Benefits of early interprofessional education

Submitted by Stephen C. Scho... on Jan 16, 2015 - 1:36pm CST

I’m wondering if there is significant evidence to support the need for early IPE vs. later-onset IPE in the course of the education of health professionals. I think we all believe that early exposure is very important. And, Bud Baldwin cites his Nevada experience in which early exposure of pre-med students led more of them to choose primary care fields when they were in medical school. But, I’m unaware of a lot of evidence (and I’m not looking for RCTs) that supports early exposure vs. starting, for example, with residents vs. medical students, newly employed nurses vs. nursing students, newly employed pharmacists vs. pharmacy students, etc.

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early vs late IPE

Submitted by Madeline H. Schmitt on Feb 2, 2015 - 11:29am CST

There is some further comment on early vs later IPE in the responses to additional questions posted with 4th National Center Journal Club offered by Dr Stuart Gilman of the Veterans Health Administration last week, under Question 3: Should interprofessional training start during medical school, "priming" future practitioners? Try this link: https://nexusipe.org/resource-exchange/national-center-journal-club-4-connecting-dots-interprofessional-health-education

Early IPE

Submitted by Valentina Brashers on Jan 25, 2015 - 9:20am CST

At the University of Virginia Center for ASPIRE, we do support activities during the first 2 years of MD/RN training, but have a stronger focus on third year students during their initial clinical rotations. While gaining positive attitudes is essential, we have created our most intense training to integrate teamwork skills with hands-on profession-specific skills so that they are seen by students as seamless requirements for optimal care rather than as separate topics. We have completed our three year Macy-sponsored grant that supported the creation of clinical simulations and associated interprofessional teamwork OSCEs, and are in the process of writing up the data for a manuscript. We will also be reporting our outcomes at CAB V in the fall. In the meantime, we can say that our objective data supports the effectivienss of IPE simulation training during the third year of medical and nursing undergraduate training for greatly improving teamwork skills in our selected clinical scenarios.

Thank you, Tina

Early IPE

Submitted by Jill Thistlethwaite on Jan 23, 2015 - 11:31pm CST

Part of the issue here is what are we trying to measure when we look at effectiveness and try to compare early and late IPE. Attitudes and perceptions are important but behaviour is what can be observed and what affects patient care. It is similar to the debates about early patient/clinical contact and how this influences students. The other question could be - what is the minimal exposure required to interprofessional learning or practice to develop an interprofessional way of working or identity? This is unlikely to be the same for every student. Is late IPE better than none at all? The pervasive effect of the hidden curriculum also needs more exploration in this area. We know that many students who have exposure (using the UBC terminology) to IPE early in their curricula do not necessarily have optimal immersion experiences during their clinical rotations if they are located in an area where IPP is not well established or explicit. We need so much more work in these areas.

Early Intervention and IPE

Submitted by David Pole on Jan 21, 2015 - 11:46am CST

Thank you for your inquiry. There is a significant amount of literature to support this point. Our main perspective at Saint Louis University Center for IPE on early integration are based on the following:

- it is important to create positive attitudes about IPE early and this impacts attitudes and perceptions to future IPE learning experiences

- integrating IPE early and embedding within the professional programs supports professional formation that includes IPCP and collaborative approaches to patient centered care into the students view of how they see themselves as a health care professional in the future

- the volume of content at the clinical level of training is requiring student to integrate lots of new information, having knowledge and skills to practice IPE and its value at engaging with otter professionals to improve shared learning and patient centered care are part of their foundation preparation for moving into this clinical level, it is not an added skills set to learn separate from clinical care

For more details and references, I would refer the reader to the article we published last year on early intervention and outcomes in IPE: "A comparison of student attitudes and perceptions before and after an introductory interprofessional education experience" Ruebling, et.al. published in the Journal of Interprofessional Care.

Thank you, David

early versus later ipe

Submitted by Madeline H. Schmitt on Jan 21, 2015 - 10:18am CST

Hi Steve,

I agree that many of us think starting earlier is important. In fact i just attended an introductory workshop with medical and nursing students focused on ipe and they pleaded for earlier exposure. Generating the evidence supprtive of an earlier start is a bit tricky. The nature of earlier ipe - even earlier in basic health professions education - needs to be factored in when defining appropriate outcomes. Many embrace a learning trajectory starting early and continuing through the practice years. An IOM consensus panel emerging from the IOM Forum on Innovations on Health Professions Education is currently doing a fast track study of the links between ipe and outcomes. They may have their hands on evidence. I will try to engage others who can help add to this discussion.

Thanks for this important question.

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