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Case Studies of Interprofessional Education Initiatives From Five Countries

Article in Journal of Nursing Scholarship · April 2018

DOI: 10.1111/jnu.12384

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Case Studies of Interprofessional Education Initiatives From Five
Countries
Tracy Levett-Jones, PhD, MEd & Work, BN, RN, DipAppSc(Nursing)1 , Teresa Burdett, PhD, PGDipAP, MSc,
BSc(Hons), DPSN, FHEA, RGN, RMN, RHV2 , Yeow Leng Chow, PhD, MSc, RN, RMN, Dip(N), Dip(Nur Edu)3 ,
Lisbeth Jönsson, PhD, RSCN4 , Kathie Lasater, EdD, RN, ANEF, FAAN5 , Launa Rae Mathews, MS, RN6 ,
Margaret McAllister, EdD, MEd, BA, DipAppSc(Nursing)7 , Alison Pooler, PhD, MSc(Health), BSc(Hons), RGN,
RNT, PGCHPE, V200, V3008 , Stephen Tee, DClinP, MA, PGCEA, BA, DPSN, RMN, PFHEA, NTF9 ,
& Jonas Wihlborg, MsN, RN, PEN10
1 Professor of Nursing Education, Discipline Lead, Faculty of Health, University of Technology Sydney Ultimo, NSW, Australia
2 Lecturer in Integrated Health Care, Faculty of Health and Social Sciences Bournemouth University, Bournemouth, Dorset, England
3 Associate Professor, National University of Singapore, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore
4 Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
5 Professor, Oregon Health & Science University, School of Nursing, Portland, OR, USA
6 Clinical Assistant Professor, Oregon Health & Science University, School of Nursing, Portland, OR, USA
7 Professor of Nursing, CQUniversity, The School of Nursing and Midwifery, Noosaville, Australia
8 Director of learning and teaching, lead for IPE and prescribing education, Lecturer in adult nursing, School of Nursing and Midwifery, Keele University,
Stoke on Trent, UK
9 Professor and Executive Dean, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, Dorset, England
10 Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden

Key words Abstract

Collaborative practice, communication,
interprofessional education, nursing student, Background: Although teamwork and interprofessional collaboration are
patient outcomes, teamwork critical to patient safety, nursing, medical, and allied health graduates often
feel ill-prepared to confidently communicate and collaborate with other team
Correspondence members. While interprofessional education (IPE) has been advocated as a way
Tracy Levett-Jones Faculty of Health, University
of addressing this issue, there are multiple barriers to its systematic and sus-
of Technology Sydney, Ultimo, NSW 2007,
tained integration in undergraduate healthcare programs. Despite these chal-
Australia. E-mail:
[email protected] lenges, examples of effective IPE initiatives have emerged.
Innovation: This article profiles seven case studies of innovative interpro-
Accepted January 21, 2018 fessional education activities that have been successfully implemented across
five countries, for a variety of learners, using different delivery modalities, and
doi: 10.1111/jnu.12384 with evaluation results attesting to their success.
Conclusions: The case studies demonstrate innovative ideas that have the
potential to overcome some of the barriers to IPE through the use of creative
and targeted approaches. This article provides a wealth of ideas for the suc-
cessful design and implementation of IPE initiatives and will be of benefit to
educators wishing to expand their repertoire of teaching approaches.
Clinical Relevance: A body of research attests to the relationship between
interprofessional communication, teamwork, and patient outcomes. IPE is im-
perative for facilitating the development of nursing graduates’ communication
and teamwork skills; however, innovative approaches are needed to overcome
the perceived and actual impediments to its implementation.

