Marilyn Hammick

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...

Learning in interprofessional teams: AMEE Guide no 38

This guide is for health and social care professionals who teach or guide others’ learning before and after qualification, in formal courses or the workplace. It clarifies the understanding of interprofessional learning and explores the concept of teams and team working. Illustrated by examples from practice, the practicalities of effective interprofessional learning are described, and the underlying concepts of patient-centred care, excellent communication, development of capacity and clarity of roles that underpin this explored.

Conducting a best evidence systematic review. Part 1: From idea to data coding. BEME Guide No. 13

This paper outlines the essential aspects of conducting a systematic review of an educational topic beginning with the work needed once an initial idea for a review topic has been suggested through to the stage when all data from the selected primary studies has been coded. It draws extensively on the wisdom and experience of those who have undertaken systematic reviews of professional education, including Best Evidence Medical Education systematic reviews. Material from completed reviews is used to illustrate the practical application of the review processes discussed. The paper provides practical help to new review groups and contributes to the debate about ways of obtaining evidence (and what sort of evidence) to inform policy and practice in education.

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

Interprofessional Education: Concept, Theory and Application

This paper explores conceptual and pragmatic aspects of interprofessional education, with the aim of adding to its epistemology. It includes an examination of the issues involved in the translation of interprofessional educational theory into practice. The work for the paper was aimed at creating a framework for interprofessional education that could inform practice in relation to a cancer care course. It draws upon Bernsteins contribution to the sociology of education, in particular his concepts of classification and framing as theoretical tools, to understand knowledge production and reproduction. The concept of terrains of knowledge created by interprofessional education is suggested and the issues associated with these new ways of knowing are elaborated. Differences for pre-and post-registration students are identified and utilised to highlight issues associated with creating effective interprofessional learning environments. Finally, personal and generic applications of the theory are discussed.

Interprofessional education: evidence from the past to guide the future

By reflecting on current systematic reviews of the evaluation of interprofessional education (IPE), this paper will consider the potential shape of IPE, for health and social care practitioners, in 2020. The reviews to be presented relate to evaluations of undergraduate, postgraduate and continuing education programmes. The patterns emerging from the data will be extrapolated into a vision of the developmental pathways that IPE might take. This will be done, within the context of, first, policy and practice for professional higher education and, second, strategies to enhance services to patients through closer collaboration.

Theoretical insights into interprofessional education: AMEE Guide No. 62

In this Guide, we support the need for theory in the practice of interprofessional education and highlight a range of theories that can be applied to interprofessional education. We specifically discuss the application of theories that support the social dimensions of interprofessional learning and teaching, choosing by way of illustration the theory of social capital, adult learning theory and a sociological perspective of interprofessional education. We introduce some of the key ideas behind each theory and then apply these to a case study about the development and delivery of interprofessional education for pre-registration healthcare sciences students. We suggest a model that assists with the management of the numerous theories potentially available to the interprofessional educator. In this model, context is central and a range of dimensions are presented for the reader to decide which, when, why and how to use a theory. We also present some practical guidelines of how theories may be translated into tangible curriculum opportunities. Using social capital theory, we show how theory can be used to defend and present the benefits of learning in an interprofessional group. We also show how this theory can guide thinking as to how interprofessional learning networks can best be constructed to achieve these benefits. Using adult learning theories, we explore the rationale and importance of problem solving, facilitation and scaffolding in the design of interprofessional curricula. Finally, from a sociological perspective, using Bernsteins concepts of regions and terrains, we explore the concepts of socialisation as a means of understanding the resistance to interprofessional education sometimes experienced by curriculum developers. We advocate for new, parallel ways of viewing professional knowledge and the development of an interprofessional knowledge terrain that is understood and is contributed to by all practitioners and, importantly, is centred on the needs of the patient or client. Through practical application of theory, we anticipate that our readers will be able to reflect and inform their current habitual practices and develop new and innovative ways of perceiving and developing their interprofessional education practice.