Year : 2022 | Volume
: 1 | Issue : 2 | Page : 63--64
Understanding the interprofessional phenomenon: Transforming health professions’ education from within
President, the Centre for the Advancement of Interprofessional Education, UK
President, the Centre for the Advancement of Interprofessional Education
|How to cite this article:|
Barr H. Understanding the interprofessional phenomenon: Transforming health professions’ education from within.Adv Biomed Health Sci 2022;1:63-64
|How to cite this URL:|
Barr H. Understanding the interprofessional phenomenon: Transforming health professions’ education from within. Adv Biomed Health Sci [serial online] 2022 [cited 2022 Sep 29 ];1:63-64
Available from: http://www.abhsjournal.net/text.asp?2022/1/2/63/344317
Those of you like me who can recall its humble beginnings may marvel at the speed with which interprofessional learning is pervading health professions’ education. No longer on the margins, interprofessional learning is now in the mainstream of professional education. Yet it remains ill-understood beyond those of us who experience it first-hand as students or teachers. The onus rests on us to explain. Easily said; less easily done. Interprofessional learning has many roots in different countries at different times focusing on different problems with different patient groups. Generalization is hazardous. Let’s begin by sifting through World Health Organziation (WHO) and related reports. Too many to digest; permit me to recommend three:
WHO (1987) Learning together to work together. Technical Report No. 759121 .
WHO (2010). Framework for action on interprofessional education and collaborative practice. Geneva: WHO .
The Independent Lancet Commission Health professionals for a new century: transforming education to strengthen health systems in an interdependent world.
THE WHO 1987 STUDY GROUP
Neglected in recent debates, the first of the two WHO interprofessional education (IPE) Study Groups grounded its case in teamwork. Noting a worldwide trend towards teamwork, its members argued that healthcare workers could perform their responsibilities more efficiently in carefully composed teams of people with various types and degrees of knowledge. The concept of teamwork implied a coordinated delivery of healthcare in the form of preventive, promotive, curative, and rehabilitative services. Education should stress ways to help members of healthcare teams understand team responsibilities, the role of each member in carrying out those responsibilities, the extent to which their roles overlap, the need to work together, and the part played by the team in the overall healthcare delivery system. Effectiveness could only be ensured by training members together. Education should stress ways to help members of healthcare teams understand team responsibilities, the role of each member in carrying out those responsibilities, the extent to which their roles overlap, the need to work together, and the part played by the team in the overall healthcare delivery system.
THE WHO 2010 STUDY GROUP
Members of the second study made the case for building IPE into health professions’ education for a stronger workforce, responding more effectively to population and community needs, increasing public appreciation of the health care team and encouraging holistic care. Reluctant to make assertions that they could not substantiate from their experience, members were nevertheless intent upon persuading policy makers in positions of influence to test the desirability and the feasibility of a package of interprofessional propositions responsive to national and international needs, priorities, and opportunities. IPE was presented as a necessary step toward a collaborative practice ready health workforce. Collaborative practice would strengthen health systems and improve health outcomes. It would maximize the strengths and skills of health workers, enabling them to function at the highest capacity made more necessary by the shortfall in the global workforce.
THE INDEPENDENT LANCET COMMISSION (2010)
Much the same proposition was asserted more forcefully in the same year when the Lancet Commission called for a global vision and strategy for health professions’ education transcending national borders and professional demarcations. Learning needed not only to be formative and informative but also to be transformative and develop leadership for change. Education had not kept pace with the challenges. Fragmented, outdated, and static curricula had produced ill-equipped graduates. The problems were systemic: mismatch of competencies to patient and population needs; poor teamwork; persistent gender stratification of professional status; narrow technical focus without broader contextual understanding; episodic encounters rather than continuous care; predominant hospital orientation at the expense of primary care; quantitative and qualitative imbalances in the professional labor market; and weak leadership to improve health-system performance. Laudable efforts to address these deficiencies had mostly foundered. A thorough and authoritative re-examination was clearly needed: a shared vision and a common strategy for postsecondary education in medicine, nursing, and public health reaching beyond the confines of national borders and professional silos.
Transformative learning entailed a shift from fact memorization to searching, analysis, and synthesis of information for decision making; from seeking professional credentials to achieving core competencies for effective teamwork in health systems; and from non-critical adoption of educational models to creative adaptation of global resources to address local priorities. Competency-driven approaches would adapt to rapidly changing local conditions drawing on global resources to promote interprofessional and transprofessional education that would break down professional silos while enhancing collaborative and non-hierarchical relationships in effective teams, exploit the power of information technology for learning, strengthen educational resources with special emphasis on faculty development, and promote a new professionalism that uses competencies as objective criteria for classification of health professionals and that develops a common set of values around social accountability.
Meeting at much the same time, communication between the second WHO Study Group and the Lancet Commission was conspicuous by its absence. The opportunity was missed to formulate a single strategy. That came later but without reference to either of them via the WHO 2013 narrative .
Expectations escalate and objectives multiply. Outcomes are less easily measured despite reviews to assemble evidence. Nor has the case for interprofessional learning remained unchanged during the last decade. Patient safety has come to the fore driven by relentless reports attributing clinical and surgical error to lack of trust or lapses in communication between professions variously responsible for the same cases .
Challenging though the arguments are, their effect may be to threaten universities and their teachers driving them on to the defensive when progress depends critically on winning their collaboration; progress that is gathering momentum. Interprofessional learning is being woven into the fabric of professional education. Curricula are being written jointly by practitioners, educators, and service managers. Practice learning is being reinforced by advances in educational technology like simulated learning. Theory is underpinning learning for practice. Evidence is being assembled.
To summarize, interprofessional learning can help to repair relationships, build interprofessional teams, develop services together, integrate care, protect patients, and transform professional education.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||Learning together to work together for health: report of a WHO Study Group on Multiprofessional Education of Health Personnel: The Team Approach [meeting held in Geneva from 12 to 16 October 1987]. Geneva: WHO World Health Organization.|
|2||World Health Organization. Framework for Action on Interprofessional Education and Collaborative Practice. Geneva: World Health Organization; 2010.|
|3||Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet 2010;376:1923-58.|
|4||World Health Organization. Transforming and Scaling Up Health Professionals’ Education and Training: World Health Organization Guidelines 2013. Geneva: World Health Organization; 2013.|
|5||Stelfox HT, Palmisani S, Scurlock C, Orav EJ, Bates DW. The “to err is human” report and the patient safety literature. Qual Saf Health Care 2006;15:174-8.|