A wide body of research attests to the relationship be- and allied health graduates lack the confidence and
tween interprofessional communication, teamwork, and skills needed to communicate and collaborate effec-
patient outcomes (Levett-Jones, Oates & MacDonald- tively as members of interprofessional teams (Gilligan,
Wicks, 2014; Reeves, Pelone, Harrison, Goldman, & Outram & Levett-Jones, 2014). Interprofessional educa-
Zwarenstein, 2017). Yet, too often nursing, medical, tion (IPE) has been proposed as the most appropriate

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Case Studies of Five Interprofessional Education Initiatives Levett-Jones et al.

educational strategy for facilitating the development of each other to enable effective collaboration and improved
these skills (Teodorczuk, Khoo, Morrissey, & Rogers, health outcomes (Centre for the Advancement of Inter-
2016). However, multiple barriers to the efficient, ef- professional Education, 2002). However, contemporary
fective, sustained, and systematic integration of IPE in teaching and learning approaches in higher education
undergraduate education programs have been described do not always facilitate the development of healthcare
(Lapkin, Levett-Jones, & Gilligan, 2012). Despite these students’ communication, collaboration, and teamwork
challenges, examples of successful and innovative IPE ini- skills, and formal teaching and assessment in these ar-
tiatives have emerged. eas are often neglected (Leonard, Graham & Bonacum,
The aim of this article is to profile seven case stud- 2011). Additionally, when educational opportunities are
ies of creative IPE activities that have been successfully offered, they tend to focus mainly on communication
implemented across five countries. These case studies with patients, and much less attention is given to com-
used both online and face-to-face teaching approaches municating with other health professionals. As a result,
and were conducted in classrooms, clinical and com- graduates and their employers often report that they are
munity settings. The IPE initiatives targeted a range of not well equipped to communicate and contribute effec-
specific learning outcomes and practice issues for under- tively as team members (Gilligan et al., 2014).
graduate and postgraduate nursing, medical, and allied The IPE agenda emerged more than 30 years ago, but
health students. its importance was recognized following multiple inter-
national patient safety reports detailing adverse patient
outcomes resulting from poor interprofessional commu-
nication and collaborative practice. Consequently, these
Background
concerns led to changing policy directions with regard
Healthcare professionals are required to work both au- to IPE. For example, in Canada there is a clear policy
tonomously and collaboratively in complex and dynamic supporting the incorporation of IPE into health profes-
clinical environments. Interprofessional collaboration is sional education, with the Health Council of Canada rec-
defined as members of the healthcare team working to- ommending that each university health sciences program
gether to improve the quality and safety of patient care offer an IPE subject (Bandali, Niblett, Yeung, & Gamble,
using complementary knowledge and skills, and with re- 2011). Similarly, the Institute of Medicine Committee on
spect for each other’s expertise (Rogers et al., 2017). An the Robert Wood Johnson Foundation Initiative on the
effective interprofessional team requires knowledge and Future of Nursing at the Institute of Medicine (2011) in
understanding of each member’s roles and responsibili- the United States advocated that healthcare profession-
ties as well as mutual valuing of the unique contributions als should be educated to deliver person-centered care
made by each professional group to patient care (Wilson, as members of interprofessional teams. In the United
Palmer, Levett-Jones, Gilligan, & Outram, 2016). Kingdom, outrage at the findings of the Bristol Royal
When teams communicate and collaborate effectively, Infirmary inquiry, which attributed a significant propor-
knowledge and information is shared, joint decision mak- tion of clinical errors to poor interprofessional teamwork
ing is enabled, and team members feel more confident (Department of Health, 2002), led to IPE becoming a
and empowered to assume leadership for patient care is- mandatory inclusion in preregistration training in health
sues appropriate to their scope of expertise (World Health and social care programs (Department of Health &
Organization, 2010). A recent systematic review identi- Quality Assurance Agency, 2006). In Australia, the im-
fied that interprofessional collaboration has a significant portance of IPE came to prominence in reports such as
impact on patient outcomes and use of healthcare re- Towards a National Primary Health Care Strategy (De-
sources (Reeves et al., 2017). However, too often deeply partment of Health and Ageing, 2008) and Garling’s
entrenched cultures, power differentials, and the hier- Special Commission of Inquiry into Acute Care Services
archical nature of healthcare environments can present in NSW Public Hospitals (Garling, 2008). Both of these re-
barriers to interprofessional collaborative practice. Thus, ports recommended that university education should be
many healthcare graduates enter clinical environments undertaken in a manner that supports interprofessional
where the rhetoric of teamwork contrasts markedly with teamwork and collaboration. However, these recommen-
workplace realities (Rice et al., 2010). dations have not yet translated into the implementation
Thistlewaite (2015) suggested that the opportunity for of systematic and sustainable IPE initiatives in all health-
healthcare students to learn together prepares them to care programs (Lapkin, Levett-Jones, & Gilligan, 2012). It
work within interprofessional teams, ultimately leading is evident that, despite the progress that has been made,
to improved patient care. IPE occurs when learners from strategies to overcome the barriers to IPE and examples
two or more professions learn about, from, and with of having done so are still needed.

