Interprofessional Education in Six US Colleges of Pharmacy

American Journal of Pharmaceutical Education, 2009 by Smith, Kelly M, Scott, Doneka R, Barner, Jamie C, DeHart, Renee M, Scott, James D, Martin, Steven J

Objective. To present and describe interprofessional education (IPE) in 6 US colleges of pharmacy including benefits, barriers, and strategies for implementation.

Methods. A focus group with campus faculty IPE leaders and administrators was conducted at each of the 6 colleges. External facilitators used a structured script with open-ended questions to guide each session. A qualitative approach was used and content analysis of transcripts was conducted.

Results. On a 10-point scale, mean participant interest in IPE was 8.8 � 1.7. Incentives included enhanced student education, instructional economies of scale, improved communication among disciplines, and promotion of teamwork to improve quality of care. Curricular logistics, limited resources, lack of conceptual support, and cultural issues were the major barriers to IPE. Institutions were at various stages of IPE implementation. Participants emphasized that full institutional support was critical in maintaining IPE programs.

Conclusion. Interest in IPE was high and opportunities were numerous as described by faculty members at the institutions; however, numerous challenges to implementation were identified.

Keywords: interprofessional education, focus group, pharmacy

INTRODUCTION

One of the 10 primary tenets set forth by the Institute of Medicine (IOM) for reforming healthcare education to improve quality and better meet patient needs is teaching students to work in interprofessional practice, reflective of the importance of teamwork in effective, comprehensive healthcare.1 The corollary to interprofessional practice is to be educated in such a manner. Yet, the long-held educational paradigm at most healthcare institutions, including schools and colleges of pharmacy, is to deliver instructionwithin professions.Atmany institutions, healthcare professional students have been trained in "silos," as separate disciplines are not exposed to one another until clinical experiences late in their educational training. An instructional realignment through efforts across the healthcare disciplines has the potential to create many challenges, as well as previously unexplored opportunities, within professional education.

The approach to interprofessional education (IPE), particularly within healthcare professions, is still a developing concept, with the bulk of the literature reflecting models outside the United States. Focus group interviews of patients, students, and academic staff members in England indicated all groups realized the importance of IPE in influencing professional identity.2 There was also broad agreement across professions that the implementation of IPE can create organizational challenges, and there was a lack of consensus regarding the optimal sequencing of such instruction within the curricular spectrum (ie, early vs. late in course of study). The attitudes of faculty members towards IPE, and factors influencing those opinions, were recently assessed in a Canadian academic health center.3 Although collective (ie, medicine, nursing, pharmacy, social work) scores were positive, medicine faculty members had significantly lower attitude scores, while female faculty members and those with experience in IPE reported significantly higher scores.

Since faculty attitudes are an important factor driving the implementation of IPE initiatives, awareness of these attitudes and influencing attributes is important. The contemporary issues that US pharmacy faculty members face in considering the approach to IPE, and how these issues compare to their professional colleagues, are still unclear, as is the approach UShealthcare professions have taken to respond to the IOM's call to arms about IPE. Thus, using a qualitative approach, we set out to identify the nature of IPE implementation, specific organizational challenges to implementation, and opportunities for integration that remain among US schools and colleges of pharmacy and their campus colleagues.

METHODS

Focus groups of faculty members from 6 US colleges of pharmacy and affiliated health professions colleges were conducted. Only 1 focus group session was conducted on the campus of each participating institution, with groups ranging in size from 5 to 8 participants.

Campus faculty leaders in educational delivery, administration, and IPE were invited to participate in the 2- hour sessions, following their consent to participate in the institutional review board-approved investigation. These leaders were identified by virtue of their administrative position (eg, dean of academic affairs), engagement in formalized campus IPE endeavors, involvement in existing IPE committees, or related activities. Students or trainees engaged in interprofessional education were not eligible for study participation. No participants were excluded upon the basis of gender, racial/ethnic group, or other characteristics.

External facilitators used a singular, structured group script to guide each session. The definition of IPE according to Steinert, "occasions when 2 or more professions learn with, from and about each other to improve collaborations and the quality of care," was used in this investigation. 4 Open-ended questions were used to determine the campus climate towards IPE and identify any previous instructional methods attempted, current campus IPE endeavors, implementation barriers encountered in the past or expected, potential approaches to overcoming challenges and sustaining progress, and perceived IPE benefits. Because each participant's verbal comments were audiotaped, each member was assigned a code number for grouping and categorization of data. Two questions were posed to the group to initially guide the discussion: