Nursing Inter Professional Education

Inter Professional Education In Nursing

What Is Inter-professional Education,External Influence In Nursing Education

What Is Inter-professional Education

    As students and faculty from multiple health professions begin to work together in teams, there is a need to have a common language and understanding of inter-professional education (IPE) and collaborative practice. In 2002, the United Kingdom's Center for the Advancement of Interprofessional Education (CAIPE) defined IPE as more than students studying together (CAIPE, 2002). The CAIPE definition of IPE is the most accepted one used in health professions education and inter-professional practice. 

    IPE includes purposeful activities designed so that students can learn from, with, and about each other and work toward the ultimate goal of providing collaborative, team-based care focused on quality of care (CAIPE, 2002). It's not just about students from different disciplines taking the same courses together.Two national initiatives affecting how nurses are educated to address the need for IPE and collaborative practice are the Institute of Medicine's (JOM, 2011) report The Future of Nursing: Leading Change. Advancing Health and the 2010 Lancet Commission Report Health Professionals for a New Century Transforming Education to Strengthen Health Systems in an Interdependent World ( Frenk et al., 2010). 

    These two reports include recommendations that have implications for nursing education. One of the recommendations from the Future of Nursing report (2011) was that nurses should be full partners with physicians in redesigning health care. This recommendation was not specifically about IPE but was about empowering nurses to be leaders to participate with doctors and other health professionals in the design, implementation, and evaluation of reforms in health care. The implication for nursing education was to train nurses to be leaders and collaborative partners in addressing health care system reform. 

    In order for nurses to be full partners, they need to gain knowledge in process improvement, health care systems, health care financing, patient safety initiatives, and health care policies. Leadership training that promoted collaboration and mutual respect was also recommended, so that nurses could work effectively with other members of the health care team to make decisions and act independently. The recommendations for nursing leaders were very much aligned with the subsequent “Team and Teamwork” sub competencies recommended for health profession students ( Inter-professional Education Collaborative [IPEC] Expert Panel Report, 2011)

    Specific Team and Teamwork Competency #5-Apply leadership practices that support collaborative practice and team effectiveness and Specific Team and Teamwork Competency W7-Share accountability with other professions patients, and communities for outcomes relevant to prevention and health care. (p. 25)

External Influence In Nursing Education

    In the last 10 years, there have been numerous external forces influencing changes in health professions education that have resulted in a renewed focus on IPE. These forces include: 

(a) the establishment of national and international organizations and institutes supporting IPE

(b) changes in accreditation standards requiring IPE ( Zorek & Raehl , 2013)

(c) health care reform that aligns financial incentives for team-based care with a focus on quality and not volume of care (Patient Protection and Affordable Healthcare Act, 2010)

(d) discipline-specific and international reports and forums dedicated to improving health and the delivery of health care in a more efficient and equitable manner

(e) funding of a national center through private and public partnerships to coordinate IPE and collaborative practice (University of Minnesota's National Center for Inter-professional Practice and Education.

    The relationship between IPE and collaborative practice was described in a 2010 World Health Organization (WHO) report: Framework for Action on Inter-professional Education and Collaborative Practice, which stated:After almost 50 years of inquiry, the World Health Organization and its partners acknowledge that there is sufficient evidence to indicate that effective inter-professional education enables effective collaborative practice. Collaborative practice strengthens health systems and improves health outcomes. (p. 7)

    In 2010, six national health profession associations formally joined together to create the IPEC. The IPEC's founding organizations include the American Association of Colleges of Nursing, the Association of American Medical Colleges, the American Association of Colleges of Osteopathic Medicine, the American Dental Education Association, the American Association of Colleges of Pharmacy, and the Association of Schools of Public Health. 

    In 2011. the IPEC published a report describing four competency domains and 38 sub-competence statements for inter-professional collaborative practice (IPEC, 2011). Increasingly, professional organizations and accrediting bodies have recognized the importance of IPE, which has led to accreditation standards for including IPE The four, broad-based IPE domains for which most health professional students are held accountable are values/ethics for inter-professional practice, roles/ responsibilities, inter-professional communication, and teams and teamwork.

    The Lancet Commission Report ( Frenk et al., 2010) was a seminal article in health professions education and of great importance for nurse educators. One outcome of this article was the creation of an international global forum (IOM Global Forum on Innovations in Health Professions Education) involving educational leaders from academia and practice, as well as professional organizations and governments, to share perspectives and discuss needed institutional and instructional reforms that were addressed in the report.

    Two of ten instructional and institutional reforms proposed by the Lancet Commission for the purpose of advancing the transformations needed in health professions education to enhance patient and population-centered care (2010) had direct implications for nursing education:“Promotion of inter-professional and trans professional education that breaks down professional silos while enhancing collaborative and non-hierarchical relationships in effective teams” (reform #2) and promote a new professionalism that uses competencies as the objective criterion for the classification of health professionals, transforming present conventional silos (reform #6, p. 1951)

    The recommendations from the two reports (Future of Nursing [2011] and the Lancet Commission Report [2010]) address the changes needed in nursing education and nursing organizations (purposeful leadership training and IPE) that will lead to competent nursing leaders who can engage in decision making with other professionals in health care reform and competent nursing students who are “collaborative-practice-ready” to provide high-quality and safe, patient or population-centered care as a member of a team on graduation

    To realize these recommendations in day-to-day practice, nurses at all levels, from deans to pre-licensure students, need to demonstrate leadership. Nursing deans need to collaborate with other health science deans to provide infrastructure support for IPE and resources to develop IPE competent faculty. Nurse educators need to create opportunities for students to be educated with other health professional students as part of their core curriculum. Nursing students need to be engaged and lead IPE student activities to break down the professional silos. Through leadership and participation at all levels, nurses will be able to demonstrate competency in IPE and collaborative practice.