Scholarly Paper on Interprofessional Education

Scholarly Paper on Interprofessional Education
Prepared by
Raed Jaradat
Ibrahim Ayasreh
Submitted to
Professor. Ferial Hayajneh
The University of Jordan
Faculty of Nursing
Nursing education and curriculum development course
In the clinical area, all healthcare providers work together to provide high-quality care for
their clients. However, the undergraduate education of potential nurses and other healthcare
providers is separate. Interprofessional education (IPE) was developed and applied in some
western countries as teaching-learning strategy in which students from different health disciplines
meet and learn together. In this paper, we will analyze the concept of IPE beginning from definition
of it, moving to discussing its relevance to the learning theories, its benefits, barriers hindering its
application, and strategies assisting the faculties and educators to facilitate the IPE
Overview of Interprofessional Education
Interprofessional education (IPE) is a pedagogical approach in which teachers or educators
engage in teaching a group of students from diverse disciplines such as nursing, medicine,
pharmacy, and other health care specialties, in order to enhance communication and collaboration
between peers with different roles and perspectives and this will reflect positively in improving
the quality of care administered to the clients in the health institutions (Edwards, 2016).
The need for interprofessional education arose from the complexity of the health care
system which means that all health care providers are coming together from different professions
and specializations to provide the best quality of care to the clients, and this necessitate presence
of effective relationships between health care providers and working as a team rather than as
fragments (Lipsitz, 2012). However, the majority of current health institutions face the problem of
disharmony between nurses and physicians represented by disrespect, power relationships,
conflicts, and tensions (Matziou et al, 2014). This disharmony may be related to the lack of
awareness of each discipline about the roles of the others or may be related to differences in
educational cultures of both nurses and physicians. Therefore, there was a strong need to enhance
the communication skills of health care providers not just during their work, but also during their
study before graduation, and this will be achieved effectively through application of
interprofessional education.
Interprofessional Education Collaborative Expert Panel (2011) identified a number of
competencies that must be covered during interprofessional education curriculum, including:
communication, and teams / teamwork. American Association of Colleges of Nursing (AACN) is
the representative of nursing profession in this panel and recommended involving the
interprofessional education as a requirement for all university degrees in nursing: bachelor, master,
doctoral degrees (Cranford & Bates, 2015). To the best of my knowledge, no Jordanian nursing
faculties adopt the interprofessional education principles in their curriculum.
Relevance of IPE to Other Learning Theories
In this section, the principles of interprofessional education are compared to the
assumptions of some learning theories, and this will assist in the planning and implementation of
interprofessional education in our curriculum and nursing education.
Adult Learning Theory
Adult learning theory was developed by Malcolm Knowles (1978) who stressed on the
point that adults learn in different way from children. Knowles set a number of assumptions
distinguished his theory including: (1) movement from being dependent to self-directed person,
(2) growing learning experience as person matures, (3) readiness to learn increases as person
matures, (4) movement from postponed application of knowledge to immediacy of application,
and (5) adults are more influenced by internal motivations rather than external ( Keating, 2015).
Interprofessional education runs counter to adult learning theory in that learning process is
not centralized to one person, but it is collaborative and groupwork, and that persons are learning
with others not independently. On the other hand, both theories agree on the importance of
experiences constructed either personally or through social interaction (Edwards, 2016).
Transformative Learning Theory
This theory assumes that persons reshape and reset their beliefs, conceptions and feelings
based on their experiences and not exclusively dictated from others. Use of critical reflection and
experience are considered as the major concepts of this theory (Keating, 2015). Transformative
theory is highly accordant with interprofessional education, in that teachers enhance the learners
within a group to critically reflect their ideas, experiences, and perspectives in a specific situation
and not just doing what teachers dictate to them.
Constructivist Learning Theory
This theory emphasizes that persons construct their subjective evidence based on their
understandings and on their culture and context. This is congruent with the principles of
interprofessional education in that learners are active and create solutions to problems face them
according to their diverse knowledge and perspectives and based on the interaction between all
health-related students.
Benefits of IPE
Advantages of interprofessional education were discussed richly in the literature by
researchers from different disciplines including medicine, pharmacy, dentistry, rehabilitation
sciences in addition to nursing. There is an evidence that interprofessional education has great
positive influence on students as it enhances the awareness of nursing and other healthcare students
about their expected roles in the clinical area after graduation (Lash et al, 2014), and this may lead
to diminishing the potential conflicts which may arise between healthcare providers in their work,
and improved decision-making process (Illingworth & Chelvanayagam, 2017; Lash et al, 2014).
