Recent Developments on the IPE Front

In this month’s letter, ADEA President and CEO Dr. Rick Valachovic visits with folks on two campuses where interprofessional education (IPE) initiatives are just getting underway and shares links to resources that all ADEA members can use.

If you didn’t get your fill of interprofessional education (IPE) in my letter last month, I have more good news to share. We are witnessing an unprecedented willingness to collaborate among schools of the health professions, an IPE support infrastructure that is now firmly in place, and dentistry as a highly respected partner in this endeavor. These are welcome developments, especially for those schools that are just beginning to embrace the IPE paradigm.

Let me begin by sharing some conversations I recently had, the first with Dr. Carol A. Aschenbrener, Chief Medical Education Officer at the Association of American Medical Colleges (AAMC). Carol is the AAMC’s point person on all things interprofessional. She noted that the uptake of IPE has been “incredibly brisk,” faster than either of us would have predicted, and she attributed this pace to a number of external factors. Health care reform has forced us to recognize that no single profession can achieve health care quality and safety goals on its own. The accrediting bodies for our institutions have recently embedded IPE in their standards. And, as Carol pointed out, we also have a generation of learners who are strongly oriented toward collaborative work and diversity.

“They see IPE as just another dimension of diversity,” Carol told me, “as another way of understanding that people who come from different backgrounds have different perspectives.”

That idea resonated with Dr. Leo E. Rouse, Dean of the Howard University College of Dentistry. Leo, along with Dr. Sandra C. Andrieu, Professor and Associate Dean of Academic Affairs at the Louisiana State University School of Dentistry, represented ADEA on the panel that created a seminal document, Core Competencies for Interprofessional Collaborative Practice, three years ago. The day he and I talked, Leo had just spoken at the 49th ADA Foundation Dental Students’ Conference on Research dinner, telling students about IPE and the importance of collaborating across professional lines on research aimed at optimizing patient care.

“I was really fired up last night,” he volunteered. “An NYU student told me that she loves working with the nurse practitioners in the clinic because they are always discussing systemic health, and she said, ‘We’re getting our answers at the point of care.’”

If you missed last month’s Charting Progress, it will tell you more about how IPE occurs at New York University (NYU). Right now I want to tell you about what is happening with the Interprofessional Education Collaborative (IPEC) and at two schools that have recently embraced IPE.

As you know, ADEA has been getting in step with IPE for several years now and was a founding member of IPEC, which produced the competency document I mentioned above. Since then, IPEC’s focus has been on removing some of the obstacles that stand in the way of IPE at most of our institutions. That has meant sharing learning resources (more on that later) and hosting Interprofessional Faculty Development Institutes, where health professions schools can send faculty teams to acquire the skills and knowledge that will help them implement plans for IPE on their home campuses. Three institutes have been held to date, and each sold out at record speed.

To find out how the institutes are assisting schools that are just getting started in this area, I telephoned Dr. Marsha A. Pyle, Dean of the School of Dentistry at the University of Missouri – Kansas City (UMKC). Marsha told me that the deans of medicine, nursing, pharmacy, and dentistry at UMKC are all committed to making IPE a reality. They sent a team of five faculty to Virginia for the first Interprofessional Faculty Development Institute in May 2012. They hoped to learn how other schools had managed to deal with the kinds of institutional barriers that can make IPE challenging. Marsha cited lock-step curricula, students entering the health professions at various educational levels, and the challenge of creating meaningful learning experiences that will ultimately advance the health of patients.

Since returning home, the group has put several programs in place. They have decided to use UKMC’s January intersession—the one time of year when all four schools have the same schedule—to offer joint courses on topics such as patient safety, bioethics, quality assurance, and oral health assessment for the non-dentist.

“Each of our schools is very independent,” Marsha tells me. “We each teach health ethics, communication, and patient evaluation skills. It seems natural that we figure out a way to educate our students together, particularly in these common curricular areas.”

