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The Interprofessional Education Collaboration (IPEC) developed a
report by an expert panel that highlighted what they believed are the 4
core competencies of interprofessional education (IPE): (1) values and
ethics for interprofessional practice; (2) roles and responsibilities; (3)
interprofessional communication; (4) teams and teamwork.
The IPEC report considers communication a key competency but can be
negatively impacted by demographic and professional differences that
may exist between healthcare professionals. To address this issue, the
IPEC report encourages all team members to be willing to speak up in a
respectful way if they have a patient-related concern.
Although one should understand what IPE is, it is also important to
clarify what does not constitute IPE. Experiences on Advanced
Pharmacy Practice Experience (APPE) rotations that are directed by
someone from another profession that do not include sharing of
responsibility for patient care are not considered IPE.
Early exposure to IPE enhances students’ confidence in their
professional value, supports their respecting the contributions of other
professions, and better prepares them for providing patient care. These
early experiences also increase the appeal of collaborating with other
professions, reduce any negative stereotypical attitudes toward these
other professions, and strengthen communication skills.
One element of an IPE model is understanding that different professions
may vary in how they approach patient care. Team-based care means a
shared responsibility for patient care on the part of all team members
and should not be dominated by any one profession.
It is important to understand that IPE models can place in a variety of
settings, such a classroom, laboratory, and a patient care setting.
Regardless of the environment, IPE-related activities should represent a
Despite the progress made in advancing IPE over the past few years,
some barriers to implementing it exist on different levels, from the
institution/organization level down to the individual level. Overcoming
these barriers is important in order to continue to work toward preparing
students to collaborate with other healthcare professionals.
Interprofessional education (IPE) is considered to be a major attempt to better
prepare medical, pharmacy, nursing, and other health profession students to
collaborate and deliver patient care as part of a team.
1 Despite the recent attention it
has received, IPE is actually not new, and the idea behind it has been in existence for
some time. The first phase was initially launched in the 1940s, and a second wave of
IPE coinciding with a move to enhance primary care was described in the 1960s.
the early 1970s, the Institute of Medicine (IOM) Report “Educating for the Health
Team” addressed pharmacy as a component of the team as well as medicine, nursing,
3 However, there remains a concern that many practitioners, including
pharmacists, are commonly trained in programs that are removed from other
healthcare professionals. This educational separation could potentially have a
detrimental effect on the beliefs and values that these practitioners may have on the
contribution of other providers to patient care.
In 2003, the IOM addressed this
matter in their report “Health Professions Education: A Bridge to Quality.”
The report stressed incorporating interprofessional experiences into healthcare
education and establishing core competencies for IPE. The 2003 IOM report states
“all health professionals should be educated to deliver patient-centered care as
members of an interprofessional team, emphasizing evidence-based practice, quality
improvement approaches, and informatics.” These IOM recommendations generated
the momentum for health professions to advance the need for IPE.
with the increasing prevalence of chronic diseases and the complexities of delivering
health care today, an interprofessional approach toward patient care is important.
addition, new approaches to health care, including the Patient Protection and
Affordable Care Act of 2010, have stimulated a movement toward team-centered
health care, such as the patient-centered medical home (PCMH) concept which
encourages interprofessional teamwork in providing primary care.
model, physicians share responsibility with nurses, pharmacists, social workers, and
others to manage complex patient care cases.
7 The PCMH model puts the patient at
the center of his/her health care and expands access and improves mechanisms for
patient–provider communication, including the use of technology (e.g., email) for
patients to interact with their healthcare provider.
7 Although studies have shown that
collaboration of healthcare professionals can result in improved patient outcomes,
more work needs to be done to examine the relationship between IPE and positive
The reader is encouraged to apply these concepts to subsequent chapters as many
of the cases presented can be used as part of IPE activities. In addition, students are
encouraged to apply these concepts to IPE activities at their own institution.
The Interprofessional Education Collaboration (IPEC), a group representing
schools of pharmacy, nursing, medicine, osteopathic medicine, dentistry, and public
health convened an expert panel to develop core competencies for IPE. The expert
panel report was originally published in 2011
5 and was recently updated in 2016.