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Levett-Jones et al. Case Studies of Five Interprofessional Education Initiatives

In the following section of this article, seven diverse ideal platform for students from two or more professions
case studies of innovative but practical IPE activities from to learn together, they are also effective when used for
five countries are profiled. These examples were selected teaching single disciplines as they illustrate the roles and
following a review of relevant literature and conference contributions of all members of the medication team. The
papers, and because they each included nursing students modules can be used online for self-directed learning or
and one or more other healthcare groups, demonstrated as stimulus materials for lectures or tutorials. A facilitator
the essential elements of IPE (Centre for the Advance- guide is provided to support educators in their integration
ment of Interprofessional Education, 2002), and used of IPE into their teaching (Levett-Jones, Gilligan, Lapkin,
innovative and creative approaches to overcome rec- & Hoffman, 2012).
ognized barriers and challenges to IPE (Lapkin et al., Findings from a quasi-experimental study attest to the
2012). effectiveness of the IPE modules. Three hundred and
twenty nursing, pharmacy, and medical students were al-
located to either an experimental (n = 155) or control
Interprofessional Education for Quality Use
group (n = 165). Participants in the experimental group
of Medicines (Australia)
who completed the modules demonstrated a significantly
In Australia, opportunities for healthcare students to higher intention to practice in a manner that enhances
engage in IPE are often limited by the constraints im- collaborative practice and medication safety than those in
posed by timetabling and large student cohorts. To the control group who did not have access to the modules
overcome these issues, academics from the University (p < .001; Lapkin et al., 2015).
of Newcastle designed a set of e-learning IPE modules
to enable nursing, medical, and pharmacy students to
Learning With Other Healthcare Students in
learn from and about each other’s roles in the medica-
Population Practice (United States)
tion team (www.ipeforqum.com.au). Evidence suggests
that online IPE experiences can contribute to an im- Many IPE initiatives focus on co-learning in the class-
proved understanding of professional roles and responsi- room; however, the School of Nursing at Oregon Health
bilities, enhancement of students’ attitudes towards each and Science University developed the Interprofessional
other, and improved interprofessional communication Care Access Network (I-CAN), an authentic interpro-
and teamwork skills (McKee, Goodridge, Remillard, & fessional clinical experience. Students were allocated to
D’Eon, 2010) a neighborhood with vulnerable and underserved pop-
The project targeted medication safety and quality ulations and a high prevalence of poverty or com-
use of medicines (QUM) in the IPE modules because plex health needs. There were three neighborhoods
(a) prescribing, dispensing, and administering medica- where students served: (a) an inner-city neighborhood
tions are interdependent processes that require collab- with many people who are homeless and live in single
oration between all members of the medication team; room occupancy (SRO) hotels; (b) a rural community,
(b) safe medication practices are a focus of the global served by a large Spanish-speaking clinic; and (c) an ur-
strategy to improve patient safety (Sears, Ross-White, ban neighborhood with large numbers of recent immi-
& Godfrey, 2012); and (c) the prevalence of adverse grants and refugees, primarily Bhutanese, Congolese, and
patient outcomes associated with medication errors re- Syrian.
mains unacceptably high, with the World Health Orga- Throughout the term, nursing students carried a
nization (2011) estimating that more than 50% of all caseload of two to four clients who required care coor-
medications are prescribed, dispensed, or administered dination services and were referred by partner agencies
inappropriately. within these neighborhoods. Nursing students worked
Each of the five IPE for QUM e-learning modules side by side with medical, dental, and/or pharmacy stu-
includes a video recording of a patient journey that dents visiting clients in their homes or a common meeting
is based on an authentic representation of an actual place. Typical examples of these services included a phar-
clinical situation. A number are reenactments or adapta- macy and nursing student working together to provide
tions of publicly available critical incident reports or coro- education and support to a homeless client with men-
nial inquests. They present patients, nurses, pharmacists, tal health issues who had difficulty obtaining and using
and doctors of different genders, ages, and ethnic back- prescribed medications; and nursing, dental, and medical
grounds. The IPE modules have been designed for flex- students addressing issues associated with poor nutrition
ible use, and educators can select the most appropriate and dentition in neighborhoods where unstable housing
resource to align with the particular learning objectives and food scarcity were common (Wros, Mathews, Voss,
of their subject. Although these IPE modules provide an & Bookman, 2015).