UMKC has also instituted:

• The School of Dentistry has become a clinical site for the nursing program;
• A pharmacy-led service-learning course now includes dental, nursing, and social work students; and
• A health sciences research summit during which students present posters and hear from a keynote speaker.

The group’s next agenda item is to establish the infrastructure needed to sustain these activities.

“Fortunately, the Chancellor is very supportive,” Marsha says. “He thinks that interprofessional collaboration is the future of health professions education.”

A similar attitude exists at the University of Michigan, another academic health center that has recently committed to revving up its IPE game. I spoke with Dr. Carol Anne Murdoch-Kinch, Clinical Professor and Associate Dean for Academic Affairs at the University of Michigan School of Dentistry. Carol Anne created an interprofessional steering committee primarily composed of associate deans from the schools of dentistry, medicine, nursing, pharmacy, kinesiology, social work, and public health. Together they have developed a vision for IPE on their campus that involves a menu of electives, competency acquisition, and, ultimately, the development of a certificate program.

Carol Anne told me that the IPEC Institute was the catalyst that moved her group from ideas to action. They have launched, or will soon launch, six interprofessional pilot programs, and dentistry is participating in five of them. These include the following IPE innovations:

• The School of Dentistry has become a clinical site for the nursing program;
• A pharmacy-led service-learning course now includes dental, nursing, and social work students; and
• Dentistry is taking the lead in designing a pilot that will bring fourth-year dental and other advanced practice health professions students together to provide care at federally qualified health centers.

Students have also taken a strong interest in IPE, evident in an interprofessional student group—established by a dental student—that began meeting in January. There is also a newly created master’s degree in health professions education offered by the University of Michigan Medical School and active discussion of creating an interprofessional clinic to better serve dental patients with special needs.

“I have to say,” Carol Anne told me, “we would not be where we are today if we hadn’t gone to the IPEC Institute. IPE is now part of every discussion on campus. We’re always thinking about how we can interact with other health professions no matter what we’re talking about.”

IPEC plans to continue hosting faculty development institutes for the foreseeable future, and I urge schools that have not yet attended to take advantage of this opportunity. In the meantime, IPEC is making other valuable resources available to everyone via MedEdPORTAL, our online collaborative publishing venture with AAMC. The Interprofessional Education PORTAL contains peer-reviewed, competency-based learning modules for interprofessional education in the health professions. The Josiah Macy Jr. Foundation has helped jumpstart this collection by awarding funding to 16 interprofessional teams to accelerate educational content refinement and submission to MedEdPORTAL.

Resources will also soon be available through a newly funded coordinating body based at the University of Minnesota, the National Center for Interprofessional Practice and Education. The center is being supported by multi-year grants from the Health Resources and Services Administration and four leading health foundations.

Where does dentistry fit in this picture? As Dr. Geraldine “Polly” Bednash, my counterpart at the American Association of Colleges of Nursing, recently said, “Leaders in dental education are at the forefront of the national movement to integrate interprofessional education across the health professions. Both at the national level and at the institutional level, dental educators are working to advance the concept of effective team-based care through curricular redesign and cross-disciplinary partnerships.”

I couldn’t have said it better myself. As the NYU experience illustrates well, nursing has welcomed the opportunity to collaborate with the dental professions to further engage students in clinical learning. It’s also striking how the other health professions have embraced the opportunity to learn about oral health.

Given dentistry’s historic isolation, I asked Leo what has surprised him most about the rapid uptake of IPE. His answer? “How easily our colleagues have come to us seeking our expertise in assisting them in understanding the oral health space. All over the country, everyone is becoming aligned in terms of oral health.”

This evolution has come about in part because of the groundwork ADEA laid in establishing collaborations with AAMC some years back. “It’s a vital partnership,” Carol Aschenbrener observes, “and I think it will become more so as we work to create a better connection between collaboration and prevention and health promotion.”

I certainly hope so.