European Interprofessional Education Network Conference, Nijmegen, the Netherlands: Bridging education and practice

Introduction

From all directions we hear the call for a rise in interprofessional collaboration (IPC) to meet the needs of the growing number of (ageing) patients with multi-morbidity and of children and their families with multiple needs (Conti et al., 2016; Watson, Townsley, & Abbott, 2002). There is an increasing focus on the role of interprofessional education (IPE) as a method of realising IPC. IPC and IPE are closely related to each other. The World Health Orzanization (2010) has clearly promoted IPE as a means to enhance IPC. The relation between education and practice is inherent in the definition of IPE: different professionals learn with, from and about one another, with the aim to collaborate more effectively in the delivery of high-quality patient care. The evidence is growing that IPE does contribute to IPC. In a recent review, the effects of IPE on the conclusion offered was that this form of education can improve learners’ attitudes and perceptions of one another, as well as increase in collaborative knowledge and skills (Reeves et al., 2016). This review also reported that there was growing, but limited, evidence related to changes in behaviour, organizational practice, and benefits to patients/clients.

However, the relationship between IPE and IPC in daily healthcare practice is not straightforward. Although workplace based learning is a key component of training social and healthcare professionals, there still is a gap between the aims of educational institutes and the realities of daily practice. It is difficult to align educational programmes with the workplace reality. Is the workplace ready to demonstrate best practices of IPC to students? Is an optimal IPC setting in the clinical environment a prerequisite to educate students? A study of midwifery students demonstrated that pre-clinically trained IPC skills would only survive if the students were subsequently placed in a fertile IPC workplace (Murray-Davis, Marshall, & Gordon, 2012). On the other hand, one could presume that well-prepared students contribute to the development of new collaborative routines by acting as a change agent (Frenk et al., 2010). Furthermore, interprofessional training of faculty may serve to result in transformation of clinical practice and residency training programmes (Eiff et al., 2016).

How should higher education and healthcare be optimally connected to enhance the impact of IPE on collaborative practice and patient outcomes? Some influencing factors have been described, like an explicit agreement on collaboration, providing resources for partnership and participatory change management. (Haggman-Laitila & Rekola, 2014) Many questions remain unanswered. Gaps exist in the evidence how to link IPE to patient, population, and system outcomes (Institute of Medicine, 2015). There is a need for a purposeful and more comprehensive system of engagement between the education and healthcare delivery systems.

EIPEN conference

For the European Interprofessional Education Network (EIPEN) Conference in 2015 in Nijmegen, The Netherlands, we chose the relation and the tension between IPE and IPC as the conference theme: bridging the gap between education and practice.¹ In a broad sense, contributors discussed aspects of this fascinating relation. Some of these contributions are presented in this themed section of the journal. Some articles focus on the quality of IPC in the workplace, others focus on the implementation of IPE by educational institutions.

Articles focusing on the quality of IPC at the workplace

Agreli, Peduzzi, and Bailey (2017) report on the relation between team climate and IPC in Brazilian primary healthcare teams. They chose a mixed-method approach. By measuring the team climate in 18 primary healthcare teams, the researchers identified two contrasting groups with respect to participative safety, support for innovation, objectives and task orientation. Individuals within the two groups were interviewed on their perception of the level of IPC in their team. The preliminary results of these interviews confirm the contrasts between the groups and give further input to explore how team climate and IPC relate to each other.

Vyt (2017) presents the development and validation of a questionnaire for self-assessment of the quality of interprofessional team meetings in primary and community healthcare. The authors tested a set of quality indicators to measure the quality of interprofessional consultation meetings. Internal consistency and reliability indexes were good.

van Dijk-de Vries, van Dongen, and van Bokhoven (2017) analysed facilitators of and barriers to the sustainable implementation of interprofessional care for elderly patients in a Dutch primary care setting. Their focus was on the external relations, i.e. between healthcare team, healthcare insurer and municipality. They only report on the barriers, which were extensive. They conclude that all the energy spent on effective teamwork is futile if the team do not learn how to deal with important external factors.

Anderson, Gray, and Price (2017) report on the contribution of IPC in the area of patient safety. They describe a workshop which they contextualised with cases to illustrate that historically, patients were not involved in the management of their disease. A culture of blaming and legislation arose among the different professionals managing these patients. Workshop participants from various countries concluded that the safety culture is changing but old and new cultures co-exist. The historical cases served as a method of facilitating participants to reflect on non-clinical aspects of their work. This opportunity for self-reflection is often more challenging in daily working circumstances. One of the conclusions is that a non-blaming culture is essential for a safe learning environment to promote the quality of learning. In that sense this workshop could as well be seen as IPE.

Articles focusing on the implementation of IPE

Kolb et al. (2017) performed a survey among first-year medical and nursing students, experienced professionals and management staff to explore the institutional readiness for IPE. The dual focus of the article was on attitudes related to IPC as well as preferences for IPE topics. One could ask the question whether a positive attitude towards IPC is a prerequisite for the enrolment of an IPE programme. A lack of IPC readiness in students could also be regarded as a good reason to implement an IPE programme. Faculty however should be ready to do so.

Frantz and Rhoda (2017) report on the implementation of IPE and Interprofessional practice at the Faculty of Community and Health Sciences at the University of the Western Cape in South Africa. The short report centres on three concerns: the lack of an explicit framework, challenges in the operationalisation and the lack of critical mass in terms of human resources.

Seaman et al. (2017) studied the effects of an IPE-focused student placement on students’ attitudes to older adults and readiness for interprofessional learning. Pre- and post-placement measurement of attitudes to older adults were collected using the Ageing Sematic Differential questionnaire, and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale. The results support the premise that IPE-focused student placements within residential aged care facility (RACF) positively influence students’ attitudes towards older adults as well as increasing students’ readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.

de Vries-Erich, Reuchlin, de Maaijer, and van de Ridder (2017) qualitatively explored the current IPE situation in the Netherlands by interviewing experts within medical education and pioneers of successful best practices. They identified several barriers and facilitators of IPE implementation. Their conclusion is that good leadership and committed teams are prerequisites to enhance facilities, communication and cohesiveness when implementing IPE.

Berger et al. (2017) describe the process of planned change to anchor IPE seminars in the undergraduate curricula at Heidelberg University Medical Faculty. Lessons learned through the implementation of four interprofessional seminars at Heidelberg University Medical Faculty are described, in particular relating to team communication, medical error communication and small business management.

Concluding comments

This themed section of EIPEN Conference presentations explored the synergies and disparities between IPE and IPC aimed to contribute to a better connection between education and healthcare. The research studies included highlight the myriad of work in this area. However, there are still many aspects of the relationship between educational institutions and IPC in daily practice for further development. The importance of the team climate in the workplace is underpinned. Many facilitators and barriers concerning implementation of IPE by educational institutions are mentioned including resources, faculty development, role modelling and agreement on student outcomes.

One should not forget that the force of external factors, like changing policies, could override all good intentions within the team. Therefore, we should not only invest in the collaboration between health professionals, but also work on our external stakeholders and, more importantly, prepare our students to do so.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes

^1. For more information on the conference, including the programme and photographs see: http://www.eipen.eu/conferences_4.html.