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Case Studies of Five Interprofessional Education Initiatives Levett-Jones et al.

Students were supported by nursing faculty-in- IPE teams consisting of nursing, medical, and phys-
residence (FIRs) who provided continuity for clients and iotherapy students undertook 8-day (4 days per week)
the project as a whole. The FIRs also facilitated ongoing clinical placements. During this time students were en-
population health projects in which nursing students par- couraged to learn with, from, and about each other to
ticipated and served as resources in the neighborhoods develop knowledge and skills beyond their own profes-
with interprofessional teams. Findings from a qualitative sional role. Supervisors were on hand at all times; nursing
study (Gordon, Lasater, Brunett, & Dieckmann, 2015) supervisors worked day and night shifts 7 days a week,
that explored the impact of the I-CAN IPE demonstrated and the medical and physiotherapy supervisors worked
the benefits of this learning experience from students’ weekdays.
perspectives, for example: The IPE activity took place in a 14-bed hospital ward
that specialized in the care of older people with condi-
I really enjoyed working amongst teams of nursing, dental, tions such as heart failure, pneumonia, and diabetes. Pa-
physician assistant and medical students to share ideas, learn tients and their families were informed on admission that
from each other, and develop plans to best serve the needs of undergraduate students would be caring for them dur-
the clients. [pharmacy student] ing their hospital stay, and their verbal consent was ob-
Over the 10 week I-CAN program it was rewarding to see tained. Each IPE team had the responsibility for providing
how clients were able to accomplish or make strides towards care for three to six patients. Provision of routine per-
many of their healthcare goals with the help of their I-CAN sonal care, for example, provided opportunities for the
team. [physician assistant student] students to gain to gain a deeper understanding of each
other’s roles, responsibilities, knowledge, and skills.
We had the opportunity to work with medical students to Following the IPE experience, students met with their
provide care to patients in the community. This collaborative supervisor and a lecturer from the university to reflect
education gave us practice working as a member of an inter- on issues associated with their own profession and the
professional team. Our group came up with the analogy of transition between their role as students and their profes-
a football team; the most effective offense is one where each sional roles. They were also required to submit a written
teammate knows each other’s role. Likewise, in order to pro- reflection about their IPE experiences, focusing specifi-
vide best patient care, physicians, nurses, and other members cally on team collaboration, their role in the professional
of the healthcare team should have an understanding of each team, what they learned, and how they will make use of
other’s roles and responsibilities. [nursing student] their IPE experiences in their future practice. The reflec-
By working with students from different professional back- tions were graded on both content and quality.
grounds we are able to apply our own knowledge towards This IPE activity has been running, in its current form,
a common goal and also learn from each other. [pharmacy since 2013, and the ward has hosted approximately
student] 60 students per semester. Although patient feedback is
not routinely sought, several patients specifically ask to
Like many IPE initiatives, the major challenge for the return to the student ward on re-admission. Students
I-CAN project was scheduling and provision of appro- evaluated the IPE experiences using a 10-item question-
priate opportunities for students to learn together in the naire that uses a 6-point scale. Feedback has been highly
same place at the same time (Gordon et al., 2015). positive with regard to the three domains of teamwork,
communication, and supervision, with the exception of
physiotherapy students who did not always feel that the
Interprofessional Education in a Ward Setting
IPE experience allowed them to develop their profes-
(Sweden)
sional competence (see Figure 1).
Students from Lund University participated in manda-
tory ward-based IPE activities during the latter part of
An IPE Activity to Enhance Understanding of
their educational programs, with learning outcomes
Compassionate Care, Ethical Practice,
focused on teamwork, professional collaboration, and
Teamwork, and Professional Roles (United
preparation for future professional roles. Previous expe-
Kingdom)
rience indicated that opportunities for students to learn
about interprofessional collaboration and cooperation At Keele University, first-year nursing, midwifery,
varied considerably between clinical settings. Therefore, medicine, physiotherapy, pharmacy, and biomedical
this ward-based educational activity was specifically science students participated in an IPE initiative de-
designed to facilitate quality IPE experiences for all signed to enhance understanding of different healthcare
students. roles, and the importance of collaboration and teamwork.