The four major competencies that are highlighted in the report are as follows: (1)
values and ethics for interprofessional practice; (2) roles and responsibilities; (3)
interprofessional communication; and (4) teams and teamwork.
competencies were identified in order to create a coordinated effort across the
different healthcare professions to incorporate key content into their respective
curricula and to guide curricular development. The competencies also provide a
foundation for lifelong learning, as well as offer information to the different
professions’ educational program accrediting bodies that can be used to set common
Regarding the first competency, the IPEC report considers interprofessional values
and ethics an important element of establishing a professional and interprofessional
identity. These values and ethics are patient-centered and grounded in a shared
purpose to providing patient care. Working in teams adds value by bring about
patient/family and community outcomes that promote overall health, disease
prevention, and treatment of disease. In addition to being patient-centered,
competency in this area helps develop trusting relationships with patients, families,
and other members of the healthcare team. There is also an expectation that one
maintains competency in one’s own profession relative to his/her area of practice.
The second competency addresses the importance that the IPEC places on one
understanding how professional roles and responsibilities complement each other in
providing patient care and to advance the healthcare needs of patients and
populations. It is this diversity of expertise that is the foundation of an effective
healthcare team. Coordination of care occurs more effectively when each profession
knows what the other can contribute to patient care.
5 Pharmacists should be able to
effectively articulate to other team members what they can contribute to executing a
treatment plan, especially when it comes to preventing and identifying any drug-
related problems. Sharing roles has also been shown to enhance patient outcomes and
2 For example, a nurse, social worker, and pharmacist can collaborate
to develop a discharge plan that reduces the potential for hospital readmission by
addressing such issues as community resources that may be available for assistance,
medication adherence, patient education, and healthcare provider follow-up.
IPEC report notes that one should also understand the limitations of one’s abilities,
knowledge, and skills as well, and engage in continuous interprofessional
development to improve team performance.
The IPEC report also considers communication a key competency, and the expert
panel states that one should communicate with patients, families, and both healthcare
and non-healthcare professionals in a responsive and responsible manner.
Characteristics such as being available, being well-informed, showing interest, and
being receptive are key aspects of this communication area as well. Listening and
encouraging the input of other members are also important attributes for this
competency. Presenting information in a manner that patients, families, and other
team members understand can help enhance the safety and effectiveness
Communication can be negatively impacted by demographic and professional
differences that may exist between healthcare professionals (e.g., older attending
physician and younger pharmacist). To address this issue, the IPEC report
encourages all team members to be willing to speak up in a respectful way if they
have a patient-related concern. You should politely and very clearly explain to the
attending what your concern is and provide evidence-based literature to support the
nature and severity of the interaction. Despite the attending’s intimidating demeanor,
failure to communicate the problem could possibly result in harm to the patient.
Being able to provide and receive feedback with confidence helps promote teambased care.
The fourth competency cited by the IPEC, teams and teamwork, means working
together for a common shared goal for patient care. The IPEC report indicates that
working in teams not only relates to shared problem-solving, but being able to
constructively manage any disagreements that arise with other healthcare
professionals as well and patients and family. Conflicts may occur when power is
confused with expertise based on professional background. Staying patient outcome
any potential conflict openly through shared problem-solving and utilizing
effective communication skills can help establish a more effective team. The report
also indicates that working in teams also means that giving up some professional
autonomy. Healthcare teams function best when the knowledge and expertise of the
different professions on the team are integrated to make patient care decisions.
incorporate interprofessional collaboration and teamwork as part of their standards.
Pharmacy school graduates, in addition to those from other healthcare professions,
must be able to work effectively with other providers as part of a team. The basic
principle of IPE is that if students from different healthcare professions learn
together, they will be better positioned to work together in teams to provide optimal
10 As Brock and colleagues recently noted, “health care education must
The terminology related to IPE can be confusing as interpretation of
multidisciplinary, interdisciplinary, and interprofessional may differ in the
2 The Centre for the Advancement of Interprofessional Education (CAIPE)
is an organization based in the United Kingdom that promotes and develops IPE
initiatives. CAIPE defines IPE as occurring “when two or more professions learn
with, from, and about each other to improve collaboration and the quality of care.”
