Creating an Interprofessional Program: Common elements and resources.

By: Diane R. Bridges

Ten years ago, I was part of an interprofessional team (RN, MD, PharmD, MPH) who wrote an article citing three best practice models of interprofessional education. 

We shared our respective school’s interprofessional initiatives and courses and discovered in the writing process, there were common elements to creating an interprofessional initiative or course program and requisite resources that are needed. Over the years when I speak with individuals trying to create a new interprofessional initiatives or courses the barriers have changed little and I believe our tips are as helpful now as they were 10 years ago.

Interprofessional education (IPE) is an approach to develop healthcare students to become members of interprofessional teams. Students trained using an IPE approach are more likely to become collaborative interprofessional team members who show respect and positive attitudes towards each other and work towards improving patient outcomes.1,2,3  IPE has been defined as ‘members or students of two or more professions associated with health or social care, engaged in learning with, from and about each other.2.4 The desired end result of interprofessional education is to develop students to use an interprofessional, team-based, collaborative approach to patient care that improves patient outcomes and the quality of care.3.5

There are many ways to create an interprofessional initiatives and courses. Below are three models extracted from our article.

First-Year 2 Credit Course at Rosalind Franklin University of Medicine and science

At RFUMS we have a course that spans August through February which all first-year students at our university enroll (approximately 500 students).   The course has evolved over the years since its inception in 2004,  but the interprofessional competencies for the course established by the Interprofessional Education Collaborative have not. (Values and Ethics, Roles and Responsibilities, Interprofessional Communication and Interprofessional Teamwork and Team-based practices.) There is didactic content, interprofessional team assignments, and reflections as integral parts of the course.  Students learn about each other’s professions and most recently each profession is responsible for a session which typically includes interprofessional case study presentations. Representation from our programs include: allopathic and podiatric medicine, clinical laboratory, medical radiation physic, nurse anesthetists, pathologists’ assistants, psychology, and physician assistants. We will soon be adding nursing students to the course as our new program begins. Interprofessional Team Simulation and Experiential Activity at the University of Washington

The University of Washington offers over 50 interprofessional offerings. It is home to 6 health professional schools (medicine, pharmacy, nursing, social work, public health, and dentistry ) plus the allopathic medical school for the states of  Washington, Wyoming, Alaska, Montana, and Idaho,  known as WWAMI. They also have an interprofessional team simulation exercise to promote interprofessional teamwork to provide urgent care to simulated patients.  The exercise is both formative and summative allowing students to practice and demonstrate team-based skills including communication, mutual support, leadership, and situational monitoring. They also offer a program called SPARX (student providers aspiring to rural and underserved experience). The goal of SPARX is to provide health science students with a variety of co-curricular activities, including exposure to successful practitioners who serve rural and medically underserved populations. The SPARX program consists of three elements: forums and seminars on topics of interest or value for rural and urban underserved providers to stimulate student interest, training to develop skills and foster interprofessional relationships among students, and service projects to provide experiential learning and foster collaborative teamwork across involved health professions students.

Community-Centered Interprofessional Course at the University Of Florida

The University of Florida has provided interprofessional community based learning for over 20 years now. They offer an interdisciplinary family health course, required for all first year students from the Colleges of Medicine, Dentistry, and Pharmacy, the College of Nursing, the physical therapy and clinical and health psychology students from the College of Public Health and Health Professions, and the nutrition graduate students from the Institute for Food and Agricultural Sciences. Students from the College of Veterinary Medicine participate as volunteers. The course lasts for two semesters and is based upon four home visits, two per semester, with volunteer families in the local mostly underserved communities. Each family is visited by an interprofessional team of three students. The small groups meet six times during the year, in two-hour sessions. They are responsible for different tasks, learning objectives, and responsibilities on each visit including report submissions and a team project that addresses the family’s health status in some way.

Components of a Successful Initiative/Course

As we described our programs, we also identified common components that were critical to our success: responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect.  Note: these are the identified interprofessional competency domains of Values and Ethics, Roles and Responsibilities, Interprofessional Communication and Interprofessional Teamwork and Team-based practices.

1) Understanding others’ professions and your own role in the healthcare team is critical in IPE. Though at first students may not understand the complexities of the relationships between their profession and others, it is important to develop a common framework early in their education that describes a best practice model of interprofessional interaction. Offering these programs to first year students so they can hear the message early and often and then continually reinforce the importance of interprofessional teamwork throughout their years in all their represented programs is critical.

