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.1
In 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.1
An 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.5
The 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.
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