This week will focus on Interprofessional Education (IPE). For this assignment, you will write a proposal to offer an interprofessional education class that addresses an educational n

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Interprofessional collaboration: three best practice models of interprofessional education Diane R. Bridges, MSN, RN, CCM1*, Richard A. Davidson, MD, MPH2, Peggy Soule Odegard, PharmD, BCPS, CDE, FASCP3, Ian V. Maki, MPH3 and John Tomkowiak, MD, MOL4

1Department of Interprofessional Healthcare Studies, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA; 2Office of Interprofessional Education, University of Florida, Gainesville, FL, USA; 3Office of the Dean-Regional Affairs, UW School of Medicine, Seattle, WA, USA; 4Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA

Interprofessional education is a collaborative approach to develop healthcare students as future

interprofessional team members and a recommendation suggested by the Institute of Medicine. Complex

medical issues can be best addressed by interprofessional teams. Training future healthcare providers to work

in such teams will help facilitate this model resulting in improved healthcare outcomes for patients. In

this paper, three universities, the Rosalind Franklin University of Medicine and Science, the University of

Florida and the University of Washington describe their training curricula models of collaborative and

interprofessional education.

The models represent a didactic program, a community-based experience and an interprofessional-simulation

experience. The didactic program emphasizes interprofessional team building skills, knowledge of professions,

patient centered care, service learning, the impact of culture on healthcare delivery and an interprofessional

clinical component. The community-based experience demonstrates how interprofessional collaborations

provide service to patients and how the environment and availability of resources impact one’s health status.

The interprofessional-simulation experience describes clinical team skills training in both formative and

summative simulations used to develop skills in communication and leadership.

One common theme leading to a successful experience among these three interprofessional models included

helping students to understand their own professional identity while gaining an understanding of other

professional’s roles on the health care team. Commitment from departments and colleges, diverse calendar

agreements, curricular mapping, mentor and faculty training, a sense of community, adequate physical space,

technology, and community relationships were all identified as critical resources for a successful program.

Summary recommendations for best practices included the need for administrative support, interprofessional

programmatic infrastructure, committed faculty, and the recognition of student participation as key

components to success for anyone developing an IPE centered program.

Keywords: interprofessional; healthcare teams; collaboration; interprofessional education; interprofessional curricula models

Received: 25 January 2011; Revised: 25 March 2011; Accepted: 3 March 2011; Published: 8 April 2011

T oday’s patients have complex health needs and

typically require more than one discipline to

address issues regarding their health status (1).

In 2001 a recommendation by the Institute of Medicine

Committee on Quality of Health Care in America

suggested that healthcare professionals working in

interprofessional teams can best communicate and ad-

dress these complex and challenging needs (1, 2). This

interprofessional approach may allow sharing of exper-

tise and perspectives to form a common goal of restoring

or maintaining an individual’s health and improving

outcomes while combining resources (1, 3).

Interprofessional education (IPE) is an approach to

develop healthcare students for future interprofessional

teams. Students trained using an IPE approach are more

likely to become collaborative interprofessional team

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�TREND ARTICLE

Medical Education Online 2011. # 2011 Diane R. Bridges et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Citation: Medical Education Online 2011, 16: 6035 – DOI: 10.3402/meo.v16i0.6035

members who show respect and positive attitudes towards

each other and work towards improving patient outcomes

(3�5).

What is interprofessional collaboration and practice? According to the Canadian Interprofessional Health

Collaborative, interprofessional collaboration is a ‘part-

nership between a team of health providers and a client in

a participatory collaborative and coordinated approach

to shared decision making around health and social

issues’ (6). Interprofessional collaborative practice has

been defined as a process which includes communication

and decision-making, enabling a synergistic influence of

grouped knowledge and skills (7). Elements of collabora-

tive practice include responsibility, accountability, coor-

dination, communication, cooperation, assertiveness,

autonomy, and mutual trust and respect (7). It is this

partnership that creates an interprofessional team de-

signed to work on common goals to improve patient

outcomes. Collaborative interactions exhibit a blending

of professional cultures and are achieved though sharing

skills and knowledge to improve the quality of patient

care (8, 9).