2) Students need to ‘see’ the impact of interprofessional efforts and reflect on the experience to help reinforce interprofessional learning outcomes. Faculty should role model interprofessional team work and help shape the attitudes and perceptions of students regarding successful models of interprofessional teamwork.

3) It is critical that mentors/faculty are trained and feel confident in their interactions with students. Of course, it is always easier as well if you find faculty vested in the topics and in interprofessional educations.

4) Invest in student support for any interprofessional initiative-they have great ideas.

5) Build a sense of community and collaboration in the student groups by having them learn about each other professions and providing opportunities like interprofessional case-based instruction to discuss how their profession would be involved in the patient’s care. This also requires confidentiality of any participant-another lesson for students. These service learning opportunities also offer time for students to reflect on the activity.

6) Include the community in your program. Establish community partnerships and determine needs to help create a service learning project or other student activities to help and assess the community.

7) Be creative and develop interprofessional simulation experiences to help meet your objectives.

8) Acknowledge both student and faculty efforts through awards, certificates and for students’ grades.

What resources do I need to create an interprofessional program?

1- The initial buy-in starts with top-down support of interprofessional initiatives. Be a leader to speak with your Deans and even the President of your University to gain their support to create interprofessional initiatives that will impact healthcare. Help them see the big picture.  The President can relay to the Deans of the colleges this is important-he/she supports it and wants it to happen. This then filters to faculty and students.

2- A successful program will also include financial support from the university administration, deans, and faculty of your schools and programs. One way this could be done is to ask each participating program to list X amount ($50,000 in one case) from their program budget to a line item called “interprofessional initiatives”. This will help with infrastructure cost, logistical needs, and administrative assistant costs.

3- These programs usually require calendar scheduling involving all participating schools. One approach is for the university administration to message their deans and tell them the interprofessional program is going forward and to leave open X hours on X days of the week over the course of X weeks in the next academic year.  This way this time is blocked off a year in advance and everyone works around this time to schedule their other program needs. Be creative as well-use evenings and weekend time slots for activities.

4– You will need infrastructure-faculty resources.  Include interprofessional work in your workload models and year evaluations.  Give faculty “credit” for participating in interprofessional activities and the program you plan to develop. If you have positions in Interprofessional Education at your institution have these faculty lead your initiatives and participate in initiatives.

5- Share curriculum goals and objectives with each participating school to include curriculum mapping to help facilitate activities.

6- Create small group rooms to handle these interprofessional initiatives. Either one large room with many round tables to fit the IP teams or smaller rooms throughout your university for students to meet to do course work and brainstorm ideas.

7- Plan for administrative support to schedule rooms, confirm faculty mentors, help with attendance and grade submissions, and other logistical needs your program may have.

8- Technology for web-based conferences and a learning system administrator to help with content materials.

Building an IPE program is challenging but these initiatives are critically important in constructing interprofessional identify formation of the next generation of healthcare professionals so they can work in teams that will protect our patients for errors. With the dedication of leaders, faculty and students you too can create a successful program and overcome barriers. 

About the Author: Diane R. Bridges Ph.D., MSN, RN, CCM has been a registered nurse for over 30 years with experience in Obstetrics, Neonatal Nursing, Medical-Surgical Nursing, and Orthopedics. She is an Associate Professor and Assistant Dean for Distance Learning and Curricular Resources. Associate Professor of Humanities & Health Care at the Chicago Medical School at Rosalind Franklin University of Medicine and Science (RFUMS)

References

1.Barker K, Oandasan I. Interprofessional care review with medical residents: lessons learned, tensions aired – a pilot study. J Interprof Care. 2005; 19: 207–14. [Taylor & Francis Online][Google Scholar]

2 .Barr H, Koppel I, Reeves S, Hammick M, Freeth D. Effective interprofessional education: argument, assumption and evidence. Blackwell Publishing. Oxford, 2005. [Crossref][Google Scholar]

3. Karim R, Ross C. Interprofessional education and chiropractic. J Can Chiropr Assoc. 2008; 52: 766–78. [PubMed]

4. Craddock D, O’Halloran C, Borthwick A, McPherson K. Interprofessional education in health and social care: fashion or informed practice? Learn Health Soc Care. 2006; 5: 220–42. [Crossref][Google Scholar]

5. Young L, Baker P, Waller S, Hodgson L, Moor M. Knowing your allies: medical education and interprofessional exposure. J Interprof Care. 2007; 21: 155–63. [Taylor & Francis Online][Google Scholar]

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