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Levett-Jones et al. Case Studies of Five Interprofessional Education Initiatives

A
6
J 5 B
4
3
I 2 C Physiotherapists
1
0 Physicians

H D Nurses

G E
F
A: I developed a new perspective on my role in the team
B: I have developed my professional competence
C: I have developed my understanding of other professional competence
D: I have developed my understanding of the importance of team communication
E: I have developed my ability to communicate as a team member
F: The overall supervision was good
G: The specific professional supervision was good
H: I felt informed after the joint introduction
I: The team simulation task was considered meaningful
J: This placement was an essential element of my education so far

Figure 1. 2015 evaluation results from the ward-based interprofessional education activity (n = 58).

Situating the IPE initiative in the first year aimed to ad- was then presented by the group to other students, aca-
dress students’ preconceived stereotypes about the roles demic staff, and service users.
of other team members (Derbyshire & Machin, 2010; The interprofessional nature of the learning experi-
Lewitt, Ehrenborg, Scheja, & Brauner, 2010). This ap- ence facilitated interesting discussions about the content
proach also helped to develop a sense of professional and professional training requirements of the different
identity, empathy towards other members of the team, healthcare disciplines. Students (n = 562) welcomed the
and understanding of the importance of effective team- opportunity to learn alongside healthcare students who
work and communication (Anderson & Lennox, 2009; they would not otherwise interact with during their
Baker, Egan-Lee, Martimianakis, & Reeves, 2011). courses. Feedback from staff was also positive; they val-
Students attended an introductory plenary session that ued the unique opportunity to work with colleagues from
outlined the structure, concepts, and content of the other schools and the sharing of ideas about learning and
IPE activity. They then divided into smaller interprofes- teaching practices.
sional groups of no more than 15 students to discuss the Students expressed a marked increase in their under-
concepts of compassionate care, ethical practice, team- standing of how poor teamwork, ineffective communi-
work, and professional healthcare roles. The stimuli for cation, and lack of compassionate care can result in poor
this activity were cases from the Mid Staffordshire Na- patient outcomes. The IPE experience also dispelled many
tional Health Service Foundation Trust Public Enquiry preconceived ideas that students had previously held and
into patient neglect, safety, and death (Francis, 2013). resulted in an enhanced appreciation of the roles of other
To support the discussion and to help facilitate students’ healthcare professionals. Biomedical science and phar-
understanding of relevant concepts, the six Cs (care, macy students shared insightful comments acknowledg-
compassion, competence, communication, courage, and ing that, although they would not be at the forefront of
commitment); (Cummings, 2013) and ethical principles care, they nevertheless made a valuable contribution to
of care (Beauchamp & Childress, 2009) were provided the work of the team. They also recognized the relevance
electronically as prereading. This activity took place over of the six Cs and ethical principles to their roles, that pa-
two afternoons, with online discussions in between. At tient dignity and respect were integral to managing pre-
the end of the IPE activity, each group developed a poster scriptions and samples, and that effective communication
depicting key issues associated with their case. The poster was essential to prevention of errors. Following the IPE