There are important characteristics that determine

team effectiveness, including members seeing their roles

as important to the team, open communication, the

existence of autonomy, and equality of resources (9). It is

important to note that poor interprofessional collabora-

tion can have a negative impact on the quality of patient

care (10). Thus skills in working as an interprofessional

team, gained through interprofessional education, are

important for high-quality care.

What is interprofessional education? 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’

(4, 11). IPE provides an ability to share skills and

knowledge between professions and allows for a better

understanding, shared values, and respect for the roles of

other healthcare professionals (5, 11, 12). Casto et al.

described the importance of developing early IPE

curricula and offering them before students begin to

practice in order to build a basic value of working within

interprofessional teams (13, 14). The desired end result is

to develop an interprofessional, team-based, collabora-

tive approach that improves patient outcomes and the

quality of care (5, 15).

In this paper we showcase three exemplary models of

collaborative and interprofessional educational experi-

ences so that other institutions may benefit from these

when creating interprofessional curricula.

Models of interprofessional collaborative student experiences

Rosalind Franklin University of Medicine and

Science: HMTD 500 Interprofessional Healthcare

Teams course Rosalind Franklin University of Medicine and

Science (RFUMS) has responded to the challenge of

interprofessional training by designing a one-credit-hour,

pass/fail course called HMTD 500: Interprofessional

Healthcare Teams (2, 16). The course is a required

experiential learning opportunity where students interact

in interprofessional healthcare teams. Students focus on

a collaborative approach to patient-centered care, with

emphasis on team interaction, communication, service

learning, evidence-based practice, and quality improve-

ment.

The course, which was instituted in 2004, spans the

months of August�March every year, and has evolved

into three separate components each with its own course

director: a required didactic component (Table 1), a

required service learning component, and a clinical

component with limited enrollment.

During the course, all first-year students (approxi-

mately 480) are grouped into 16-member interprofessional

teams. Each team has student representation from allo-

pathic and podiatric medicine, clinical laboratory, medical

radiation physic, nurse anesthetists, pathologists’ assis-

tants, psychology, and physician assistants. Each team has

a faculty or staff member, with a minimum of a master’s

degree, serving as a mentor. Mentors are trained prior to

each class, and the lunch hour of every class day is set

aside for mentors to review material and ask questions if

necessary.

Didactic component

During the didactic phase, students attend nine 90-

minute interprofessional small group sessions, currently

held every Wednesday afternoon. Five sessions are

Table 1. RFUMS HMTD 500 interprofessional healthcare

teams course objectives

1. Demonstrate collaborative interprofessional team character-

istics and behavior

2. Analyze a healthcare interaction for qualities of patient-

centered care 3. Reflect on service learning as a way to demonstrate social

responsibility

4. Identify other healthcare providers that may be of benefit to a particular patient

5. Analyze a medical error situation to formulate a suggestion

for solving the problem

6. Identify situations in which individual, institution, or govern- ment advocacy may be appropriate

7. Discuss current issues that impact all healthcare professions

Diane R. Bridges et al.

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Citation: Medical Education Online 2011, 16: 6035 – DOI: 10.3402/meo.v16i0.6035

devoted to the learning concepts of interprofessional

healthcare teams, collaborative patient-centered care

(functioning as a collaborative team), service learning

and county health assessment, healthcare professions (a

time to learn about their own health profession), and

error cases and advocacy.

The remaining sessions are set aside for discussion,

preparation, presentations, and celebrations of achieve-

ments. Student objectives, case studies, and role-play are

used to develop discussion. Two different students

volunteer each session to moderate the class to develop

their own leadership and communication skills. All

course materials are loaded into our information man-

agement learning system.

