by Taemi Cho, Pharm.D., PGY1 Community Pharmacy Practice Resident, University of Maryland School of Pharmacy
When you were a pharmacy student, did you ever experience interprofessional team teaching? Many will probably answer without hesitation, “Yes of course. On rounds during my acute care rotation.” But consider these questions: What exactly is an interprofessional team? How does an interprofessional team differ from a multidisciplinary team?
Although the terms multidisciplinary and interprofessional are frequently used interchangeably, multidisciplinary teams differ from interprofessional teams. Multidisciplinary and interprofessional teams differ based on the degree of interaction and sharing of responsibilities.1In patient care, multidisciplinary teams are described as being led by the highest ranking team member which is usually the physician.1 Each member works independently but in parallel. The medical record serves as the primary tool for information sharing.1
In contrast, interprofessional healthcare teams include members with different professional training coming together to interdependently develop goals.1,2 In an interprofessional team, leadership is shared, members engage each other and learn from one another.1An interprofessional team approach involves the collaboration of people with diverse perspectives to devise a unified approach.2 The aim of the interprofessional team is to provide more comprehensive patient care than what is typically achieved today.
Are there real benefits to adopting interprofessional team teaching in healthcare education? Unlike instruction received from people from a single professional background, interprofessional teaching introduces multiple (two or more) perspectives in a teaching-learning process that enhances each profession.3 Interprofessional teaching challenges students to integrate alternative views and helps them to understand complex issues that must be considered when providing optimal patient care.2 This approach also educates students about conflict resolution and group dynamics, important skills that must be learned in order to be an effective member of a high-functioning team.4
A recent paper described interprofessional education at the Rosalind Franklin University of Medicine and Science, the University of Florida, and the University of Washington.5 Each of these interprofessional education programs included didactic instruction, a community-based experience, and an interprofessional-simulation exercise.5 The didactic instruction taught principles of collaborative patient centered care and clinical concepts.5The community service component included interprofessional teams working with community partners on a community service project.5 And the simulation activity had students from different disciplines working together on a skills assessment. All three interprofessional education programs felt they had achieved their programmatic goals. Students were reported to comprehend their professional roles and understood the contribution of other professional’s roles on the team.5
One pilot study assessed an interprofessional team reasoning framework
(IPTRF) utilized to teach and learn cases studies among student of different health professions.6 The following flowchart is the framework used in the study:
Figure from: Packard K et.al. Interprofessional team reasoning framework as a tool for case study analysis with health professions students: A randomized study.
JRIPE Vol 2.3 August 2012.
JRIPE Vol 2.3 August 2012.
Eighteen students from dentistry, medicine, nursing, occupational therapy, pharmacy, and physical therapy were randomized into 3 teams of six members.6 The first team received only the case; the second received the case and framework; and the third received the case, framework, and a videotaped example of interprofessional interactions. The primary end point evaluated students’ perceptions and the secondary endpoint evaluated students’ performances.6 The results found that students’ perception of team skills improved when they were given the IPTRF tool (second and third teams). Moreover, team three’s students’ performance was significantly better when compared to students on the other two teams.6
The success of an interprofessoinal education lies in developing a curriculum that prepares students to collaborate in an interprofessional manner. One cannot expect recently graduated pharmacists to successfully work within an interprofessional team without instruction, both didactic and experiential. Many barriers exist in implementing interdisciplinary team education including a lack of administrative/faculty support, insufficient faculty with interdisciplinary training, limited financial resources, entrenched power dispositions/territorial imperatives, logistics, scheduling, and reimbursement.3
To progress, these barriers need to be addressed. Collaborators from successful schools that have implemented interprofessional education indicated that their success relied on resolving conflicts in the initial stages of developing an interprofessional course.7 Collaborators need to understand each other’s pedagogical views and negotiate those differences.7 Integral to an interprofessional education are the core competencies identified by the Interprofessional Education Collaborative Expert Panel.8
You may be wondering if I have experienced interprofessional team teaching. I can honestly say, “Yes!” I took a class as a pharmacy student that had interdisciplinary components. My Geriatric Imperative class had a geriatric dementia team consisting of a physician, nurse, pharmacist, psychologist, and social worker from the Veterans Affairs (VA). The team members discussed how they met with their patients and shared their perspectives to optimize each patient’s care. Later, as a P4 student, I rotated through the Dementia clinic at the VA. For 3 months, I worked in this interdisciplinary team where we made assessments based on our various perspectives, integrated the information, and together developed a patient care plan.
References
1. Cooper BS, Fishman E. The interdisciplinary team in the management of chronic conditions: has its time come? Partnerships for Solutions Better Lives for People with Chronic Conditions [Internet]. New York: Mount Sinai School of Medicine; 2003 June: 2-4.
2. Goldsmith AH, Hamilton D, Hornsby K, Wells D. Interdisciplinary Approaches to Teaching. Lexington (VA): Washington and Lee University; [updated 2012 May 29; cited 2012 Nov 17].
3. Page RL, Hume AL, Trujillo JM, & Leader WG. ACCP White Paper Interprofessional Education: Principles and Application. A Framework for Clinical Pharmacy. Pharmacotherapy 2009; 29: 145e-164e.
4. Allen DD, Penn MA, Nora LM. Interdisciplinary Healthcare Education: Fact or Fiction? Am J Pharm Educ 2006 April 15;70(2): Article 39.
5. Bridges DR, Davidson RA, Odegard PS, Maki IV, Tomkowiak J. Interprofessional collaboration: three best practice models of interprofessional education. Med Educ Online 2011 April 8;16:6035.
6. Packard K, Hardeep C, Maio A, Doll J, Furze J, Huggett K, Jensen G, Jorgensen D, Wilken M, Qi Yongyue. Interprofessional Team Reasoning Framework as a Tool for Case Study Analysis with Health Professions Students: A Randomized Study. JRIPE 2012; 23: 251-263.
7. Shibley I. Interdisciplinary Team Teaching Negotiating Pedagogical Differences. College Teaching. 2006; 54(3): 271-274.