Getting Started in IPE/IPP
If you are accessing this document, you are probably exploring approaches for incorporating interprofessional education (IPE) and interprofessional collaborative practice (IPP) at your institution. New initiatives related to IPE/IPP often take faculty, students, and clinicians out of their comfort zone but are well worth the effort! These opportunities prepare our students to deliver more effective and efficient healthcare, avoid errors, and view their professional expertise from a more practical and collaborative perspective that includes other professions, the patient, and the broader community. For those that are new to IPE/IPP, below is a short list of practical steps to consider as you develop interprofessional training experiences at your institution:
- Reach out – network with related professional programs in your area. Think broadly and don’t limit yourself to professions that your students or clinicians already interact with.
- Follow up – assess general interest and follow up consistently with programs that show motivation and commitment to getting something off the ground.
- Choose a level – decide at what point in their training you want students to be engaging in this interprofessional experience. Try to keep the training level consistent across participants to avoid one group dominating or being perceived as ‘experts.’
- Start small – a small activity or single learning event can accomplish a lot. These can usually be provided in the absence of significant dedicated funding, can promote enthusiasm, and spark collaborative efforts among faculty and students. Collecting outcome data from these events can also demonstrate effectiveness and support further developments.
- Break the ice – icebreaker activities are an important way to help students feel comfortable, venture out of their professional silos, and begin to collaborate in a judgment-free context. These can take many different forms (see IPE Learning Resources > Activities below) and are a fun and effective way to target teamwork and get conversations started. Debriefing after the activity can ease the transition to more focused discussions and activities.
- Low-hanging fruit – look for opportunities that are readily available or easily adapted for IPE training. For example, programs with in-house clinics can coordinate cross-disciplinary observations and debriefing sessions with student teams from other programs.
- Assess outcomes – find ways to document and demonstrate what students have gained from each activity.There are many available assessment protocols (see IPE Learning Resources > Assessment and Evaluation Tools)… or create your own!
- Refine – review student feedback and reflect on the activity. Small tweaks may yield great increases in effectiveness and efficiency.
- Expand – seek opportunities to add learning experiences at different points in students’ training. Aim for students to have several opportunities that build upon each other and that promote students’ simultaneous development as a member of a distinct profession as well as a member of an interprofessional healthcare team (see Dual Identify – # 5 – in the HPAC guidelines below).
In 2019, the Health Professions Accreditor Collaborative (HPAC) created a guide for developing quality IPE experiences in healthcare training. The HPAC’s guide laid the groundwork for the development of a customizable curriculum design that any health care profession could thread throughout their program.
Before implementing the components of this curriculum, the team highly suggests examining internal and external, human and environmental factors (McHugh, 2013). This is also known as “the frame” (See Table 1). (Keating, 2006).
|External Frame Factors||Internal Frame Factors|
|Financial support||Faculty buy in|
|Regulations and accreditation||Student buy in|
|Need for IPE||Organization structure|
|Political climate||Internal economic factors|
|Health care system need|
|Characteristics of the setting|
|Note. Adapted from “Curriculum Design and Evaluation of Program Outcomes,” by M.K. McHugh, 2013, Certified Nurse Educator (CNE) Review Manual, 2nd ed, 11, p. 215-238. Copyright 2013 by Springer Publishing Company.|
Several additional considerations are encouraged in deciding what types of IPE experiences to select, as well as when and how to best implement IPE learning activities. These suggestions are based on HPAC guidelines and are also used as a way to describe and categorize individual activities listed in the IPE Learning Resources section below.
- Provide opportunities for students to learn about, from, and with each other.
|About||Learn about the roles and responsibilities, scopes of practice, licensure requirements, and stereotypes related to other professions|
|From||Engage and exchange information with other professions|
|With||Participate in learning activities with students from other health professions|
2. Target core IPE competencies described in the Interprofessional Education Collaborative 2016 update.
|Values and Ethics (VE)||Work with individuals of other professions to maintain a climate of mutual respect and shared values.|
|Roles and Responsibilities (RR)||Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.|
|Interprofessional Communication (CC)||Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.|
|Teams and Teamwork (TT)||Apply relationship-building values and principles of team dynamics to perform effectively in different team roles to plan, deliver, and evaluate patient/population-centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable.|
3. Select learning modalities (in-person, online) that best address objectives of the IPE learning activity and type and level of students involved.
|In-Person||Case discussions, simulations, service learning, cross-disciplinary clinical observations, clinical rotations|
|Online||Video conferencing, mock electronic health record reviews, interprofessional gaming, online simulations|
4. Plan longitudinal IPE training that spans different levels of student training.
5. Emphasize simultaneous development of dual identity – emergence of uniprofessional socialization and identity as a member of distinct profession, as well as identity as a member of an interprofessional team.
