Ivan Koppel

A best evidence systematic review of interprofessional education: BEME Guide no. 9

Background and review context: Evidence to support the proposition that learning together will help practitioners and agencies work better together remains limited and thinly spread. This review identified, collated, analysed and synthesised the best available contemporary evidence from 21 of the strongest evaluations of IPE to inform the above proposition. In this way we sought to help shape future interprofessional education and maximize the potential for interprofessional learning to contribute to collaborative practice and better care. Objectives of the review: To identify and review the strongest evaluations of IPE. To classify the outcomes of IPE and note the influence of context on particular outcomes. To develop a narrative about the mechanisms that underpin and inform positive and negative outcomes of IPE. Search strategy: Bibliographic database searches as follows: Medline 1966–2003, CINAHL 1982–2001, BEI 1964–2001, ASSIA 1990–2003 which produced 10,495 abstracts. Subsequently, 884 full papers were obtained and scrutinized. In addition, hand searching (2003–5 issues) of 21 journals known to have published two or more higher quality studies from a previous review. Topic definition and inclusion criteria: Peer-reviewed papers and reports included in the review had to be formal educational initiatives attended by at least two of the many professional groups from health and social care, with the objective of improving care; and learning with, from and about each other. Data collection, analysis and synthesis: Standard systematic review procedures were applied for sifting abstracts, scrutinizing full papers and abstracting data. Two members of the team checked each abstract to decide whether the full paper should be read. A third member was consulted over any discrepancies. Similarly, each full paper was read by at least two members of the team and agreement sought before passing it to one member of the team (SR) for data abstraction. Other members of the team checked 10% of the abstraction records. Coding into a Statistical Package for Social Scientists (SPSS) data base led to collection of different outcome measures used in the primary studies via the common metric of an adapted Kirkpatricks four-level model of educational outcomes. Additionally, a narrative synthesis was built after analysis of primary data with the 3-P model (presage-process-product) of education development and delivery. Headline results: Government calls for enhanced collaboration amongst practitioners frequently leads to IPE that is then developed and delivered by educators, practitioners or service managers. Staff development is a key influence on the effectiveness of IPE for learners who all have unique values about themselves and others. Authenticity and customization of IPE are important mechanisms for positive outcomes of IPE. Interprofessional education is generally well received, enabling knowledge and skills necessary for collaborative working to be learnt; it is less able to positively influence attitudes and perceptions towards others in the service delivery team. In the context of quality improvement initiatives interprofessional education is frequently used as a mechanism to enhance the development of practice and improvement of services.

The effectiveness of interprofessional education: key findings from a new systematic review.

Over the past decade systematic reviews of interprofessional education (IPE) have provided a more informed understanding of the effects of this type of education. This paper contributes to this literature by reporting an update of a Cochrane systematic review published in this journal ten years ago (Zwarenstein et al., ). In updating this initial review, our current work involved searches of a number of electronic databases from 1999–2006, as well as reference lists, books, conference proceedings and websites. Like the previous review, only studies which employed randomized controlled trials, controlled-before and-after-studies and interrupted time series studies of IPE, and that reported validated professional practice and health care outcomes, were included. While the first review found no studies which met its inclusion criteria, the updated review located six IPE studies. This paper aims to add to the ongoing development of evidence for IPE. Despite some useful progress being made in relation to strengthening the evidence base for IPE, the paper concludes by stressing that further rigorous mixed method studies of IPE are needed to provide a greater clarity of IPE and its effects on professional practice and patient/client care.

Evaluating Interprofessional Education: two systematic reviews for health and social care

Learning between professions has been widely invoked in health and social care in the belief that it improves collaboration in practice. Evidence to substantiate that belief is, however, elusive. Obstacles to the rigorous evaluation of interprofessional education are formidable, but this article reports progress towards establishing an evidence base. It describes two reviews. One is subject to criteria for Cochrane Collaboration, the other less constrained. Findings are reported for the first and methodology is discussed for the second. The article begins with an overview of interprofessional education in health and social care.

A systematic review of interprofessional education

This article reports the process and outcomes of a systematic review of the evidence base for the effectiveness of interprofessional education, conducted using the guidelines for systematic review developed by the Cochrane Collaboration, whose function is described. Electronic databases (Medline and CINAHL) were searched using a combination of terms for rigorous study designs and for interprofessional education. We found 552 articles indexed with these terms from CINAHL and 510 from Medline. Two researchers reviewed each abstract independently. In total, the reviewers selected 39 articles from Medline and 44 from CINAHL which, on the basis of their abstracts, appeared to meet the criteria for our specific subject and for adequacy of quantitative research method. We obtained the full texts and two reviewers read each article independently. None of these articles were eligible for inclusion in the review, most failing to meet the Cochrane Collaboration methodological criteria. We conclude that no rigorous q...

The evidence base and recommendations for interprofessional education in health and social care

Emeritus Professor of Interprofessional Education, School of Integrated Health, University of Westminster, UK, Reader in Education for Health Care, Institute of Health Sciences, City University, London, UK, Education and Research Consultant and Visiting Professor, Anglia Ruskin University, UK, General Practitioner and Principal Lecturer, School of Integrated Health, University of Westminster, UK and Associate Professor, Wilson Centre, University of Toronto, Canada