Service learning component

Students are tasked with working as an interprofessional

team to identify a community partner and engage in a

community service project. Each team is expected to

perform a service learning project. One of the original

five sessions is designed to allow students time together to

discuss ideas for their projects. Students assess local

community needs in their didactic phase and are given a

list of community projects performed in the past to help

them decide on a project and partner. Two additional

sessions allow them to plan their projects and subse-

quently design a poster which showcases their service

learning experience and reflection. The focus of student

projects is prevention education in the form of physical

fitness training, nutrition education, health screening, or

instruction in making healthy choices.

Service learning allots time for students to process what

they learned about their community: how their knowl-

edge was used to help meet the needs of the community

and how they better understand them as a result of this

activity (17). All HMTD 500 students complete a

reflection form.

The last session of the course culminates each year with

a group reflection and a celebration poster day where our

community partners are invited to visit the university to

review the work our students have accomplished. Com-

munity partners see posters created by each team and are

invited to join their student groups to reflect upon the

service learning project and share with the students how

the project impacted their organization.

The collaborative interprofessional prevention educa-

tion service learning projects have been very rewarding

and well accepted by our community partners and

students, as noted by student surveys and focus groups

and awards received from some community partners.

Student attitudes were positive regarding this aspect of

the course. Post-course survey indicated a majority of

respondents agreed or strongly agreed with statements

regarding collaboration, teamwork, social responsibility,

and diversity (18).

Clinical component

The third component is a clinical experience offered to

interested students. Three students from different profes-

sional programs such as physician assistant, physical

therapy, and podiatry form an interprofessional team and

attend four sessions at a clinical site. This helps put their

didactic knowledge into actual patient care practice.

Approximately four teams are created: as more clinical

sites agree to accept students, more groups will be formed

each year (Table 2).

Phase II � HMTD 501 Culture in Healthcare RFUMS promotes teaching students the importance of

the impact of culture on healthcare and its delivery. A

second one-credit course entitled HMTD 501 Culture

in Healthcare was developed to accomplish this goal

(Table 3). Students remain in their same HMTD 500

interprofessional groups, and class sessions for this

course are interwoven with the HMTD 500 course dates.

There are two main projects in this course: the proposal

of an education tool and performing a patient interview.

To complete the education tool assignment students

work in interprofessional teams within each group to

present a proposal summary for a culturally appropriate

patient education tool. Students identify a specific health

Table 2. RFUMS clinical component sessions

Session 1 (two hours) The assigned groups of students attend a two-hour session to

observe patients at the clinic, have an interprofessional

discussion after each, and choose one patient to follow Session 2 (one hour) Each group of students meets to discuss the patient history and

their responses to the five interprofessional questions dis- cussed in the clinic

1. How will medicine, physical therapy, physician assistant

practice, and podiatric medicine contribute to the care of

this patient? 2. What would the treatment objectives be for that care?

3. How would your profession address these objectives?

What is the evidence to support the methods used to

address the issue? 4. Besides medicine, physical therapy, physician assistant

practice, and podiatric medicine, which other professions

would you collaborate with to assist this patient? What is your rationale for these collaborations?

5. What other information will you need from the patient and

how will it guide the treatment?

Session 3 (30�60 minutes) Each group of students returns to the clinic for a follow-up

appointment with the chosen patient

Session 4 (one hour) All four groups of students meet over lunch with the three course

coordinators and present their patient and responses to the

interprofessional questions: due to available sites to perform

this clinical component, enrollment is currently limited, but we

are actively seeking additional clinical sites so we can eventually offer this experience to all students

Models of interprofessional education

Citation: Medical Education Online 2011, 16: 6035 – DOI: 10.3402/meo.v16i0.6035 3 (page number not for citation purpose)

conditions impacted by cultural beliefs and practices for a

selected target group. They are asked to recognize the role

that culture plays in health beliefs and practices and the

specific impact culture has on health outcomes. Students

propose patient educational materials for the prevalent

identified health conditions for the selected target group.

They then present their proposals to their peers.