6. Develop plans to assess learner outcomes: Scope may include reactions to IPE, changes in perceptions of other professions, acquisition of interprofessional knowledge and skills, and demonstration of collaborative behaviors in learning activities and clinical practice.
Student Learning Outcomes (SLOs)
The four core IPEC competencies provide a useful starting point for building curricula related to IPE and for identifying target outcomes. Instructors may also want to refer to the more specific sub-competencies in developing effective IPE learning activities and preparing course syllabi:
Values/Ethics Sub-competencies: (IPEC, 2016)
VE1.Place interests of patients and populations at center of interprofessional health care delivery and population health programs and policies, with the goal of promoting health and health equity across the life span.
VE2. Respect the dignity and privacy of patients while maintaining confidentiality in the delivery of team-based care.
VE3. Embrace the cultural diversity and individual differences that characterize patients, populations, and the health team.
VE4 Respect the unique cultures, values, roles/responsibilities, and expertise of other health professions and the impact these factors can have on health outcomes.
VE5 Work in cooperation with those who receive care, those who provide care, and others who contribute to or support the delivery of prevention and health services and programs.
VE6 Develop a trusting relationship with patients, families, and other team members (CIHC, 2010).
VE7. Demonstrate high standards of ethical conduct and quality of care in contributions to team-based care.
VE8 Manage ethical dilemmas specific to interprofessional patient/ population centered care situations.
VE9. Act with honesty and integrity in relationships with patients, families, communities, and other team members.
VE10. Maintain competence in one’s own profession appropriate to scope of practice.
Roles/Responsibilities Sub-competencies: (IPEC, 2016)
RR1. Communicate one’s roles and responsibilities clearly to patients, families, community members, and other professionals.
RR2. Recognize one’s limitations in skills, knowledge, and abilities.
RR3. Engage diverse professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific health and healthcare needs of patients and populations.
RR4. Explain the roles and responsibilities of other providers and how the team works together to provide care, promote health, and prevent disease.
RR5. Use the full scope of knowledge, skills, and abilities of professionals from health and other fields to provide care that is safe, timely, efficient, effective, and equitable.
RR6. Communicate with team members to clarify each member’s responsibility in executing components of a treatment plan or public health intervention.
RR7. Forge interdependent relationships with other professions within and outside of the health system to improve care and advance learning.
RR8. Engage in continuous professional and interprofessional development to enhance team performance and collaboration.
RR9. Use unique and complementary abilities of all members of the team to optimize health and patient care.
RR10. Describe how professionals in health and other fields can collaborate and integrate clinical care and public health interventions to optimize population health.
Interprofessional Communication Sub-competencies: (IPEC, 2016)
CC1. Choose effective communication tools and techniques, including information systems and communication technologies, to facilitate discussions and interactions that enhance team function.
CC2. Communicate information with patients, families, community members, and health team members in a form that is understandable, avoiding discipline-specific terminology when possible.
CC3. Express one’s knowledge and opinions to team members involved in patient care and population health improvement with confidence, clarity, and respect, working to ensure common understanding of information, treatment, care decisions, and population health programs and policies.
CC4. Listen actively, and encourage ideas and opinions of other team members.
CC5. Give timely, sensitive, instructive feedback to others about their performance on the team, responding respectfully as a team member to feedback from others.
CC6. Use respectful language appropriate for a given difficult situation, crucial conversation, or conflict.
CC7. Recognize how one’s uniqueness (experience level, expertise, culture, power, and hierarchy within the health team) contributes to effective communication, conflict resolution, and positive interprofessional working relationships (University of Toronto, 2008).
CC8. Communicate the importance of teamwork in patient-centered care and population health programs and policies.
Team and Teamwork Sub-competencies: (IPEC, 2016)
TT1. Describe the process of team development and the roles and practices of effective teams.
TT2. Develop consensus on the ethical principles to guide all aspects of team work.
TT3. Engage health and other professionals in shared patient-centered and population focused problem-solving.
TT4. Integrate the knowledge and experience of health and other professions to inform health and care decisions, while respecting patient and community values and priorities/preferences for care.
TT5. Apply leadership practices that support collaborative practice and team effectiveness.
TT6. Engage self and others to constructively manage disagreements about values, roles, goals, and actions that arise among health and other professionals and with patients, families, and community members.
TT7. Share accountability with other professions, patients, and communities for outcomes relevant to prevention and health care.
TT8. Reflect on individual and team performance for individual, as well as team, performance improvement.
TT9. Use process improvement to increase effectiveness of interprofessional teamwork and team-based services, programs, and policies.
TT10. Use available evidence to inform effective teamwork and team-based practices.
TT11. Perform effectively on teams and in different team roles in a variety of settings.