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Case Studies of Five Interprofessional Education Initiatives Levett-Jones et al.

activity, students expressed a determination to apply their of methodologies and how different approaches emerged
learning to their future practice, particularly with regard from a discipline’s particular interest and worldview. For
to effective communication, teamwork, respecting other example, ethnography emerged from the sociology and
healthcare professionals, and ensuring that patients and anthropology disciplines to take a broad and unobtrusive
family members remain at the center of care provision. examination of culture; but ethnography is now being
This IPE activity has been conducted for two consecu- utilized by many other disciplines such as nursing and
tive years. Enabling first-year healthcare students to an- creative writing students.
alyze actual cases from the Francis Report together has Students stated that this IPE activity assisted them
proven to be a powerful influence on their educational to match their research question with an appropriate
and professional development. Feedback from students methodology. For example, one student discussed the
who completed the activity in previous years has demon- historical inquiry approach taken to tell the story of a
strated how their learning from this activity has influ- group of First World War nurses. She argued that histori-
enced their clinical placements, with patient safety and cal research has its own conventions and traditions (phi-
compassionate care remaining top priorities. losophy), and requires researchers to be impartial but also
curious (ontology), take a rigorous approach to discern-
ing fact from hearsay to identify truths (epistemology),
Building Connection Between Researchers From
but that the retelling of history is always partial, incom-
Different Disciplines (Australia)
plete, and dependent on the researcher’s interpretation
When students study in silos, they can gain a limited of events (methods).
appreciation of the diverse research agendas, approaches, Evaluation results from this IPE activity demonstrated
and worldviews of different disciplines. However, expo- that following the IPE POEM activity students (n = 17)
sure to different philosophies, ontologies, epistemologies, felt they had an enhanced understanding of the re-
and methods can open up new and illuminative ways search process (71%) and confidence in themselves as
of thinking about social phenomena, global issues, and researchers (76%). Importantly, they also reported that
disciplinary perspectives. Learners can also gain an un- a key highlight of the activity was the opportunities to
derstanding of the critical thinking skills that tend to communicate with and learn from students from other
be emphasized and developed in different research disciplines.
traditions.
In this example of IPE the aim was to enhance
IPE Patient Safety Workshops (Singapore)
communication, collegiality, and interdisciplinary under-
standings between research students. The philosophy, In recognition of the relationship between patient
ontology, epistemology, and methods (POEM) activity safety and effective interprofessional communication and
was a creative way to facilitate conversations between collaboration (World Health Organization, 2010), the
students about their similarities and differences. It was Yong Loo Lin School of Medicine at the National Uni-
used at Central Queensland University as a critical think- versity of Singapore implemented a 1-day IPE patient
ing activity, with nursing, education, and creative writing safety workshop focusing on the six International Pa-
research students participating as part of a research train- tient Safety Goals identified by the Joint Commission
ing activity. International (2011). These included correct patient iden-
The rationale for, and background to, this activity was tification; effective communication; medication safety
explained to students and they were given two examples (high-alert medications); correct patient, site, and
of POEMs previously constructed by a social worker and procedure for surgery; reduced healthcare-associated in-
an occupational therapist (McAllister et al., 2012). Pairs fections; and reduced falls. By focusing on these issues
of students from the same discipline were asked to re- as an interprofessional group, it was hoped that the
flect on their research approach and philosophy and to medical, nursing, and pharmacy students would iden-
develop a POEM that represented their worldviews. The tify teamwork strategies that could influence their future
POEMs were then shared with the entire group and in- professional practice.
terdisciplinary similarities and differences were discussed. Each workshop was facilitated by trained academic staff
The ensuing discussions were illuminative and engaging. and practitioners from different disciplines. In order to
Students began to recognize the diversity of approaches encourage interactivity, a variety of teaching and learn-
used in different disciplines, and that research questions ing strategies were employed, for example, brief lectures,
and designs are shaped by underpinning knowledge tra- videos, root-cause analyses from real case scenarios, role
ditions and methods of data collection and analysis. Stu- plays, and posters. To date 554 students have partici-
dents said that the activity expanded their understanding pated in the workshops. As with many IPE initiatives,

