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Introducing IPE: process and practice

Based on our understanding of teamworking, communities of practice and professional identity formation, it seems that IPE should provide us with the opportunity to develop health practitioners who are capable of working effectively in many multidisciplinary teams, that they will gain good understanding of their own professional role and boundaries and that of others, and that they will gain respect for other professionals’ roles. How best can IPE be introduced into the different (often competing in terms of timetable and space) health professions programmes?

Course and curriculum design needs to take account of IPE which needs to be embedded in the curriculum rather than seen as an ‘add-on’, which may be easy to cut when budgets are tight. It is not always easy, however, to champion IPE across different professions, departments and organisations, so let us consider some of the practical ideas that teachers might introduce into day-to-day teaching to promote and raise awareness of IPE.

CAIPE (2011, http://caipe.org.uk/about-us/the-definition-and-principles-of-interprofessional-education) sets out the process of Interprofessional education as follows:

Interprofessional education  

Process

 

Comprises a continuum of learning for education, health, managerial, medical, social care and other professions 

Sequencing interprofessional learning progressively throughout pre-registration and post-experience studies                 

Encourages student participation in planning, progressing and evaluating their learning

Including them with teachers and others in working groups

Reviewing policy and practice critically from different perspectives

Subjecting policy and practice to critical analysis against experience and evidence

Enables the professions to learn with, from and about each other to optimise exchange of experience and expertise

Facilitating interaction, exchange and co-reflection as they compare perceptions, values, roles, responsibilities, expertise and experience          

Deals in difference as it searches for common ground

Showcasing different yet mutually reinforcing roles and expertise in collaborative practice grounded in mutual understanding, working towards shared objectives  

Integrates learning in college and the workplace

Teachers and practice supervisors planning, delivering, assessing and evaluating classroom and practice-based learning together      

Synthesises theory and practice

Deriving theory from and applying it to practice

Grounds teaching and learning in evidence

Citing findings from research including those in systematic reviews of process and outcomes from interprofessional learning

Includes discrete and dedicated interprofessional  sequences and placements

Building in dedicated interprofessional learning based on these principles

Applies consistent assessment criteria and processes for all the participant professions

Including summative assessment by the same means to the same standards 

Carries credit towards professional qualifications

Negotiating ways in which satisfactory fulfilment of interprofessional assignments meets requirements for professional awards

Involves service users and carers in teaching and learning

Including them in planning, delivery, assessing and evaluating teaching        

 

Freeth suggests that typical successful choices in which to include IPE activities are:

  • Clinical and service-based quality improvement initiatives where the embedded model is already well-developed at post-qualification level
  • Multi-professional learner teams shadowing real teams or providing supervised care
  • Curriculum strands that address patient groups whose needs can only be met through interprofessional or inter-agency collaboration
  • Patient-safety initiatives (2014, pp. 87–89).

 

Other opportunities include:

  • Introduction of a new clinical protocol, approach or technique
  • Joint, multiprofessional handovers
  • Interprofessional debriefs about significant events
  • Case conferences (these are often multi-disciplinary, but more emphasis could be placed on learning from other professionals)
  • Bringing learners from different professions together in structured formal sessions around specific topics, or inviting learners from other professions to sessions which traditionally have been for single professions. Teaching modes might include lectures, seminars, tutorials, case studies/scenarios or problem-based learning
  • Involving learners from different professions to work together in clinical situations (such as the clinic, consulting room, theatre, ward, community, home visits) to learn together and share experiences and perspectives on patient care or understanding of situations
  • Promoting informal IPE, while providing opportunities for discussion, sharing of knowledge and learning from other professions.

 

Clinical skills acquisition lends itself well to interprofessional working, particularly in the latter years of the undergraduate course or in postgraduate contexts, such as anaesthetics, operating theatres, clinics or day centres. Guided by the principle ‘learning from one another’, rather than ‘with one another’, the learning can use a range of interprofessional clinical scenarios, including simulation.


Such scenarios can be led by an interprofessional team, coordinated by an interprofessional skills teacher. In focusing on learning as a team to address patient care, participants can develop mutual respect and appreciation of the difficulties each may face when dealing with (for example) the acutely sick patient or a frail older person with complex needs.

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