Additionally, Visser, et al (2018) found that meeting of students with different disciplines may
improve the quality of care because the focus of this meeting will be based on the client not the
specialty of these students. Furthermore, effectiveness of teaching and learning process is
maximized as interprofessional education provide the student with opportunity to see how the other
healthcare providers work, to ask questions in freely manner, and to facilitate effective feedback
based on discussion of students from different disciplines (Visser et al, 2018). In conclusion,
interprofessional education is so helpful at the long term as it assists potential nurses to achieve
higher level of holism in providing multidimensional care to their clients (Goldsberry, 2018).
Barriers to the Implementation of IPE
There were many obstacles which may hinder the application of interprofessional
education in universities and health institutes. According to Visser, et al (2018), power hierarchal
relationships between healthcare professions which dominates the environment of health setting
may make the meeting of students and employees from different disciplines more difficult and less
effective and may arise harsh conflicts between them.
It is so essential for each healthcare profession such as nursing to have a specialized
knowledge, theories, and beliefs. However, these distinguished boundaries of the professions may
dampen the agreement among professional curriculum developers (Goldsberry, 2018). For
example, nursing curriculum developers may focus on nursing theories which are socially and
humanistically based, whereas medicine curriculum developers may focus on theories which are
more physically and physiologically based. This discrepancy may make the interprofessional
education more difficult.
In her earlier research work, Vesser and her colleagues (2017) found that non-nursing
employees were less familiar with the roles and responsibilities of nurses, and this make these nonnursing professionals especially physicians to underestimate the competencies and capabilities of
nurses and this may complicate the implementation of interprofessional education.
Financial factor was considered as another obstacle facing the faculty and teachers in
implementation of the interprofessional education as it requires different resources such as
money, laboratories, simulation labs, and internet networks. At the level of individuals, feelings
and attitudes of students and teachers which arise from their different specialties may also affect
the popularity and acceptance of the interprofessional education as teaching/learning strategy.
For example, faculty who have negative attitudes and who don’t understand IPE principles will
not values any benefit of it. Additionally, the workloads of the faculty may discourage them to
develop or participate in IPE strategies (Lawlis, Anson, & Greenfield, 2014).
Suggestions for Facilitating the Implementation of IPE
It is so obvious through reading the literature that application of IPE is not easy mission.
So that a set of strategies may be used to facilitate the incorporation of IPE in the curriculum. For
successful implementation of IPE, the first step is to form a team from different health schools
such as nursing, medicine, pharmacy, … etc. This team must be composed of teaching staff who
are enthusiastic to apply IPE and use it in their curriculum. This team also has the responsibility
to determine areas or subjects which are appropriate to be taught through IPE, and to determine
the time, place, and technology used in IPE. According to Herrmann, Woermann, & Schlegel
(2014), most of failures in applying IPE were related to the differences in the timetables and
schedules of the courses, classes, and clinical training times among the all health schools.
Informal relationships was one of the essentials for successful application of IPE as
revealed by Herrmann, Woermann, & Schlegel (2014) who assured that conflicts and negative
prejudices are controlled and overcome, and this facilitate the positive interaction and feedback
between all students.
Administrative support primarily from the deans and heads of health schools must be
existent and this type of support may take many forms (Lash et al, 2014). For example,
administration of the educational settings must provide the needed resources to implement IPE
effectively, they are responsible to supply the schools with simulation labs in which
comprehensive interprofessional scenarios can be developed. Also, the administration of the health
schools has a great role in selecting appropriate competent enthusiastic staff for the committees of
interprofessional curriculum development.
Ways for Implementing IPE
The application of IPE has been evolved over time as a result of the advancement of
technology. Traditionally, IPE was operationalized through bringing the students from different
disciplines together in single classes to take specific subjects. This traditional method may be
beneficial in teaching theoretical courses such as basic sciences of biology and chemistry, and
basic medical sciences such as anatomy and physiology. However, this classical format of IPE
may be useful as a first step in adoption of IPE programs before moving to interprofessional
clinical training. The major advantage of merging theoretical classes is that it doesn’t need
extensive or expensive resources (Illingworth & Chelvanayagam, 2017).