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there have been challenges. Foremost among these were The integration event is just one of a series of IPE ac-
the logistical and scheduling issues associated with co- tivities that occur throughout the 3-year undergraduate
ordinating a large number of students from three dif- programs at Bournemouth University. Others look at is-
ferent schools and the resource-intensive nature of the sues such as safeguarding, dementia, and learning disabil-
workshops. ities. The reported learning outcomes for the IPE events
Students’ (n = 527, response rate 95%,) evaluations include an increased knowledge about the subject itself,
of the workshops have been positive, and an average of an increased capacity to work together, enhanced creativ-
86% of the participants found the six IPE sessions to be ity, and a broadening understanding of each other’s roles.
“good” or “very good.” Suggestions for improvement in-
cluded the use of teamwork games and refined in-house
videos.
Discussion
A body of research speaks to the relationship be-
An IPE Activity to Achieve Integrated Care
tween interprofessional communication, teamwork, and
(United Kingdom)
patient outcomes (Rogers et al., 2017). Healthcare grad-
The integration of health and social care is at the heart uates’ ability to work effectively as members of inter-
of health policy in England (Department of Health, 2014). professional teams is therefore critical, both to patient
It involves care that is individualized and person centered safety and to work satisfaction (Reeves et al., 2017),
(National Voices, 2013), with effective communication and IPE has been identified as a key strategy for de-
and coordination between members of the interprofes- veloping these skills (World Health Organization, 2011).
sional team. Importantly, integrated care aims to ensure However, although IPE is integral to the preparation of
that the level of control over the planning of care is deter- future health professionals, there are many pragmatic
mined by the patient or service user. When implemented constraints that can impede implementation (Lapkin
effectively, integrated care helps reduce confusion, rep- et al., 2012). This article has demonstrated that despite
etition, duplication, and delays (Department of Health, the acknowledged challenges, integration of IPE is not
2014). only possible, but in many environments has already
Workforce preparation for integrated care requires the been successfully achieved through shared commitment
bridging of gaps within and between health and social and the use of creative educational approaches.
care services through the promotion of positive attitudes The IPE activities profiled in this article illustrate the
that overcome boundaries between professions and or- impact of various online and face-to-face teaching ap-
ganizations. The core competencies of integrated care in- proaches, conducted in classrooms, clinical settings, and
clude interprofessional working and an understanding of community settings, for both undergraduate and post-
whole systems networking, person-centered care, shared graduate healthcare students (including nursing, medical,
decision making, and care pathways (Shaw, Rosen, & pharmacy, dental, physiotherapy, occupational therapy,
Rumbold, 2011). paramedic science, midwifery, and biomedical science
Bournemouth University provides IPE focused on in- students) across five countries. Key to the success of these
tegrated care for all undergraduate nursing, occupational initiatives was a shared purpose and commitment of all
therapy, paramedic science, midwifery, and physiother- team members; the determination to overcome perceived
apy students. Approximately 200 students attended each barriers to IPE; the willingness to take a risk with inno-
IPE event, where they collaboratively examined case ex- vative and novel IPE approaches; support from all lev-
amples that impacted negatively on patients and their els of the organization; and, lastly, a scholarly approach
family. They then identified strategies to alleviate or pre- with a clear evaluation framework. What is clear from
vent this type of error occurring in the future with the the examples provided is that there is no one ideal IPE
support of expert practitioners, and presented their emer- approach; instead, each of the initiatives purposively ad-
gent ideas to the wider group. dressed a specific need within a specific context, taking
Students worked in small and large groups that formed, into account available resources and learning objectives.
reformed, splintered, and enlarged on an ongoing basis. While a number of the IPE interventions were undoubt-
This meant that they had the opportunity to learn with edly resource intensive (e.g., the Interprofessional Care
students from a range of disciplines over the course of the Access Network and the ward-based IPE activities), oth-
event. This interworking and cross-disciplinary engage- ers required up-front funding but then became cost neu-
ment enhanced patient safety by providing opportunities tral over time (e.g., the IPE for QUM e-learning module).
for students to work together towards a person-centered It is hoped that the seven examples provided will moti-
outcome (Ndoro, 2014). vate educators to recreate, adapt, and implement these

