By Paul Solinsky, PharmD
Community Pharmacy Resident, University of Maryland School of Pharmacy
In today's healthcare system, there
is a focus on delivering quality and coordinated care between different healthcare
disciplines. This type of teamwork will not only decrease the fragmentation of
care, but also improve the quality of care and lead to better patient outcomes.1
Pharmacists are increasingly being involved in the delivery of team-based care.
Therefore, having more education regarding interprofessional teams may benefit
pharmacy students in the future. Having students from different disciplines,
come together to collaborate on patient care can help foster a relationship of
teamwork and problem solving.2 The WHO, in 2010 released this definition on interprofessional
education (IPE): “Interprofessional education occurs when students from two
or more professions learn about, from, and with each other to enable effective
collaboration and improve health outcomes. Once students understand how to work
interprofessionally, they are ready to enter the workplace as a member of the
collaborative practice team. This is a key step in moving health systems from
fragmentation to a position of strength.” 2
One of the organizations that helps
to promote interprofessional education is the Interprofessional EducationCollaboration (IPEC)3. It is composed of the education associations
of all the major healthcare disciplines including medicine, pharmacy, social
work, nursing, podiatry, physical therapy, and others. IPEC has core
competencies published concerning interprofessional education. IPEC’s four main
core competencies include:
1.
Work with individuals of other professions to
maintain a climate of mutual respect and shared values. (Values/Ethics for
Interprofessional Practice)
2.
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.
(Roles/Responsibilities)
3.
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.
(Interprofessional Communication)
4.
Apply relationship-building values and the
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. (Teams and Teamwork)
Interprofessional education
activities for students are varied. Health care education literature describes
a few different ways interprofessional activities have been developed. One way
to create an activity is having a case base discussion between health care
disciplines. Greene et al, has described an activity where pharmacy and medical
students would collaborate on patient cases. The medical students would present
the patient’s current medical problems, while the pharmacy students would
review a medication history and discuss with the physicians about the drug for
each disease, the rationale, and monitoring parameters.4 Having
cases during the didactic portion of education may be beneficial in creating
the foundations for interprofessional collaboration early in healthcare
education.
Sicat et al, describes having an
actual primary clinic set up, students from different disciplines come together
and collaborate on patient care. Medicine students on clerkships, and pharmacy
students on APPE rotations were included in this clinic. The roles and
responsibilities of team-members were outlined for the student participants.
The students reported having a negative reaction to orientation materials and
pre-clinic online modules delineating each role of the healthcare team-member.
There was no overall change in attitudes towards interprofessional teamwork and
team-members using the Interdisciplinary Education Perception scale (IEPS) and AttitudesToward Health Care Teams scale (ATHCTS). IEPS is a scale which measures how
students perceive interprofessional experiences. ATHCTS is a scale which
measures interprofessional teamwork and attitude towards team members. However,
because of the clinic, participants perceived an increased willingness to seek
help from the other profession, comfort working with the other discipline, and
recognizing the specific contributions of the other profession to patient care.
5
There may also be potential
barriers to creating interprofessional educational activities. Finding funding,
resources, and support for creating interprofessional education clinics can be
a challenging barrier to overcome. Another challenge to IPE activities is
preconceived biases of student participants. Having students reflect on
importance, abilities, and roles of each healthcare member is a critical first
step for students.6 Educators may not be aware of any preconceived
biases students may have about other healthcare professions. Another barrier
may include language of different disciplines. For example, a social work
student may not know what “A1C” means. A pharmacy student may not understand
certain diagnostic tests or interpreting test results. Finally, conflict may
arise during the activity between different health care disciplines. Having the
students understand basic principles of conflict resolution may be an important
skill for students to learn before the activity. Understanding the barriers to
setting up an interprofessional educational activity may be important to
creating a team that trusts and relies upon each other.
As healthcare systems move to more
team-based care, interprofessional education will become increasingly important
towards the standard education to students in healthcare disciplines. Therefore,
there is a need for educators to understand the benefits and challenges to
creating activities geared towards multiple disciplines.
1(1)
Vazirani S, Hays RD, Shapiro MF, Cowan M. Effect
of a multidisciplinary intervention on communication and collaboration among
physicians and nurses. Am J Crit Care. 2005;14(1):71-77.
2(2)
Titzer J, Swenty C, and Hoehn G. An
interprofessional Simulation Promoting Collaboration and Problem Solving among
Nursing and Allied Health Professional Students. Clinical Simulation in Nursing.
2012; 8(8):e325-e333. doi:10.1016/j.ecns.2011.01.001.
3(3)
WHO staff. World Health Organization (WHO).
Framework for action on interprofessional education & collaborative
practice. Geneva: World Health Organization. 2010. Available at http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf.
4(4)
Interprofessional Education Collaborative.
(2016). Core competencies for interprofessional collaborative practice: 2016
update. Washington, DC: Interprofessional Education Collaborative.
5(5)
Greene, R. J., Cavell, G. F. and Jackson, S. H.
D. (1996), Interprofessional clinical education of medical and pharmacy
students. Medical Education, 30: 129–133.
doi:10.1111/j.1365-2923.1996.tb00730.x
6(6)
Sicat B, et al. Interprofessional education in a
primary care teaching clinic: findings from a study involving pharmacy and
medical students. J Interprof Care. 2014 Jan;28(1):71-3. doi:
10.3109/13561820.2013.829424. Epub 2013 Sep 3.
7(7)
Page L, et al. ACCP white paper.
Interprofessional education: principles and application. A framework for
clinical pharmacy. Available at: https://www.accp.com/docs/positions/whitePapers/InterProfEduc.pdf
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