Online learning is another way to apply IPE in which computer platforms such as
Blackboard is used to develop an online environment for students to discuss and learn together. In
these platforms the instructors from different disciplines can participate in developing a scenarios
and case studies, and then all students who already a have an account on these platforms can come
in online and participate in discussion of theses scenarios through blogs and they can share their
ideas, knowledge, opinions from their different perspectives and specialties. Teachers and students
can also share different types of information related to the cases and scenarios such as videos,
audios, pictures, Word documents, and PowerPoint files, and this enhance the learning and
teaching process (Myers & Obrien, 2015).
High fidelity simulation (HFS) which is considered as a modern form of education utilizing
computer-based mannequin, gives the students the opportunity to learn and demonstrate different
types of skills, to enhance the decision-making capabilities, and assist them in building confidence
in a safe environment. Incorporation of High fidelity simulation in interprofessional education has
manifold benefits such as enhancing the awareness of students from each discipline about other
roles of other disciplines (Meyer et al, 2017), and enhancing the clinical problem solving and
collaboration (Joyal et al, 2014).
Framework of the Scholarly Paper
Cranford, J. S., & Bates, T. (2015). Infusing Interprofessional Education Into the Nursing
Curriculum. Nurse Educator, 40(1), 16-20. doi:10.1097/nne.0000000000000077
Edwards, M. E. (2016). Interprofessional education and medical libraries: Partnering for success.
Lanham, MD: Rowman & Littlefield.
Goldsberry, J. W. (2018). Advanced practice nurses leading the way: Interprofessional
collaboration. Nurse Education Today, 65, 1-3. doi:10.1016/j.nedt.2018.02.024
Herrmann, G., Woermann, U., & Schlegel, C. (2014). Interprofessional education in anatomy:
Learning together in medical and nursing training. Anatomical Sciences Education, 8(4),
324-330. doi:10.1002/ase.1506
Illingworth, P., & Chelvanayagam, S. (2017). The benefits of interprofessional education 10 years
on. British Journal of Nursing, 26(14), 813-818. doi:10.12968/bjon.2017.26.14.813
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for
interprofessional collaborative practice: Report of an expert panel. Washington, D.C.:
Interprofessional Education Collaborative.
Joyal, K. M., Katz, C., Harder, N., & Dean, H. (2014). Interprofessional education using simulation
of an overnight inpatient ward shift. Journal of Interprofessional Care, 29(3), 268-270.
Keating, S. B. (2015). Curriculum development and evaluation in nursing. New York: Springer.
Lash, D. B., Barnett, M. J., Parekh, N., Shieh, A., Louie, M. C., & Tang, T. T. (2014). Perceived
Benefits and Challenges of Interprofessional Education Based on a Multidisciplinary
Faculty Member Survey. American Journal of Pharmaceutical Education, 78(10), 180.
Lawlis, T. R., Anson, J., & Greenfield, D. (2014). Barriers and enablers that influence sustainable
interprofessional education: A literature review. Journal of Interprofessional Care, 28(4),
305-310. doi:10.3109/13561820.2014.895977
Lipsitz, L. A. (2012). Understanding Health Care as a Complex System. JAMA, 308(3), 243.
Matziou, V., Vlahioti, E., Perdikaris, P., Matziou, T., Megapanou, E., & Petsios, K. (2014).
Physician and nursing perceptions concerning interprofessional communication and
collaboration. Journal of Interprofessional Care, 28(6), 526-533.
Myers, C. T., & Obrien, S. P. (2015). Teaching Interprofessional Collaboration: Using Online
Education Across Institutions. Occupational Therapy In Health Care, 29(2), 178-185.
Meyer, B. A., Seefeldt, T. M., Ngorsuraches, S., Hendrickx, L. D., Lubeck, P. M., Farver, D. K.,
& Heins, J. R. (2017). Interprofessional education in pharmacology using high-fidelity
simulation. Currents in Pharmacy Teaching and Learning, 9(6), 1055–1062.
Solnick, A., & Weiss, S. (2007). High Fidelity Simulation in Nursing Education: A Review of
the Literature. Clinical Simulation in Nursing, 3(1). doi:10.1016/j.ecns.2009.05.039
Visser, C. L., Ket, J. C., Croiset, G., & Kusurkar, R. A. (2017). Perceptions of residents, medical
and nursing students about Interprofessional education: A systematic review of the
quantitative and qualitative literature. BMC Medical Education, 17(1).
Visser, C. L., Kusurkar, R. A., Croiset, G., Cate, O. T., & Westerveld, H. E. (2018). Students’
motivation for interprofessional collaboration after their experience on an IPE ward: A
qualitative analysis framed by self-determination theory. Medical Teacher, 1-9.