Journal of Nursing Scholarship, 2018; 50:3, 1–9. 7

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Case Studies of Five Interprofessional Education Initiatives Levett-Jones et al.

innovative and practical IPE activities within their own Cummings, J. (2013). Developing a vision and strategy for
educational context. nursing, midwifery and care givers. London, England:
Department of Health.
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Conclusions Department of Health’s response to the report of the public inquiry
into children’s heart surgery at the Bristol Royal Infirmary
The case studies profiled in this article demonstrate that
1984–1995. London, England: Author.
the very real barriers to IPE can be overcome when com-
Department of Health. (2014). Delivering better integrated care.
mitted educators work together to develop creative and London, England: Author. Retrieved from https://www.
targeted approaches. This article has provided a range gov.uk/guidance/enabling-integrated-care-in-the-nhs
of ideas for the design and implementation of IPE and Department of Health and Ageing. (2008). Towards a
will be of benefit to nurse educators, as well as educa- national primary health care strategy. Canberra, Australia:
tors from other health disciplines, who want to expand Author.
their repertoire of teaching approaches. Ultimately, the Department of Health & Quality Assurance Agency. (2006).
investment in IPE has the potential to enhance graduate Department of Health Phase 2 benchmarking project—Final
employability and lead to improved teamwork and safer report. Gloucester, UK: Department of Health, London and
health care. Quality Assurance Agency for Higher Education.
Derbyshire, J., & Machin, A. (2010). Learning to work
collaboratively; nurses views of their pre-registration
Clinical Relevance interprofessional education and its impact on practice.
Nurse Education in Practice, 11, 239–244.
A body of research attests to the relationship between
Francis, R. (2013). Report of the Mid Staffordshire NHS
interprofessional communication, teamwork, and patient
Foundation Trust Public Enquiry. London, England:
outcomes. Interprofessional education is imperative for
Her Majesty’s Stationery Office.
facilitating the development of nursing graduates’ com-
Garling, P. (2008). Final report of the Special Commission of
munication and teamwork skills; however, innovative Inquiry Into Acute Care Services in NSW Public Hospitals.
approaches are needed to overcome the perceived and Retrieved from http://www.lawlink.nsw.gov.au/lawlink/
actual impediments to its implementation. Special_Projects/ll_splprojects.nsf/vwFiles/E_Overview.
pdf/$file/E_Overview.pdf
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