The term interdisciplinary is sometimes interchanged with interprofessional and may
be the more appropriate term to use in those situations where individuals who are not
health professionals (e.g., nursing aides) are part of the team.
multidisciplinary should not be confused with interprofessional. The former is simple
and additive approach to patient care, with several healthcare providers providing
independent services, and each responsible for their own specialty. As described
earlier, IPE is a more coordinated approach in which there is an integration and
collaboration to include the viewpoints of many different professions in order to
QUESTION 1: You are on an internal medicine APPE rotation and round with a patient care team that
without actually involving anyone else on the team. Is your experience considered an example of IPE?
Although one should understand what IPE is, it is also important to clarify what
does not constitute IPE. For example, students from different health professions
learning the same topic in a classroom setting (e.g., pharmacology) without
interacting and discussing the material as it pertains to their respective discipline are
1 Nor is it IPE when a faculty member from another profession
lectures pharmacy students unless that person incorporates some component on how
the professions would interact in providing patient care.
Advanced Pharmacy Practice Experience (APPE) rotations that are directed by
someone from another profession that do not include sharing of responsibility for
patient care are not considered IPE.
1 Consequently, the experience described in Case
7-3 is not considered IPE. Clearly the underlying theme of any IPE activity is that it
should be a collaborative effort of students representing different professions.
INCORPORATING IPE IN THE CURRICULUM
healthcare students in an introductory-level course?
The goal of IPE is to develop knowledge, skills, and attitudes that result in
interprofessional team competence.
9 This includes not only clinical skills but
communication, conflict resolution, team building skills, in addition to respecting the
roles and responsibilities of other health professions.
incorporated throughout the entire curriculum in a vertically and horizontally
integrated fashion, in which collaboration, teamwork, and patient-centered care are
introduced to students prior to their entering the professional phase of the
It has been reported that early exposure to IPE approach enhances
students’ confidence in their professional value, supports their respecting the
contributions of other professions, and better prepares them for providing patient
It has additionally been noted that early educational experiences within an IPE
program increase the appeal of collaborating with other professions, reduce any
potential negative stereotypical attitudes one may have toward these other
professions, and enhance communication skills regardless of any specialized
The pharmacy education accrediting body, the American Council for Pharmacy
Education (ACPE), has included IPE in their 2016 Standards and Guidelines for
Accreditation for the PharmD program.
15 The goal is to make sure that schools of
pharmacy incorporate the IPE within the PharmD curriculum. Standard 11 of the
2016 ACPE Standards specifically covers IPE. In order to meet this standard, the
PharmD curriculum of a particular pharmacy school should prepare “all students to
provide entry-level, patient-centered care in a variety of settings as a contributing
member of an interprofessional team.”
15 The key elements of this standard include
interprofessional team dynamics, interprofessional team education, and
interprofessional team practice.
The interprofessional dynamics section of the standard addresses issues such as
values and ethics, interprofessional communication, conflict resolution, and honoring
interprofessional roles and responsibilities. The standard indicates that “these skills
should be introduced, reinforced, and practiced in the didactic and Introductory
Pharmacy Practice Experience (IPPE) components of the curriculum, and competency
is demonstrated in the APPE practice settings.”
The interprofessional team education and team practice elements of the standard
concern working together to improve patient care. Team education can include
simulation exercises where pharmacy students can collaborate with medical, nursing,
and other health professions students to better understand the contributions that each
makes to the healthcare team. Team practice encompasses providing direct patient
care as part of a shared decision-making process. It includes face-to-face interactions
with individuals from other healthcare professions that are designed to improve
interprofessional team effectiveness.
Despite its merits, not every student may be initially understanding or accepting
IPE. There are validated methods to
evaluate an individual’s ability to accept IPE. The Readiness for Interprofessional
Learning Scale (RIPLS) has been used a research tool to assess attitudes and
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