were broadened to better achieve the Triple Aim with reference to population health.
Now back to my husband’s original question of “why is IPE important?” From my perspective leading IPE the University of Washington for over 12 years, and leading team science for our clinical translational science award, I would say the importance of IPE is focus on teams and teamwork. Whether they be clinical, research, or education teams, all members of the team need to communicate effectively, have defined roles and responsibilities, and have a shared understanding and goals to address the aims of their collaboration (clinical – patient safety and quality of care; research – discovery and productivity; education – knowledge, skills, and attitudes).
Future blog pieces will address the evidence for IPE on improving health and health outcomes, describe how IPE is currently evaluated, provide examples of how to translate IPE competencies into practice, explore the role of IPE in professional identify formation, and discuss the challenges associated with retraining the current workforce to increase interprofessional collaborative practice.
About the author:
Brenda K. Zierler, PhD, RN, FAAN is the Director of the Center for Health Science Interprofessional Education, Research and Practice, School of Nursing at the University of Washington