To complete the patient interview, student groups

(including third-and fourth-year students who are in

their clinical years) work with facilitators for a class

session (trained interpreters and nurse anesthesia stu-

dents). The university community volunteers as patients.

The scenario of a patient with a ‘pre-diabetes’ condition

is used for the interview. Students are asked to discuss

laboratory findings, collect historical and lifestyle infor-

mation, and elicit a cultural history. Students then have a

post-interview reflection assessment with their mentors to

discuss their communication and cultural sensitivity skills

and to identify best approaches for culturally sensitive

and appropriate patient interactions.

At the end of each HMTD 500 and 501 course, focus

group meetings are held with mentors and another with

students to obtain feedback. Changes are made to the

curriculum for improvement based on this. Student focus

groups yielded positive comments that working in small

groups promotes teamwork and teaches them about the

communication process (18).

University of Florida Interdisciplinary Family Health

The Interdisciplinary Family Health (IFH) course has

been providing interprofessional community-based learn-

ing experiences for over 10 years. Based in the Office of

Interprofessional Education within the Office of the

Senior Vice-President for Health Affairs, it is a required

course for all first-year students in the Colleges of

Medicine, Dentistry, and Pharmacy, the accelerated and

traditional nursing students in 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 (19). A core faculty representing each of the

involved Health Science Center colleges helps set policy

for the course. Grading of the course is centralized, but

the grading status of the course is determined by each

college. In dentistry and pharmacy the course is part of a

larger first-year course in terms of credit. In the Colleges

of Medicine and Nursing it is a stand-alone course. The

development of the Office of Interprofessional Education

and the course are described elsewhere (20). However, in

summary the office is supported by money from each of

the participating colleges. This institutionalization of the

office and course was essential to its success. The office is

charged with facilitating and supporting multiple cross-

college curricular developments in addition to the IFH

course, but it represents the most widely integrated effort

to date. Over 3,500 students have completed the course,

which resulted in almost 8,000 home visits serving over

500 families from the Gainesville area.

The course lasts for two semesters and is based upon

four home visits, two per semester, with volunteer families

in the local community. Approximately 60 per cent of the

families are underserved. Each family is visited by an

interprofessional team of three students. Four of these

teams make up a small group, which is supervised by two

interdisciplinary faculty members. The distribution of

families to groups is not random; the goal is to provide a

rich diversity of family types to each small group, because

the groups learn a considerable amount about each of the

four teams’ families. One group may include a Medicaid

family with multiple children, a single elder living alone, a

retired university faculty couple, and a hospice patient.

All families sign Health Insurance Portability and

Accountability Act (HIPAA) releases at the time of their

recruitment into the program.

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. The ‘raw material’ for the course thus requires

around 615 students, 125 faculty members, 200 families

and 50 meeting rooms. All group meetings are held at the

same time, as each college has made this time available

for IPE. Home visits are scheduled by team members,

who contact the family and arrange an appropriate and

mutually convenient time.

Course content

Our goals for the course are primarily to demonstrate to

students the significant impact of environment and

resources on health status, and emphasize the importance

of interprofessional collaborative effort in providing

services to patients. The overall competencies and learn-

ing objectives are shown in the appendix. Each objective

is evaluated by being linked to a course assignment. The

Table 3. RFUMS cultural course objectives

Discuss the scope and definition of culture

Examine one’s own ethno-cultural heritage and how it impacts

his/her interactions with patients, clients, and co-workers

Analyze one’s own personal and professional stereotypes and prejudices

To interpret the world of healthcare is a culture in itself

Become familiar with disparities in healthcare and aware of

government involvement in this issue Identify and discuss the impact of barriers to healthcare

Apply concepts related to the impact of culture, ethnicity, and

religion on the health beliefs, practices, and behaviors of patients and clients

Diane R. Bridges et al.

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Citation: Medical Education Online 2011, 16: 6035 – DOI: 10.3402/meo.v16i0.6035

competencies are in three major categories: patient care,

interpersonal and communication skills, and profession-

alism. The assigned tasks for the course are designed to

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